Competitividad de los gobiernos subnacionales y su relación con la mortalidad por COVID-19 en Perú / Competitiveness of subnational governments and their relationship with COVID-19 mortality in Peru

Introducción: La pandemia por COVID-19 ha puesto de manifiesto las grandes desigualdades en la población mundial. Objetivo: Describir la correlación entre la competitividad y la mortalidad por COVID-19 en el Perú, teniendo como elemento de estudio a los gobiernos subnacionales. Material y Métodos: Estudio observacional basado en el análisis secundario de las muertes por COVID-19 en el 2020 y el índice de competitividad regional de los gobiernos subnacionales 2019. Se calcularon: tasas bruta y estandarizada, índice de efecto y de desigualdad de la pendiente, diferencia y razón de tasas brutas y estandarizadas, riesgo atribuible poblacional, gradiente social, así como brechas relativas y absolutas de mortalidad por COVID-19. Resultados: En el año 2020, la tasa estandarizada de mortalidad por COVID-19 (TEM-COVID-19) fue 267,61 muertes x 105 habitantes. El 21,53 por ciento de la varianza de la TEM-COVID-19 es explicada por el índice de competitividad regional del año 2019 (p= 0,019); el índice de desigualdad de la pendiente fue 29,68 y, por cada punto en el INCORE 2019, la TEM-COVID-19 aumentó 100,78 puntos (R2a= 0,181). En el quintil 1 de competitividad regional, esta fue 151,83, mientras que en el quintil 5 llegó a 449,15. La brecha de desigualdad absoluta entre ambos quintiles fue 297,32 y alcanzó 2,95 en la brecha de desigualdad relativa. La curva de concentración evidenció la desigualdad socio geográfica de las muertes por COVID-19 en el año 2020. Conclusiones: La mortalidad por COVID-19 se incrementó a medida que aumentaba la competitividad de los gobiernos subnacionales evidenciando la desigualdad socio-geográfica del impacto de la pandemia(AU)

Introduction: The COVID-19 pandemic has revealed high disparities in the world population. Objective: To describe the correlation between competitiveness and mortality from COVID-19 in Peru, with subnational governments as an element of study. Material and Methods: Observational study based on the secondary analysis of deaths from COVID-19 that occurred in 2020 and the regional competitiveness index of subnational governments in 2019. The crude and standardized rates, the effect index, the difference and ratio of crude and standardized rates, the population attributable risk, the inequality gradient, and the relative and absolute gaps in mortality from COVID-19 were calculated. Results: In 2020, the standardized mortality rate for COVID-19 (COVID-19-SMR) was 267,61 deaths per 105 inhabitants. Additionally, 21,53 percent of the variance from the COVID-19-SMR is explained by the regional competitiveness index 2019 (p= 0,019); the slope inequality index was 29,68 and, for each point in the INCORE 2019, the COVID-19-SMR increased 100,78 points (R2a= 0,181). In quintile 1 of regional competitiveness, it was 151,83, while in quintile 5 it reached 449,15. The absolute inequality gap between both quintiles was 297,32 and it reached 2,95 in the relative inequality gap. The concentration curve evidenced the socio-geographic inequality of deaths from COVID-19 in 2020. Conclusions: Mortality increased as subnational governments became more competitive, evidencing the socio-geographical inequality of the impact of the COVID-19 pandemic(AU)

Análise microbiológica da água em escolas públicas de Marabá, Pará / Microbiological analysis of water in public schools in Marabá, Pará

Objetivo: analisar a qualidade microbiológica da água de cinco escolas públicas da cidade de Marabá-PA e correlacionar com possíveis fatores de desigualdades sociais em saúde no entorno dessas escolas. Metodologia: as análises microbiológicas foram realizadas em cinco escolas públicas no interior do Pará, usando a técnica do número mais provável, associado a registro das características do entorno das escolas. O teste T Student foi utilizado para verificar as diferenças entre os resultados microbiológicos da água entre as escolas em que houve contaminação e também para testar as diferenças entre a vulnerabilidade socioambiental urbana no entorno das escolas e a contaminação da água. Resultados: observaram-se diferenças estatisticamente significantes entre as escolas E3 e E5 no teste para coliformes totais (p=0,043) e termotolerantes (p=0,008). A partir das condições de vulnerabilidade socioambiental urbana no entorno a escolas, encontrou-se diferenças estatisticamente significativas entre as escolas apenas em relação às condições de saneamento (p=0,05). Considerações Finais: as condições microbiológicas da água utilizada em duas escolas são insatisfatórias, o que indica risco à saúde para alunos, professores e funcionários das escolas.

Objective: to analyze the microbiological quality of water in five public schools in the city of Marabá-PA and to correlate with possible factors of social inequalities in health around these schools. Methodology: the analysis of the microbiological water quality was carried out in five schools in the interior of Pará, using the most likely number technique, associated with recording the characteristics of the schools' surroundings. We used Student T test to verify the differences between the microbiological results of water between the schools where there was contamination and to test the differences between the urban socio-environmental vulnerability around the schools and the water contamination. Results: statistically significant differences were observed between schools E3 and E5 in the test for total coliforms (p=0.043) and thermotolerants (p=0.008). We found statistically significant differences were found between schools only in relation to sanitation conditions (p=0.05). Final Considerations: the microbiological conditions of the water used in two schools are unsatisfactory, which indicates a health risk for students, teachers and school team.