Deforestation as a Public Health Risk in Bolivia’s Amazon: Associations between Fire and Pneumonia

Objectives

Since 2000, Bolivia has lost 15% of its original tree cover. Prior research identifies Amazonian deforestation as an important determinant of population health, including increased respiratory disease from fire-related air pollution to altered patterns of vector-borne disease transmission. This study assessed the association and compared spatial patterns between tree cover loss rates and disease incidence in Bolivia’s Amazon.

Methods

We analyzed annual, municipal, longitudinal data in the Bolivian Amazon from 2002 to 2023 on respiratory and vector-borne diseases. We used multivariable negative binomial regression models with a two-way fixed effects specification and a population offset to estimate rate ratios. Models were adjusted for relevant demographic, socioeconomic, and health confounders and were stratified by sex and age.

Results

In the Political Amazon (n = 23 municipalities), all forms of tree cover loss were associated with pneumonia incidence, with the strongest effects for fire-related loss. In fully adjusted models for the total population, a 1% increase in the rate of fire-related tree cover loss was associated with a 24% increase in pneumonia incidence (95% CI: 1–53; p = 0.04). This association persisted after the pneumococcal vaccine (2015–2023) (24%; 95% CI: 3–49; p = 0.03) and was evident among adults aged 60 years and older from 2007–2023 (29%; 95% CI: 5–59; p = 0.02). We found no consistent association between tree cover loss and malaria, dengue or acute respiratory infection.

Conclusions

Our findings indicate that deforestation — particularly fire-related — is associated with higher pneumonia incidence in the Bolivian Amazon. Such results are consistent with other studies discussing association between forest fires and respiratory disease, highlighting the importance of the environment in public health.

Financing

Catalan Agency for Development Cooperation; Generality of Catalunya (R/N:21482/AE0087 N-PR2022/L1).

Key messages

• Deforestation is a measurable public health risk in the Bolivian Amazon, especially when segregating for different social groups.

• Spatially disaggregated data reveal how deforestation shapes disease patterns across the Bolivian Amazon, enabling more precise and equitable public health action.