Clima, raça e saúde: interseccionalidade na produção de vulnerabilidades climáticas no Brasil

Abstract

This thesis investigates how climate change interacts with racial and territorial inequalities to produce health disparities in Brazil. Using municipal-level data, the study examines the relationship between racial composition, climate vulnerability, and hospitalizations for primary care-sensitive conditions (ICSAPs), combining factor analysis, spatial econometrics, and causal inference strategies. Initially, a Composite Climate Vulnerability Index is constructed, synthesizing four dimensions: social deprivation, urban adaptive capacity, climate stress due to droughts, and exposure to extreme heat waves. The index reveals a strong spatial concentration of vulnerability in the Northeastern semi-arid region, the Legal Amazon, the Jequitinhonha Valley, and metropolitan peripheries. Subsequently, spatial autoregressive models indicate that the proportion of the Black population is positively associated with ICSAPs after controlling for climatic, institutional, and health service supply factors, suggesting that racial inequalities persist even when observable vulnerabilities are taken into account. Finally, applying spatial propensity score matching, we estimate the causal effect of racial composition on health outcomes in matched samples of structurally similar municipalities. The findings show that municipalities with a higher proportion of Black residents exhibit ICSAP rates between 12% and 15% higher than their counterfactuals, providing evidence that climate vulnerability in Brazil is multidimensional, spatially concentrated, and racially structured. These results underscore that climate change tends to amplify historical inequalities and generate persistent health inequities.