Does sanitation matter? An analysis of the relationship between sanitary and COVID-19 conditions in Brazilian capitals

Abstract

This article analyzes the relationship between basic sanitation and the spread of COVID-19 in Brazilian state capitals. For that, the Basic Sanitation Access Index is estimated based on the reduction in the dimensions of sanitation coverage and management quality, obtained from data available in the National Sanitation Information System. Then, the level of association between sanitation and disease incidence and mortality rates in all Brazilian capitals between March and September 2020 is measured. The results suggest that Curitiba (0.824), Campo Grande (0.808), and Goiânia (0.794) lead the ranking of access to basic sanitation. Also, evidence points to a negative correlation between sanitation and COVID-19 incidence and mortality rates. However, the statistical significance of the estimates varies with time. These findings are in line with the international literature, which identifies access to sanitation as a key measure of infectious disease prophylaxis.