Objective

to analyze the influence of socioeconomic inequality on COVID-19 distribution in larger Brazilian municipalities, controlling for effect of hospital infrastructure, comorbidities and other variables.

Methods

this was an ecological study of COVID-19 hospitalizations and deaths in 2020; outcome data were obtained from the Ministry of Health; incidence ratios were estimated using a generalized linear model.

Results

we identified 291,073 hospitalizations and 139,953 deaths; we found higher mortality rates in municipalities with a higher proportion of non-White people (95%CI 1.01;1.16) and with more households with more than two people per room (95%CI 1.01;1.13); presence of sewerage systems was protective for both outcomes (hospitalizations: 95%CI 0.87;0.99 – deaths: 95%CI 0.90;0.99), while a higher proportion of the population in subnormal housing clusters was a risk factor (hospitalizations: 95%CI 1.01;1.16 – deaths: 95%CI 1.09;1.21), with this variable interacting with the proportion of people receiving Emergency Aid (hospitalizations: 95%CI 0.88;1.00 – deaths: 95%CI 0.89;0.98).

Conclusion

socioeconomic conditions affected illness and death due to COVID-19 in Brazil.

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