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Higher mortality during COVID-19 pandemic in socially vulnerable areas in Belo Horizonte: implications for vaccination prioriti

##article.authors##

  • Valéria M A Passos Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
  • Luisa C C Brant Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
  • Pedro C Pinheiro Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
  • Paulo R L Correa Secretaria Municipal de Saúde de Belo Horizonte, MG, Brasil
  • Isis E Machado Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brasil
  • Mayara R Santos Secretaria Municipal de Saúde de Belo Horizonte, MG, Brasil
  • Antonio L P Ribeiro Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
  • Lucia M MM Paixão Secretaria Municipal de Saúde de Belo Horizonte, MG, Brasil
  • Fabiano G Secretaria Municipal de Saúde de Belo Horizonte, MG, Brasil
  • Maria de Fatima M de Souza Vital Strategies
  • Deborah Carvalho Malta Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil https://orcid.org/0000-0002-8214-5734

DOI:

https://doi.org/10.1590/1980-549720210025

Keywords:

Mortality, Elderly, Coronavirus Infections, Social Inequity, Vaccines

Abstract

Objective: To assess mortality during the COVID-19 pandemic according to social vulnerability by areas of Belo Horizonte (BH), aiming at strategies for vaccination. Methods: Ecological study with mortality analysis, according to census tracts classified by the Health Vulnerability Index, a composite indicator that includes socioeconomic and sanitation variables. Deaths due to natural causes and COVID-19 were obtained from the “Mortality Information System”, between the 10th and 43rd epidemiological weeks (EW) of 2020. Excess mortality was calculated by a time series model, considering observed deaths by EW, between 2015 and 2019, for census tracts. Mortality rates (MR) were calculated and age-standardized =using population estimates from 2010 census. Results: Excess mortality in BH was 16.1% (n =1524): 11.0%, 18.8% and 17.3% in the low, intermediate and high vulnerability areas, respectively. The differences between observed and expected age-standardized MR by natural causes were equal to 59/100,000 inhabitants in BH, increasing from 31 to 77 and 95/100,000 inhabitants, in the areas of low, intermediate and high vulnerability, respectively. There was an aging gradient in COVID-19 MR, ranging from 4 to 611/100,000 inhabitants among individuals of 20-39 years and 75+ years. The COVID-19 MR per 100,000 elderly (60+ years) was 292 in BH, increasing from 179 to 354 and 476, in the low, intermediate and high vulnerability areas, respectively. Conclusion: Inequalities in mortality, particularly among the elderly, combined with the limited supply of doses, demonstrate the importance of prioritizing socially vulnerable areas during vaccination against COVID-19.

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Posted

2021-04-05

Section

Health Sciences