Keywords
Social Determinants of Health
Morbidity and Mortality
Spatial Analysis
Brazilian Amazon
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Abstract
Objective: To characterize the clinical-epidemiological, demographic, and territorial profiles of COVID-19 morbidity and mortality in Belém, Pará, from 2020 to 2023, analyzing inequalities associated with the Amazonian urban territory. Methods: Epidemiological and ecological study based on secondary data from the State Health Department of Pará (SESPA) on COVID-19 cases and deaths. Clinical and sociodemographic variables were analyzed using descriptive statistics and the chi-square test (p < 0.05). Joinpoint regression was applied for temporal trend analysis, and spatial analysis by neighborhoods was performed using TerraView 4.2.2 and ArcGIS 10.2 software. Results: A total of 157,477 cases and 5,478 deaths were recorded. Cases predominated among women (58.6%), adults aged 18–59 years (73.2%), and individuals of mixed race/color (43.7%). Deaths were more frequent among men (56.1%), older adults (74.1%), and mixed-race individuals (51.9%). The highest incidence rates occurred in Reduto, Campina, and Val-de-Cães, while mortality was higher in Campina, Val-de-Cães, and Nazaré. A decreasing trend in morbidity and mortality was observed throughout the period. Conclusion: The unequal distribution of COVID-19 in Belém highlights the influence of social determinants and territorial conditions on health outcomes, confirming the territory as a structuring component of inequalities in the Amazonian context.
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