System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Systematic Review Epublish

PubMed: 40426138 DOI: 10.1186/s12889-025-22921-y

Gini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studies.

BMC Public Health 25(1):1960

Authors: Amir Farhang Abbasi, Negin Karimi Dehkordi, Neda SoleimanvandiAzar, Mahshid Roohravan Benis, Marzieh Nojomi

Affiliations

  • Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Department of Sociology and Anthropology, Nipissing University, North Bay, ON, Canada.

Abstract

BACKGROUND

Since December 2019, when Wuhan officially reported COVID-19, the disease has spread globally, revealing significant variations in mortality rates influenced by socio-economic factors and health policies. This study aims to identify two predictors of COVID-19 mortality differences-GDP (Gross Domestic Product), and Gini Coefficient index-across various countries through a systematic review.

METHODS

The study was a systematic review conducted according to PRISMA guidelines. The search strategy was searched in the titles and abstracts of the articles in three main databases: PubMed, Scopus, and Web of Science. Gini Coefficients and the Gross Domestic Product (GDP) of the countries were used as mortality predictors. The initial search yielded 331 articles, which were assessed for quality using the Newcastle Ottawa Scale (NOS). Ultimately, 31 articles were included in the final synthesis.

RESULTS

Most studies analyzed data from multiple countries, with only ten of the thirty-one articles focusing on a single nation. Initial research in 2020 aimed to understand the immediate socioeconomic factors affecting COVID-19 outcomes. Later studies in 2021 and 2022 explored more complex interactions between the pandemic and socioeconomic factors, while long-term outcomes were published in 2023 and 2024. Some studies found a paradoxical relationship between GDP and COVID-19 mortality rates, whereas most indicated a positive correlation between COVID-19 mortality rates and the Gini index.

CONCLUSION

Both income inequality and GDP significantly influence COVID-19 mortality rates. While a higher GDP can provide some protective benefits, it does not completely shield countries from high mortality, especially when considering economic activity and demographics. Researchers consistently identify income inequality as a predictor of poorer health outcomes, highlighting the need for equitable health and social policies to mitigate vulnerabilities in future pandemics.

MeSH

Mortality, Guanosine Diphosphate, Income, Public Health, Covid-19, Pandemics, Economic Factors, Socioeconomic Factors