Determinants of COVID-19 Mortality and Temporal Trends in the Health Regions of the State of São Paulo, Brazil

Tatiana Pestana Barbosa (), Thais Zamboni Berra, Antônio Carlos Vieira Ramos, Yan Mathias Alves, Reginaldo Bazon Vaz Tavares, Fernando Spanó Junqueira de Paiva, Jonas Bodini Alonso, Titilade Kehinde Ayandeyi Teibo, Juliana Soares Tenório de Araújo, Ariela Fehr Tártaro and Ricardo Alexandre Arcêncio
Additional contact information
Tatiana Pestana Barbosa: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Thais Zamboni Berra: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Antônio Carlos Vieira Ramos: Department of Nursing, State University of Minas Gerais, Passos Campus, Passos 37900-106, Brazil
Yan Mathias Alves: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Reginaldo Bazon Vaz Tavares: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Fernando Spanó Junqueira de Paiva: Polytechnic School, University of São Paulo, São Paulo 05508-010, Brazil
Jonas Bodini Alonso: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Titilade Kehinde Ayandeyi Teibo: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Juliana Soares Tenório de Araújo: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Ariela Fehr Tártaro: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Ricardo Alexandre Arcêncio: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil

IJERPH, 2025, vol. 22, issue 5, 1-14

Abstract: Background: This study investigated the determinants of COVID-19 mortality and its temporal trends within São Paulo state’s Departamentos Regionais de Saúde (DRS) (health regions) to inform the development of targeted public health interventions. Methods: Utilizing an ecological study design, we analyzed confirmed COVID-19 cases and deaths (February 2020–December 2021) obtained from the COVID Panel, incorporating relevant social and health indicators. The Generalized Additive Model for Location, Scale, and Shape (GAMLSS) was used to identify key determinants, and temporal trends in mortality and vaccination rates were analyzed across each DRS. Results: The average mortality rate was 15.1 deaths per 100,000 inhabitants (median 7.00). Higher chronic disease mortality was associated with an increase in COVID-19 mortality. Moreover, an increase in the percentage of adults led to a decrease in deaths from COVID-19. Conclusions: COVID-19 mortality in São Paulo is shaped by a complex interplay of 12 behavioral, economic, demographic, and environmental factors. Region-specific public health policies should consider these factors, along with geographic, socioeconomic, and budgetary contexts, to effectively address health disparities across the state’s DRS.

Keywords: COVID-19; mortality indicators; epidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/22/5/772/pdf (application/pdf)
https://www.mdpi.com/1660-4601/22/5/772/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:22:y:2025:i:5:p:772-:d:1655064

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().