ABSTRACT
In this chapter we investigate how geographically contrasting socio-economic factors, such as health conditions and social inequality, affect the evolution of COVID-19 lethality differently over time in the Brazilian municipalities and states. Through multilevel modeling, we examine how the quantity of hospital beds in the municipalities (municipality effect) and the states’ Gini indexes (state effect) affect COVID-19 lethality over time. Given the statistical significance of the fixed and random effects’ parameters of the proposed three-level hierarchical model with repeated measures, we verify that 19.9% of the COVID-19 lethality in Brazil is due to differences among states, 74.5% is due to differences among municipalities, and 5.6% of the change in lethality is due to the temporal effect. We further conclude that little has changed over time in Brazil since the beginning of the pandemic, and changes in the lethality indicator occur, in fact, among locations. In sum, we demonstrate that Brazil has not been capable of treating and fighting homogeneously the contamination and lethality of the disease in its territories, resulting in regional differences and increased inequalities in the society.
