Desigualdade Social para a covid-19 no estado do Rio de Janeiro no período de 2020 a 2022

Abstract

Objetive: This study aimed to assess Social Inequality (SD) for COVID-19 in the 92 municipalities of the State of Rio de Janeiro from 2020 to 2022. Materials and Methods: This is an Ecological Study, classified according to the etiological dimension, using the database of the project “Assessing the effects of social inequalities during the COVID-19 pandemic", developed by the Integrated Center for Data and Knowledge for Health (CIDACS, FIOCRUZ) Bahia, composed of 5,570 observations and 85 variables. The study site is the municipalities of the state of Rio de Janeiro, and four time points during the COVID-19 pandemic (from 2020 to 2022) were investigated. To assess the effects of SD on the COVID-19 pandemic, the Social Inequality Index for COVID-19 (IDS-COVID-19) was calculated using the CIDACS and Adapted Techniques. Regarding the temporal evolution, the results (T0 to T4) were represented on maps of the state of Rio de Janeiro, using the CIDACS technique, compared to the representation of the maps with the temporal evolution using the Adapted Technique. Regarding the measurement of the SD magnitude for COVID-19, the ordered complex measures of disproportionality (Absolute and Relative Concentration Index) and regression-based measures (Index of Inequality Angle and Relative Inequality Index) were calculated. All measures were calculated for the CIDACS technique and the Adapted Technique. Results: The results showed that the comparison between Rio de Janeiro's municipalities revealed significant heterogeneity, with regions such as Norte and Médio Paraíba showing greater inequalities, while Serrana and Centro-Sul maintained lower rates. The temporal evolution showed worsening social inequality (SD) during the pandemic, especially in T2, marked by the first wave. The CIDACS Technique indicated relative stability when situating the state within the national context. The Adapted Technique, on the other hand, showed greater sensitivity, capturing more intense internal disparities. Thus, both proved complementary: one suitable for national comparisons and the other for more detailed regional diagnoses. Conclusion: It is concluded that the pandemic exacerbated existing inequalities, reinforcing the need for equity-oriented public policies and continuous surveillance strategies to reduce health inequities.