Geography of mortality in São Paulo, 2013-2016: an update

Abstract

The urban space of the municipality of São Paulo has imprinted in its geography the social differences in the composition of its landscape. By the end of the Twentieth Century, the city took disproportionate dimensions and gained the status of metropolis. Today, the municipality is set up by concentrating a large contingent of people in the sparsely populated areas of the city, under risk of environmental events considered to be dangerous (such as floods, landslides, high thermal amplitudes associated with more precarious housing). Social and economic inequalities, access to infrastructure and urban services, and the vulnerability of urban populations is highlighted in a different way. Occupancy by socioeconomic difference of a space results directly in the worsening of the health of its population, since these places lack basic infrastructure like water supply, health equipment, education, culture and leisure. Therefore, the configuration of the geographical space of the municipality influences significantly the health of its population, and for this reason, the association between urban space and health can be verified empirically by health indicators observed in the intra-urban scale. However, as health indicators change continuously, they should be periodically evaluated to ensure health planning directed to risk areas. Therefore, this research project seeks the approximation between geography and health from the mapping of the mortality rates of the municipality of São Paulo for the years 2013 to 2016 identifying the risk areas for the most important mortalities, comparing with the analyzes made previously for the years 1999 and 2009. This update is justified considering that the 2009 survey was prior to the 2010 Demographic Census and in a different political context from the most current moment. The research will analyze spatial patterns of relative risks of mortality by major causes in the city of São Paulo and the spatial association between relative risks and socioeconomic and socioenvironmental variables. The relative risks will be calculated taking into account the stratification of the population by sex and age group, aggregated by Administrative District. Socioeconomic conditions will be evaluated based on the composite socioeconomic indicator and other five dimensions of IBEU - Urban Welfare Index, developed by the Observatório das Metrópolis. The relative risks will correspond to the dependent variables to be submitted to spatial regression analysis through the GeoDa program. A cartographic set will be obtained to identify the inequities in the different mortalities in the city of São Paulo. In addition, it will be possible to verify the existence of possible associations with the socioeconomic and socioenvironmental variables, which will allow to understand the contexts of risk areas for the main causes of death. The results will also allow us to evaluate the temporal trend of changes in relation to the mortalities studied for the years 1999 and 2009.