Association between disasters, damage and destruction of health facilities and public spending in Brazil.

The study investigated the relationship between occurrence of damage and destruction of public health facilities and losses due to disasters, health care expenditure, the indicators of disaster risk management in Brazilian municipalities in the period from 2013 to 2020. The method was secondary data analyses using national datasets in the public domain. Only records of disasters recognised by the Federal Government were selected. In total, 19,026 records of disasters and their impacts were analysed, including 949 Brazilian municipalities. The results showed that as the number of dead, injured, and ill people grows, the number of damaged health facilities also tends to increase for all years. However, the correlation coefficient was weak, except for the years 2013, 2014 and 2015, which was moderate. The spatial distribution of municipalities with the highest disaster-related expenditures is concentrated in the states of Amazonas, Pará, Acre, Mato Grosso do Sul, and in some states in the Northeast. Hydrological (flooding and flash floods) have caused the most damage and destruction of health services. The indicators of disaster risk management do not explain the variation in the occurrence of damaged or destroyed facilities, because the coefficient values indicated a very weak correlation.