02135nas a2200217 4500000000100000008004100001260001200042653002100054653002200075653001200097653002500109653002500134100003400159700003000193700002700223700003200250245011600282856010200398300001100500520140600511 2026 d c10/202610aNortheast Brazil10aSocial inequality10aLeprosy10a Spatial Durbin Mode10aSpatial econometrics1 aNaanda Kaanna Matos de Souza 1 aLuis Abel da Silva Filho 1 aDenis Fernandes Alves 1 aBruno Cesar Brito Miyamoto 00a Poverty, Inequality, and the Territorial Geography of Leprosy in Northeastern Brazil: A Spatial Panel Analysis uhttps://www.anpec.org.br/encontro/2026/submissao/files_I/i12-7e8157c47900636d86df79d27a28a4cd.pdf a1 - 203 a

Leprosy in Brazil remains closely tied to poverty, inequality, and unequal access to health and sanitation infrastructure, making it a revealing case for studying social and demographic disparities across territory. This study analyzes the socioeconomic, demographic, sanitary, and environmental determinants of the disease in 1,793 municipalities in the Northeast between 2002 and 2023. A two-dimensional fixedeffects spatial panel was used, preceded by Exploratory Spatial Data Analysis (ESDA), Moran's Global Index, and local indicators of spatial association (LISA). Among the alternative spatial models estimated, the Spatial Durbin Model (SDM) was selected based on AIC/BIC criteria and diagnostic tests. The results show a persistent positive spatial autocorrelation of leprosy, with clusters concentrated in socially vulnerable areas. Education, income inequality, sanitation conditions, infant mortality, vaccination coverage, and climatic factors proved relevant in explaining disease incidence. Indirect effects indicate that the socioeconomic and demographic characteristics of neighboring municipalities significantly influence local leprosy levels, revealing spatial externalities in poverty, inequality, and public-service provision. The findings reinforce the need for regionally coordinated social and health policies to address the territorial roots of disease transmission.