Int J Health Geogr - Highways and outposts: economic development and health threats in the central Brazilian Amazon region.


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CKGROUND: 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 Cuiab?-Santar?m highway (BR-163), i.e. in the western part of the state of Par? 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 Tapaj?s 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.

Resumo Limpo

ckground econom develop often evok drive forc capac improv social health condit remot area howev develop project produc uneven impact local communiti accord differ posit within societi studi examin spatial distribut three major health threat brazilian amazon region may undergo chang highway construct homicid mortal aid incid malaria preval rate calcul municip locat within area influenc cuiabsantarm highway br ie western part state par state northern part mato grossoresult municip character use social econom indic gross domest product gdp urban indigen popul recent migrat municip connect region main transport rout br transamazonian highway along amazon tapaj river identifi tag municip boundari cross rout use gis overlay oper multipl regress use identifi major drive forc constraint relat distribut health threat main explanatori variabl higher malaria preval proxim transamazonian highway high proport indigen popul low proport migrant high homicid rate associ high proport migrant connect amazon river play protect role aid incid higher municip recent increas gdp high proport urban populationconclus highway induc social environment chang play differ role spread maintain diseas health threat remot area still protect violenc vulner malaria rapid econom demograph growth increas risk aid transmiss violenc highway connect seclud local may threaten local popul region undergo rapid local develop boom thus creat outpost rapid temporari migrat may introduc health risk remot area

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