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HIGHWAYS AND OUTPOSTS: ECONOMIC DEVELOPMENT AND HEALTH THREATS IN THE CENTRAL BRAZILIAN AMAZON REGION
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Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Abstract
Background: Economic development is often evoked as a driving force that has the capacity to improve the social and
health conditions of remote areas. However, development projects produce uneven impacts on local communities,
according to their different positions within society. This study examines the spatial distribution of three major health
threats in the Brazilian Amazon region that may undergo changes through highway construction. Homicide mortality,
AIDS incidence and malaria prevalence rates were calculated for 70 municipalities located within the areas of influence
of the Cuiabá-Santarém highway (BR-163), i.e. in the western part of the state of Pará state and the northern part of
Mato Grosso.
Results: The municipalities were characterized using social and economic indicators such as gross domestic product
(GDP), urban and indigenous populations, and recent migration. The municipalities' connections to the region's main
transportation routes (BR-163 and Trans-Amazonian highways, along with the Amazon and Tapajós rivers) were
identified by tagging the municipalities that have boundaries crossing these routes, using GIS overlay operations.
Multiple regression was used to identify the major driving forces and constraints relating to the distribution of health
threats. The main explanatory variables for higher malaria prevalence were: proximity to the Trans-Amazonian highway,
high proportion of indigenous population and low proportion of migrants. High homicide rates were associated with
high proportions of migrants, while connection to the Amazon River played a protective role. AIDS incidence was
higher in municipalities with recent increases in GDP and high proportions of urban population.
Conclusions: Highways induce social and environmental changes and play different roles in spreading and
maintaining diseases and health threats. The most remote areas are still protected against violence but are vulnerable
to malaria. Rapid economic and demographic growth increases the risk of AIDS transmission and violence. Highways
connect secluded localities and may threaten local populations. This region has been undergoing rapid localized
development booms, thus creating outposts of rapid and temporary migration, which may introduce health risks to
remote areas.
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