ArticleEpidemiology and infection2020
Taking the inner route: spatial and demographic factors affecting vulnerability to COVID-19 among 604 cities from inner São Paulo State, Brazil.
Article in Epidemiology and infection, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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Who cites it
39 citing papers in PubMed.
- Territorial Vulnerabilities and Healthcare Capacity During the COVID-19 Pandemic: A Spatiotemporal Study of Hospitalizations and Mortality in a Large Metropolitan Area in Brazil.International journal of environmental research and public health · 2026Article
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- Pandemic vulnerability index of US cities: A hybrid knowledge-based and data-driven approach.Sustainable cities and society · 2023Article
- An assessment of the relationship between national rates of Covid-19 incidence and mortality as reported to an international comparison database: An ecological study.Health science reports · 2023Article
- Article
- Article
- Associations Between Built Environment Factors and SARS-CoV-2 Infections at the Neighbourhood Level in a Metropolitan Area in Germany.Journal of urban health : bulletin of the New York Academy of Medicine · 2023Article
- Local and regional factors of spatial differentiation of the excess mortality related to the COVID-19 pandemic in Romania.Letters in spatial and resource sciences · 2023Article
- Prediction of COVID-19 Infections for Municipalities in the Netherlands: Algorithm Development and Interpretation.JMIR public health and surveillance · 2022Article
- Resilience Improves the Quality of Life and Subjective Happiness of Physiotherapists during the COVID-19 Pandemic.International journal of environmental research and public health · 2022Article
- Article
- A parametrized nonlinear predictive control strategy for relaxing COVID-19 social distancing measures in Brazil.ISA transactions · 2022Article
- The Geographical Distribution and Influencing Factors of COVID-19 in China.Tropical medicine and infectious disease · 2022Article
- Spatial Dynamics and Multiscale Regression Modelling of Population Level Indicators for COVID-19 Spread in Malaysia.International journal of environmental research and public health · 2022Article
- A hierarchical study for urban statistical indicators on the prevalence of COVID-19 in Chinese city clusters based on multiple linear regression (MLR) and polynomial best subset regression (PBSR) analysis.Scientific reports · 2022Article
- Quantifying the impact of regional variations in COVID-19 infections and hospitalizations across Ireland.European journal of public health · 2022Article
- Factors associated with COVID-19 mortality in municipalities in the state of São Paulo (Brazil): an ecological study.Revista da Sociedade Brasileira de Medicina Tropical · 2022Article
- Impact of the COVID-19 pandemic on the hours lost by self-employed racial minorities: evidence from Brazil.Small business economics · 2022Article
- Interrogating structural inequalities in COVID-19 mortality in England and Wales.Journal of epidemiology and community health · 2021Article
- Insights on the SARS-CoV-2 genome variability: the lesson learned in Brazil and its impacts on the future of pandemics.Microbial genomics · 2021Article
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5 authors.
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Abstract
Even though the impact of COVID-19 in metropolitan areas has been extensively studied, the geographic spread to smaller cities is also of great concern. We conducted an ecological study aimed at identifying predictors of early introduction, incidence rates of COVID-19 and mortality (up to 8 May 2020) among 604 municipalities in inner São Paulo State, Brazil. Socio-demographic indexes, road distance to the state capital and a classification of regional relevance were included in predictive models for time to COVID-19 introduction (Cox regression), incidence and mortality rates (zero-inflated binomial negative regression). In multivariable analyses, greater demographic density and higher classification of regional relevance were associated with both early introduction and increased rates of COVID-19 incidence and mortality. Other predictive factors varied, but distance from the State Capital (São Paulo City) was negatively associated with time-to-introduction and with incidence rates of COVID-19. Our results reinforce the hypothesis of two patterns of geographical spread of SARS-Cov-2 infection: one that is spatial (from the metropolitan area into the inner state) and another which is hierarchical (from urban centres of regional relevance to smaller and less connected municipalities). Those findings may apply to other settings, especially in developing and highly heterogeneous countries, and point to a potential benefit from strengthening non-pharmaceutical control strategies in areas of greater risk.
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