Three countries — the US, Brazil and Mexico — account for 46 percent of the world’s reported COVID-19 deaths, yet they contain only 8.6 percent of the world’s population. Some 60 percent of Europe’s deaths are concentrated in Italy, Spain and the UK, which combined account for 38 percent of Europe’s population. There are many fewer deaths and lower death rates in most of northern and central Europe.
Several factors determine a country’s COVID-19 death rate: the quality of political leadership, the coherence of the government’s response, the availability of hospital beds, the extent of international travel and the population’s age structure.
Yet one deep structural characteristic seems to be shaping the role of these factors: countries’ income and wealth distribution.
The US, Brazil and Mexico have very high income and wealth inequalities. The World Bank reports the respective Gini coefficients for 2016 to 2018 at 41.4 in the US, 53.5 in Brazil and 45.9 in Mexico. On a 100-point scale, a value of 100 signifies absolute inequality, with one person controlling all income or wealth, and zero means a completely equal distribution per person or household.
The US has the highest Gini coefficient among advanced economies, while Brazil and Mexico are among the world’s most unequal countries.
In Europe, Italy, Spain and the UK — with Gini scores of 35.6, 35.3 and 34.8, respectively — are more unequal than their northern and eastern counterparts, such as Finland (27.3), Norway (28.5), Denmark (28.5), Austria (30.3), Poland (30.5) and Hungary (30.5).
The correlation of death rates per million and income inequality is far from perfect, and other factors matter a lot. France’s inequality is on par with Germany’s, but its COVID-19 death rate is significantly higher. The death rate in relatively egalitarian Sweden is significantly higher than in its neighbors, because Sweden decided to keep its social distancing policies voluntary rather than mandatory. Relatively egalitarian Belgium was battered with very high reported death rates, owing partly to the authorities’ decision to report probable, as well as confirmed, COVID-19 deaths.
High income inequality is a social scourge in many ways. As social epidemologists Kate Pickett and Richard Wilkinson reported in two coauthored books, The Spirit Level and The Inner Level, higher inequality leads to worse overall health conditions, which significantly increases vulnerability to COVID-19 deaths.
Moreover, higher inequality leads to lower social cohesion, less social trust and more political polarization — all of which negatively affect governments’ ability and readiness to adopt strong control measures.
Higher inequality means a larger proportion of low-income workers — from cleaners, cashiers, guards and delivery persons to sanitation, construction and factory workers — must continue their daily lives, even at the risk of infection.
More inequality also means that more people are living in crowded conditions and are therefore unable to shelter safely.
Populist leaders exacerbate the enormous costs of inequality. US President Donald Trump, Brazilian President Jair Bolsonaro, and British Prime Minister Boris Johnson were elected by unequal and socially divided societies with the support of many disgruntled working-class voters — typically white, less-educated men, who resent their declining social and economic status.
The politics of resentment is almost the opposite of the politics of epidemic control. Such politics shun experts, deride scientific evidence and resent elites who work online and tell workers to stay home, even though they cannot.
The US under Trump is so unequal, politically divided and badly governed that it has given up on any coherent national strategy to control the COVID-19 outbreak. All responsibilities have been shifted to state and local governments, which have been left to fend for themselves.
Heavily armed right-wing protesters have, on occasion, mobbed state capitals to oppose restrictions on business activity and personal mobility.
Even masks have become politicized: Trump refuses to wear one and said that some people only wear masks to express their disapproval of him.
The result is that his followers gleefully reject wearing masks, and the virus, which first spread in “blue” coastal states with Democrat-led governments, is now hitting Trump’s base in “red” states with Republican-led governments.
Meanwhile, Brazil and Mexico are mimicking US politics. Bolsonaro and Mexican President Andres Manuel Lopez Obrador are quintessential populists in the Trump mold, mocking the virus, disdaining expert advice, making light of the risks and flamboyantly rejecting personal protection. They are also guiding their countries into a Trumpian disaster.
With the exception of Canada and few other places, the countries of North and South America are being ravaged by COVID-19, because almost the entire Western hemisphere shares a legacy of mass inequality and pervasive racial discrimination.
Even effectively-governed Chile fell prey to violence and instability last year, owing to high and chronic inequality. This year, Chile, along with Brazil, Ecuador and Peru, has suffered one of the world’s highest COVID-19 death rates.
Inequality is certainly not a death sentence. China, with a Gini score of 38.5, is rather unequal, but its national and provincial governments adopted rigorous control measures after the initial outbreak in Wuhan, essentially suppressing the virus. Last month’s outbreak in Beijing, after weeks of zero confirmed new cases, resulted in renewed lockdowns and massive testing.
However, in most other countries, we are witnessing once again the enormous costs of mass inequality: inept governance, social distrust and a huge population of vulnerable people unable to protect themselves from encroaching harms.
Alarmingly, the epidemic itself is widening inequalities even further.
The rich work and thrive online. For example, Amazon chief executive Jeff Bezos’ wealth has since January risen by US$49 billion, due to the decisive shift to e-commerce.
Meanwhile, the poor are losing their jobs, and often their health and lives.
The costs of inequality are to rise further, as revenue-starved governments slash budgets and public services vital for the poor.
However, a reckoning is coming. In the absence of coherent, capable and trustworthy governments that can implement an equitable and sustainable pandemic response strategy for economic recovery, the world is set to succumb to further waves of instability generated by a growing array of global crises.
Jeffrey Sachs is the director of Columbia University’s Center for Sustainable Development and a member of the UN Sustainable Development Solutions Network.
Copyright: Project Syndicate
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