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Dynamics of COVID-19 Outcomes is Driven by Political Landscape and Socio-Economic Factors at Local Level in Brazil

29 Pages Posted: 25 Oct 2021

See all articles by Diego Ricardo Xavier

Diego Ricardo Xavier

Oswaldo Cruz Foundation (FIOCRUZ) - Health Information Laboratory

Eliane Lima e Silva

Universidade de Brasília (UnB) - Laboratory of Geography, Environment and Health (LAGAS)

Flávio Alves Lara

Oswaldo Cruz Foundation (FIOCRUZ) - Cellular Microbiology Laboratory

Gabriel Rodrigues Rocha e Silva

Universidade de Brasília (UnB) - Laboratory of Geography, Environment and Health (LAGAS)

Marcus F. Oliveira

Universidade Federal do Rio de Janeiro (UFRJ) - Institute of Medical Biochemistry Leopoldo de Meis

Helen Gurgel

Universidade de Brasília (UnB) - Laboratory of Geography, Environment and Health (LAGAS)

Christovam Barcellos

Oswaldo Cruz Foundation (FIOCRUZ) - Health Information Laboratory

More...

Abstract

Background: Brazil has been severely impacted by COVID-19 pandemics that is aggravated by the absence of a scientifically-driven coordinated campaign. The decentralization and resultant conflicts in disease control activities produced different protection behaviours and local government measures. In the present study, we investigated how political partisanship and socio-economic factors determined the outcome of COVID-19 at the local level in Brazil.

Methods: A retrospective study of COVID-19 deaths was carried out using mortality databases between Feb 2020, and Jun 2021 for the 5570 Brazilian municipalities. Socio-economic parameters including city categories, income and inequality indexes, health service quality and partisanship, assessed by the result of the second round of the 2018 Brazilian presidential elections, were included. Regression tree analysis was carried out to identify the statistical significance and conditioning relationships of variables.

Findings: Municipalities that supported then candidate Jair Bolsonaro in 2018 elections were those that had the worst COVID-19 mortality rates, mainly during the second epidemic wave of 2021. This pattern was observed even considering structural inequalities among cities.

Interpretation: In general, the first phase of the pandemic hit large and central cities hardest, while the second wave mostly impacted Bolsonarian municipalities, where scientific denialism among the population was stronger. Negative effects of partisanship towards the right wing on COVID-19 outcomes counterbalances favorable socioeconomic indexes in affluent Brazilian cities. Our results underscore the fragility of public health policies which were undermined by the scientific denialism of right-wing supporters in Brazil.

Funding: International joint laboratories of Institute de Recherche pour le Développement,
partnership between the University of Brasília and the Oswaldo Cruz Foundation (LMI-Sentinela
- UnB - Fiocruz - IRD), Coordination for the Improvement of Higher Education Personnel
(CAPES), National Council for Scientific and Technological Development (CNPq).

Declaration of Interest: None to declare.

Keywords: COVID-19, Epidemics control, Political partisanship, Health inequalities

Suggested Citation

Xavier, Diego Ricardo and Lima e Silva, Eliane and Lara, Flávio Alves and Rocha e Silva, Gabriel Rodrigues and Oliveira, Marcus F. and Gurgel, Helen and Barcellos, Christovam, Dynamics of COVID-19 Outcomes is Driven by Political Landscape and Socio-Economic Factors at Local Level in Brazil. Available at SSRN: https://ssrn.com/abstract=3949486 or http://dx.doi.org/10.2139/ssrn.3949486

Diego Ricardo Xavier

Oswaldo Cruz Foundation (FIOCRUZ) - Health Information Laboratory ( email )

Rio de Janeiro
Brazil

Eliane Lima e Silva

Universidade de Brasília (UnB) - Laboratory of Geography, Environment and Health (LAGAS) ( email )

Brazil

Flávio Alves Lara

Oswaldo Cruz Foundation (FIOCRUZ) - Cellular Microbiology Laboratory ( email )

Rio de Janeiro
Brazil

Gabriel Rodrigues Rocha e Silva

Universidade de Brasília (UnB) - Laboratory of Geography, Environment and Health (LAGAS) ( email )

Brazil

Marcus F. Oliveira

Universidade Federal do Rio de Janeiro (UFRJ) - Institute of Medical Biochemistry Leopoldo de Meis ( email )

Rio de Janeiro
Brazil

Helen Gurgel

Universidade de Brasília (UnB) - Laboratory of Geography, Environment and Health (LAGAS) ( email )

Brazil

Christovam Barcellos (Contact Author)

Oswaldo Cruz Foundation (FIOCRUZ) - Health Information Laboratory ( email )

Rio de Janeiro
Brazil

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