Slums, social disparities and the COVID-19 pandemic: who were the people truly impacted during the pandemic in Brazil?

Brazil was heavily impacted by COVID-19 pandemic, which intensified social and health disparities, especially in vulnerable areas such as slums. Therefore, the aim of this study was to investigate which residents of slums in Brazil were most affected by COVID-19 pandemic, with a focus on food insecurity, loss of income, ethnic and racial inequalities, and other social and geographic disparities. We conducted a cross-sectional study among the populations of slums in Brazilian capitals and the Federal District by applying a validated instrument. Inferential descriptive statistics were used, with the application of a logistic regression model. The study included 1,227 individuals from slums, most of whom were women, black or mixed-race, single, self-employed, and users of the Brazilian public healthcare system. Slum residents in the North region experienced the highest income loss, while those in the South region had the lowest, though the South also had the highest food insecurity. People with incomes below one minimum wage were the most affected by income loss, while those with incomes above three minimum wages were the least affected. White individuals were less impacted by food insecurity. Government aid was associated with families experiencing both income loss and food insecurity. This study highlights the impact of the COVID-19 pandemic among those with lower incomes living in slums, being most of them black or mixed-race women working in informal employment. It also shows that social and structural disparities have been exacerbated by the pandemic, particularly regarding race/ethnicity, income, and geographic region of residence.