Mortality and morbidity caused by pneumonia in children and adolescents are associated with socioeconomic and urban conditions in São Paulo, Brazil.

OBJECTIVE

The aim of this study was to investigate the association between pneumoniarelated mortality and morbidity and urban, environmental, and socioeconomic conditions in the administrative districts of São Paulo, Brazil.

METHODS

We conducted an ecological study using aggregated data from 2010 to 2020 across 96 administrative districts in ã Paulo. Mortality and hospitalization data for individuals up to 19 years old were analyzed in relation to the Geographic Index of the Socioeconomic Context for Health and Social Studies (GeoSES), housing standards, and urban conditions. Spatial analysis involved estimating relative risk using SaTScan, and Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) were applied to assess spatial associations.

RESULTS

Between 2010 and 2020, 1486 deaths and 1,56,112 hospitalizations due to pneumonia were recorded among individuals up to 19 years old. Mortality was higher among males (54.7%) and displayed spatial clustering. Mortality rates were negatively associated with the proportion of high-standard residences and the GeoSES index and positively associated with the presence of rapid-transit roadways. The GWR model outperformed the OLS model (adjusted R2=0.44 vs. 0.40) for mortality. Hospitalization rates were more uniformly distributed and showed a weaker association with socioeconomic indicators (adjusted R2=0.17 for OLS).

CONCLUSIONS

Pneumonia mortality among children and adolescents in São Paulo is spatially associated with socioeconomic and urban conditions. These findings underscore the need for geographically targeted public health interventions that address urban planning and social inequalities in disease prevention strategies.