Spatiotemporal Associations Between Deforestation and Acute Myocardial Infarction Mortality in the Brazilian Amazon

Deforestation promotes environmental changes capable of altering regional microclimatic dynamics, intensifying wildfires, and increasing population exposure to cardiovascular risk factors. This study investigated the spatiotemporal association between deforestation and acute myocardial infarction mortality across health regions of the Brazilian Amazon between 2000 and 2023. An ecological study design was adopted using data aggregated by health region and year. Generalized additive models with a negative binomial distribution were fitted to evaluate nonlinear associations between deforestation and acute myocardial infarction mortality, including temporal lag analyses of one, two, and three years. Spatial dynamics were further investigated through Bayesian spatiotemporal modeling incorporating structured spatial effects and a smoothed temporal trend. A significant nonlinear association was identified between deforestation and acute myocardial infarction mortality, with progressive risk intensification observed in areas subjected to greater environmental degradation. Lagged models demonstrated persistence of the association over time, suggesting cumulative effects of environmental exposure. Spatial analysis revealed an expansion of areas with elevated relative risk, particularly within the Arc of Deforestation of the Amazon region. Overall, the findings indicate that deforestation may act as an important socioenvironmental determinant of cardiovascular health in the Brazilian Amazon.