Higher risk of death from COVID-19 in low-income and non-White populations of São Paulo, Brazil.

INTRODUCTION: Little evidence exists on the differential health effects of COVID-19 on disadvantaged population groups. Here we characterise the differential risk of hospitalisation and death in São Paulo state, Brazil, and show how vulnerability to COVID-19 is shaped by socioeconomic inequalities. METHODS: We conducted a cross-sectional study using hospitalised severe acute respiratory infections notified from March to August 2020 in the Sistema de Monitoramento Inteligente de São Paulo database. We examined the risk of hospitalisation and death by race and socioeconomic status using multiple data sets for individual-level and spatiotemporal analyses. We explained these inequalities according to differences in daily mobility from mobile phone data, teleworking behaviour and comorbidities. RESULTS: Throughout the study period, patients living in the 40% poorest areas were more likely to die when compared with patients living in the 5% wealthiest areas (OR: 1.60, 95% CI 1.48 to 1.74) and were more likely to be hospitalised between April and July 2020 (OR: 1.08, 95% CI 1.04 to 1.12). Black and Pardo individuals were more likely to be hospitalised when compared with White individuals (OR: 1.41, 95% CI 1.37 to 1.46; OR: 1.26, 95% CI 1.23 to 1.28, respectively), and were more likely to die (OR: 1.13, 95% CI 1.07 to 1.19; 1.07, 95% CI 1.04 to 1.10, respectively) between April and July 2020. Once hospitalised, patients treated in public hospitals were more likely to die than patients in private hospitals (OR: 1.40%, 95% CI 1.34% to 1.46%). Black individuals and those with low education attainment were more likely to have one or more comorbidities, respectively (OR: 1.29, 95% CI 1.19 to 1.39; 1.36, 95% CI 1.27 to 1.45). CONCLUSIONS: Low-income and Black and Pardo communities are more likely to die with COVID-19. This is associated with differential access to quality healthcare, ability to self-isolate and the higher prevalence of comorbidities.

Social inequality and exposure to magnetic fields in the metropolitan region of São Paulo, Southeastern Brazil.

OBJECTIVE: To estimate the prevalence of exposure to magnetic fields generated by transmission lines (TL) and characterize the exposed population. METHODS: Information about TL in the metropolitan region of São Paulo, Southeastern Brazil, was provided by the electricity companies and mapped out using geographic information system (GIS). Demographic and socioeconomic data were obtained from the 2000 Census and added to the GIS in another layer. Households and their inhabitants that were located at a distance from the TL that was sufficient to generate a magnetic field 0.3 microT (microteslas) were deemed to be exposed. The prevalence was estimated according to the area of the corridors of exposure along the TL. Two approaches were used to delimit the corridor width: one consisted of widths that were predefined by the TL voltage, and the other consisted of calculation of the magnetic field. The socioeconomic information on the exposed and non-exposed populations were compared by applying the two-proportion test (alpha= 5%). RESULTS: In the corridors with predefined widths, the prevalence of exposure was 2.4%, and in the calculated corridors, the prevalence was 1.4%. Both methods indicated higher prevalence of exposure among the younger population, and among individuals with lower education and income levels (p < 0.001). CONCLUSIONS: The prevalence of exposure to magnetic fields generated by TL in the metropolitan region of São Paulo was lower than what has been observed in other countries. The results indicate inequality in the exposure to magnetic fields in this urban area, with greater risk to vulnerable populations such as children and socioeconomically less favored individuals.

Desigualdade social e exposição a campos magnéticos na região metropolitana de São Paulo / Desigualdad social y exposición a campos magnéticos en la región metropolitana de Sao Paulo / Social inequality and exposure to magnetic fields in the metropolitan region of São Paulo, Southeastern Brazil

OBJETIVO: Estimar a prevalência de exposição aos campos magnéticos gerados por linhas de transmissão (LT) e caracterizar a população exposta. MÉTODOS: Informações sobre LT da Região Metropolitana de São Paulo foram fornecidas pelas concessionárias de energia e mapeadas usando sistema de informação geográfica (SIG). Dados demográficos e socioeconômicos foram obtidos por meio do Censo 2000 e incluídos no SIG em outra camada. Foram considerados expostos os domicílios e seus habitantes localizados a uma distância da LT suficiente para gerar um campo magnético 0,3 µT (microteslas). A prevalência foi estimada por meio da área de corredores de exposição ao longo das LT. A largura dos corredores de exposição se baseou em duas abordagens: uma consistiu em larguras pré-definidas pela tensão da LT e a outra por meio de cálculo do campo magnético. As informações socioeconômicas entre expostos e não expostos foram comparadas pela aplicação do teste de duas proporções (α= 5 por cento)...

OBJECTIVE: To estimate the prevalence of exposure to magnetic fields generated by transmission lines (TL) and characterize the exposed population. METHODS: Information about TL in the metropolitan region of São Paulo, Southeastern Brazil, was provided by the electricity companies and mapped out using geographic information system (GIS). Demographic and socioeconomic data were obtained from the 2000 Census and added to the GIS in another layer. Households and their inhabitants that were located at a distance from the TL that was sufficient to generate a magnetic field 0.3 µT (microteslas) were deemed to be exposed. The prevalence was estimated according to the area of the corridors of exposure along the TL. Two approaches were used to delimit the corridor width: one consisted of widths that were predefined by the TL voltage, and the other consisted of calculation of the magnetic field. The socioeconomic information on the exposed and non-exposed populations were compared by applying the two-proportion test (α= 5 percent)...

OBJETIVO: Estimar la prevalencia de exposición a los campos magnéticos generados por líneas de transmisión (LT) y caracterizar la población expuesta. MÉTODOS: Informaciones sobre LT de la Región Metropolitana de São Paulo (Sureste de Brasil) fueron providenciadas por las concesionarias de energía y mapeadas usando el sistema de información geográfica (SIG). Datos demográficos y socioeconómicos fueron obtenidos por medio del Censo 2000 e incluidos en el SIG en otra camada. Fueron considerados expuestos los domicilios y sus habitantes localizados a una distancia de la LT suficiente para generar un campo magnético 0,3 μT (microteslas). La prevalencia fue estimada por medio del área de corredores de exposición a lo largo de las LT. El ancho de los corredores de exposición se basó en dos abordajes: uno consistió en anchos pre-definidos por la tensión de la LT y la otra por medio del cálculo del campo magnético. Las informaciones socioeconómicas entre expuestos y no expuestos fueron comparadas por la aplicación de la prueba de dos proporciones (α=5 por ciento)...