Human development, inequality, and burden of socially determined diseases in brazil, 2014–2023
1
Maternal-Infant and Public Health Nursing Department, University of São Paulo College of Nursing at Ribeirão Preto, Ribeirão Preto, Brazil
2
Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
Popul. Med. 2026;8(Supplement Supplement 1):A1318
ABSTRACT
INTRODUCTION:
Socially Determined Diseases (SDDs) disproportionately affect socially vulnerable populations, highlighting social inequalities across settings. This study assessed the incidence of six SDDs and their association with human development and inequality in Brazil.
METHODS:
Ecological study using brazilian states as the unit of analysis from 2014 to 2023. Annual incidence per 100000 inhabitants was estimated for tuberculosis, leprosy, malaria, viral hepatitis, schistosomiasis, and Chagas disease using data from the Notifiable Diseases Information System (Sinan). Two multiple linear regression models were fitted: model A (Gini index and Municipal Human Development Index [IDHM]) and model B (replacing overall IDHM with its income, education, and longevity subindices). Results were expressed as regression coefficients (β) and 95% confidence intervals (95% CI), with statistical significance at p<0.05. Analyses were performed in R (version 4.5.1).
RESULTS:
Overall SDD incidence was negatively associated with IDHM (β=-7.85; 95% CI -11.41 to -4.30; p<0.001), indicating lower incidence in more developed contexts. Malaria showed negative associations with human development and longevity (β=-22.40; 95% CI -30.75 to -14.04; p<0.001; β=-25.14; 95% CI -36.88 to -13.41; p<0.001). Leprosy was also negatively associated with human development, longevity, and income (β=-11.91; 95% CI -14.19 to -9.63; p<0.001; β=-11.59; 95% CI -14.45 to -8.73; p<0.001; β=-6.72; 95% CI -9.78 to -3.67; p<0.001). Tuberculosis was positively associated with inequality (β=2.46; 95% CI 1.02 to 3.89; p<0.001). Viral hepatitis was less frequent in more unequal contexts (β=-3.46; 95% CI -5.64 to -1.28; p=0.002) and more frequent in states with higher human development (β=5.75; 95% CI 3.77 to 7.74; p<0.001).
CONCLUSIONS:
Human development and inequality were associated with distinct incidence patterns across SDDs. Higher development and longevity were associated with lower malaria and leprosy incidence, whereas tuberculosis increased in more unequal contexts. These findings support territorially targeted policies to reduce vulnerabilities, address inequality, and strengthen public health surveillance.
Socially Determined Diseases (SDDs) disproportionately affect socially vulnerable populations, highlighting social inequalities across settings. This study assessed the incidence of six SDDs and their association with human development and inequality in Brazil.
METHODS:
Ecological study using brazilian states as the unit of analysis from 2014 to 2023. Annual incidence per 100000 inhabitants was estimated for tuberculosis, leprosy, malaria, viral hepatitis, schistosomiasis, and Chagas disease using data from the Notifiable Diseases Information System (Sinan). Two multiple linear regression models were fitted: model A (Gini index and Municipal Human Development Index [IDHM]) and model B (replacing overall IDHM with its income, education, and longevity subindices). Results were expressed as regression coefficients (β) and 95% confidence intervals (95% CI), with statistical significance at p<0.05. Analyses were performed in R (version 4.5.1).
RESULTS:
Overall SDD incidence was negatively associated with IDHM (β=-7.85; 95% CI -11.41 to -4.30; p<0.001), indicating lower incidence in more developed contexts. Malaria showed negative associations with human development and longevity (β=-22.40; 95% CI -30.75 to -14.04; p<0.001; β=-25.14; 95% CI -36.88 to -13.41; p<0.001). Leprosy was also negatively associated with human development, longevity, and income (β=-11.91; 95% CI -14.19 to -9.63; p<0.001; β=-11.59; 95% CI -14.45 to -8.73; p<0.001; β=-6.72; 95% CI -9.78 to -3.67; p<0.001). Tuberculosis was positively associated with inequality (β=2.46; 95% CI 1.02 to 3.89; p<0.001). Viral hepatitis was less frequent in more unequal contexts (β=-3.46; 95% CI -5.64 to -1.28; p=0.002) and more frequent in states with higher human development (β=5.75; 95% CI 3.77 to 7.74; p<0.001).
CONCLUSIONS:
Human development and inequality were associated with distinct incidence patterns across SDDs. Higher development and longevity were associated with lower malaria and leprosy incidence, whereas tuberculosis increased in more unequal contexts. These findings support territorially targeted policies to reduce vulnerabilities, address inequality, and strengthen public health surveillance.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
