COVID-19 incidence and mortality in the Metropolitan Region, Chile: Time, space, and structural factors

Abstract

Demographic, health, and socioeconomic factors significantly inform COVID-19 outcomes. This article analyzes the association of these factors and outcomes in Chile during the first five months of the pandemic. Using the municipalities Metropolitan Region's municipalities as the unit of analysis, the study looks at the role of time dynamics, space, and place in cases and deaths over a 100-day period between March and July 2020. As a result, common and idiosyncratic elements explain the prevalence and dynamics of infections and mortality. Social determinants of health, particularly multidimensional poverty index and use of public transportation play an important role in explaining differences in outcomes. The article contributes to the understanding of the determinants of COVID-19 highlighting the need to consider time-space dynamics and social determinants as key in the analysis. Structural factors are important to identify at-risk populations and to select policy strategies to prevent and mitigate the effects of COVID-19. The results are especially relevant for similar research in unequal settings.

Fig 1. Evolution of cumulative cases, deaths, and policy milestones in Chile and the Metropolitan Region (March-July, 2020).

Fig 2. G_i* tests for clustering in selected variables.

(a) infections (100 days cumulative rate); (b) deaths (100 days cumulative rate); (c) population density; (d) public health insurance; (e) average years of education; (f) use of public transportation. Blue: low-value clusters (95% significance); Red: high-value clusters (95% significance); Grey: not significant areas.