São Paulo lives in different centuries when it comes to combating covid-19

In poorer areas, coronavirus mortality rates are sometimes 60% higher than in wealthier ones

Translated by: Ítalo Piva

Brasil de Fato | São Paulo |
Lack of infrastructure in poorer areas makes the coronavirus spread in these communities - Mãos Solidárias

The lethality of the novel coronavirus is 60% higher in the poorer neighborhoods of São Paulo in relation to wealthier areas, according to a study done by the epidemiologist and professor at the school of medicine of the University of São Paulo (USP), Paulo Lotufo, published last Friday (26). The finding suggests that the city is living in different centuries when it comes to combating the pandemic..

Lotufo says, “the data is able to show that the mortality rate of covid-19 has clear social delineations. It is nothing new, but a reaffirmation of the social determinism of death, which is no different with covid. The risk of getting infected is socially pre-determined, and the consequences of infection, even more so”.

The research was based on confirmed covid-19 deaths registered by the Health Secretariat of São Paulo and socioeconomic information gathered by the Brazilian Institute of Geography and Statistics (IBGE).

At first, the city of São Paulo was divided into three types of neighborhoods, based on data from IBGE: wealthier, intermediate and poorer. Cross referencing numbers with other reseachers, Lotufo put forth that three intermediate areas account for the highest number of deaths per 100,000 residents, at 87, 84.4 and 83.9 respectively. On the other hand, three neighborhoods in wealthier areas, Bela Vista, Butantã and Jardim Paulista, have 20.7, 23.4 and 23,7 deaths per one hundred thousand, for example.

The wealthier neighborhoods have the lowest death counts, averaging 36 per 100,000, when the poorer ones have a rate of 57.7. The regions classified as “intermediate” socioeconomically have a rate of 51,1 fatalities per one hundred thousand residents.

The numbers show that though covid-19 doesn’t choose its victims, the quality of protective measures, healthcare and economic assistance offered by the state, determines the part of the population most affected by the disease, as Lotufo posited.

Some of these neighborhoods are characterized by a lack of hospital infrastructure, basic sanitation and water access, like in Capão Redondo and Cidade Ademar, which don’t have any hospital care units available.

Among the districts with the lowest availability of hospital beds, higher numbers of deaths by covid-19 are occuring, while in districts with plenty of beds available, lower death rates are observed.

Research by the Pólis Institute done between March 21st and 27th shows a relationship between a large presence of low income women, responsible for sustaining their families, with the areas where the highest fatality rates are being seen. The study also points out that for this segment of the population, there is no realistic possibility of working from home, which is an aggravating factor with the closure of shools and preschools.

In the same way, the color of one’s skin is also a determining factor: the majority of deaths have occurred in areas with larger concentrations of black persons. The Cachoeirinha neighborhood, which is mentioned in Paulo Lotufo’s study, with a black population of 35%, is among the districts with the highest death rates.

There is another point of correlation, between informal labor and the lethality rates. Where the former is more expressive, the indexes are also higher. In the Grajaú neighborhood for example, around 70% of people work in the informal market and 25% to 37% of them,don’t have a fixed workplace and up to 48% cannot work from home.

Danielle Klintowitz, architect and urban planner at the Pólis institute, says that even before the pandemic reached Brazil, experts in the field had put forth the hypothesis that territorial inequalities would deeply impact the dissemination of the disease in poorer areas. After the research was completed, the hypothesis proved to be valid.

“Brazilian cities are structured in a very unequal manner. Investment is largely concentrated in areas that are already better developed, and very little is given to the areas that really need it”, says Klintowitz. In the city of São Paulo for example, “it can be said that we live in different centuries”.

When a health crisis happens, like the one occurring due to the covid-19 pandemic, the people who will be impacted most are the ones living in more vulnerable locations. In these areas, “very precarious conditions and inequality” were already commonplace.

For the architect, local authorities are not paying attention to territorial characteristics and coming up with policies appropriate for each district. On the contrary, the wealthier and the poorer neighborhoods are applying the exact same strategies to contain the coronavirus.

Edited by: Rodrigo Durão Coelho