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

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 difference...

Full description

Saved in:
Bibliographic Details
Main Authors: Amir Farhang Abbasi, Negin Karimi Dehkordi, Neda SoleimanvandiAzar, Mahshid Roohravan Benis, Marzieh Nojomi
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-025-22921-y
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850107762935070720
author Amir Farhang Abbasi
Negin Karimi Dehkordi
Neda SoleimanvandiAzar
Mahshid Roohravan Benis
Marzieh Nojomi
author_facet Amir Farhang Abbasi
Negin Karimi Dehkordi
Neda SoleimanvandiAzar
Mahshid Roohravan Benis
Marzieh Nojomi
author_sort Amir Farhang Abbasi
collection DOAJ
description 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.
format Article
id doaj-art-94a07f19ea5a4146a4591730ca990087
institution OA Journals
issn 1471-2458
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj-art-94a07f19ea5a4146a4591730ca9900872025-08-20T02:38:31ZengBMCBMC Public Health1471-24582025-05-0125111610.1186/s12889-025-22921-yGini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studiesAmir Farhang Abbasi0Negin Karimi Dehkordi1Neda SoleimanvandiAzar2Mahshid Roohravan Benis3Marzieh Nojomi4Student Research Committee, School of Medicine, Iran University of Medical SciencesStudent Research Committee, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesAbstract 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.https://doi.org/10.1186/s12889-025-22921-yCOVID-19Mortality RateGini coefficientGross Domestic Product (GDP)
spellingShingle Amir Farhang Abbasi
Negin Karimi Dehkordi
Neda SoleimanvandiAzar
Mahshid Roohravan Benis
Marzieh Nojomi
Gini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studies
BMC Public Health
COVID-19
Mortality Rate
Gini coefficient
Gross Domestic Product (GDP)
title Gini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studies
title_full Gini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studies
title_fullStr Gini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studies
title_full_unstemmed Gini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studies
title_short Gini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studies
title_sort gini coefficient gdp per capita and covid 19 mortality a systematic review of ecologic studies
topic COVID-19
Mortality Rate
Gini coefficient
Gross Domestic Product (GDP)
url https://doi.org/10.1186/s12889-025-22921-y
work_keys_str_mv AT amirfarhangabbasi ginicoefficientgdppercapitaandcovid19mortalityasystematicreviewofecologicstudies
AT neginkarimidehkordi ginicoefficientgdppercapitaandcovid19mortalityasystematicreviewofecologicstudies
AT nedasoleimanvandiazar ginicoefficientgdppercapitaandcovid19mortalityasystematicreviewofecologicstudies
AT mahshidroohravanbenis ginicoefficientgdppercapitaandcovid19mortalityasystematicreviewofecologicstudies
AT marziehnojomi ginicoefficientgdppercapitaandcovid19mortalityasystematicreviewofecologicstudies