Socio-economic inequality in global incidence and mortality rates from coronavirus disease 2019: an ecological study

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Epidemiological and clinical features of patients with COVID-19 have been examined but socio-economic aspects have been less studied. This study aimed to identify the role of the human development index (HDI) in the incidence and mortality rates of COVID-19 worldwide. Information on the incidence and mortality rates of COVID-19 was obtained from the Worldometer and data about the HDI 2019 were obtained from the World Bank database. Correlations between incidence, mortality rates and HDI parameters were assessed using linear regression. We calculated the concentration index to measure socio-economic inequality in COVID-19-related mortality and incidence. A linear regression analysis showed a direct significant correlation between the incidence and mortality rate of COVID-19 and HDI at the global level. The concentration index was positive for incidence rate (0.62) and mortality rate (0.69) of COVID-19, indicating the higher concentration of the rates among groups with high HDI. The high incidence and mortality rates of COVID-19 in countries with high and very high HDI are remarkable and should be the top priority for interventions by global health policy-makers. Health programmes should be provided to reduce the burden of this disease in regions with high incidence and mortality rates of COVID-19.