Exclusion from health information among socially vulnerable populations: an intersectional analysis in Brazil
1
Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
2
School of Science and Technology, University of Évora, Évora, Portugal
Popul. Med. 2026;8(Supplement Supplement 1):A3337
ABSTRACT
BACKGROUND:
The covid-19 pandemic intensified pre-existing social inequalities and highlighted the central role of information in health promotion. Although internet access is widespread in Brazil, mechanisms of informational exclusion in public health emergencies remain insufficiently investigated1,2.
METHODS:
Cross-sectional study aimed to identify socially vulnerable population groups with lower propensity to seek information about covid-19 on the internet in Brazil. The study was conducted in the 26 Brazilian state capitals and the Federal District. The sample comprised people experiencing homelessness, residents of rural settlements and urban communities, as well as migrants, refugees, and stateless individuals. Data were collected between 2021 and 2023 through face-to-face interviews. The analysis was conducted using the intersectional MAIHDA approach (Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy) 3.
RESULTS:
The sample consisted of 3,099 participants distributed across 133 intersectional strata defined by gender, ethnicity, educational attainment, income, and territory. The results identified five profiles with the lowest probability of seeking information about covid-19 online. These profiles were exclusively characterized by male individuals with no formal education and no income. Differences among profiles were observed only by territory, with two from rural areas and three from urban areas. Model performance was adequate, with a Variance Partition Coefficient of 21% and an area under the ROC curve of 0.75. Male sex, absence of income, and low educational attainment were independently associated with lower information-seeking.
CONCLUSIONS:
The intersectional analysis showed that inequalities in seeking online information about covid-19 do not occur uniformly, nor can they be interpreted based on isolated social markers. These patterns emerge from the overlapping of social structures that, in combination, shape access to information. In public health emergencies, health communication strategies must acknowledge these asymmetries and guide actions that are responsive to different population groups.
The covid-19 pandemic intensified pre-existing social inequalities and highlighted the central role of information in health promotion. Although internet access is widespread in Brazil, mechanisms of informational exclusion in public health emergencies remain insufficiently investigated1,2.
METHODS:
Cross-sectional study aimed to identify socially vulnerable population groups with lower propensity to seek information about covid-19 on the internet in Brazil. The study was conducted in the 26 Brazilian state capitals and the Federal District. The sample comprised people experiencing homelessness, residents of rural settlements and urban communities, as well as migrants, refugees, and stateless individuals. Data were collected between 2021 and 2023 through face-to-face interviews. The analysis was conducted using the intersectional MAIHDA approach (Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy) 3.
RESULTS:
The sample consisted of 3,099 participants distributed across 133 intersectional strata defined by gender, ethnicity, educational attainment, income, and territory. The results identified five profiles with the lowest probability of seeking information about covid-19 online. These profiles were exclusively characterized by male individuals with no formal education and no income. Differences among profiles were observed only by territory, with two from rural areas and three from urban areas. Model performance was adequate, with a Variance Partition Coefficient of 21% and an area under the ROC curve of 0.75. Male sex, absence of income, and low educational attainment were independently associated with lower information-seeking.
CONCLUSIONS:
The intersectional analysis showed that inequalities in seeking online information about covid-19 do not occur uniformly, nor can they be interpreted based on isolated social markers. These patterns emerge from the overlapping of social structures that, in combination, shape access to information. In public health emergencies, health communication strategies must acknowledge these asymmetries and guide actions that are responsive to different population groups.
| eISSN: | 2654-1459 |
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