To the many risk factors that made US President Donald Trump’s Covid-19 diagnosis feel almost inevitable – from his disdain for masks to his scorn for social distancing – add this one: his passport. It is also one indicator that raises questions about the 20th century distinction between the “developed” and “developing” world.
It’s no coincidence that the United States, a country with some of the worst inequality in the world, is also home to the most Covid-19 infections, with more than 7.5 million confirmed cases (20 percent of the global total). But neither is the pandemic-to-inequality phenomenon unique to the US. Of the top 10 countries for Covid-19 infections, seven have a Gini coefficient – a measure of income inequality based on a 0-100 scale, with 100 being absolute inequality –of over 40, which the United Nations classifies as “highly unequal.” (America’s is 41.4; Brazil, third in Covid-19 cases with 5 million, has a Gini coefficient of 53.9). And lest we forget, most world leaders who have contracted the virus – including Trump, British Prime Minister Boris Johnson, Brazil’s President Jair Bolsonaro and President Juan Orlando Hernández of Honduras – preside over countries with significant wealth gaps.
Reasons for the correlation are varied. For one, inequality means more low-income workers – people like bus drivers, cleaners and support staff who cannot easily isolate and work from home. In fact, protective behavior is closely tied to income. According to a growing body of research, one of the biggest motivators for people to wear masks, especially in unequal places, is not to guard their health; it’s to ensure they can keep earning a paycheck.
Greater levels of inequality also create large pockets of people living in close spaces, which can speed up transmission. Then there is abundant data linking inequality to poor health outcomes and high rates of chronic disease – risk factors for Covid-19-related complications. As researchers in Brazil recently noted, being poor makes Covid-19 essentially unavoidable. Covid-19 “is like air pollution,” the researchers wrote. “It is difficult for individuals to completely escape from the negative effects of air pollution in the place where they live,” and the pandemic is no different.
Well-heeled individuals are not immune, either, as evidenced by the spread of the virus in the White House. Caitlin Brown, a professor of public policy at Central European University, and Martin Ravallion, an economist at Georgetown University, say people with higher incomes in unequal countries tend to engage in more face-to-face interactions. In other words, because “people in richer places have norms of interaction that cannot be costlessly adjusted downward during the epidemic,” they are less willing to adopt habits that could negatively affect their financial (or, in Trump’s case, political) wellbeing.
As one city official from Amsterdam recently noted, socio-economic factors in her city dictate how the disease is transmitted. But whether one catches the virus while skiing in the Italian alps or crammed into a favela in Rio de Janeiro, it is the poorest who suffer the most. “[The rich bring the disease to the poor [who] suffer from it,” she wrote.
None of these trends is likely to improve anytime soon. Deloitte expects that in the US, Covid-19 will only widen the income gap, especially between whites and Asians at one end, and Black and Hispanics at the other. Gains in gender equality also are under threat. Addressing the structural causes of inequality has been a focus of human development goals for decades. The pandemic will only make this work harder, and more urgent.
To be sure, income inequality is only one factor in determining a country’s Covid-19 risk. Myriad other elements – from political leadership to population, from the quality of a country’s healthcare system to its average age – must also be considered. Nor is inequality alone a perfect predictor of Covid-19 vulnerability. For instance, China remains a highly unequal country and yet its virus infection rates have been low for months.
There are plenty of aberrations, too. For instance, in the Czech Republic, where I live, one of Europe’s most equitable countries is currently experiencing a surge in new cases.
Still, the connection between inequality and Covid-19 is becoming harder to ignore. As the pandemic accelerates homelessness, unemployment and poverty, especially in the world’s most advanced economies, the virus’s preference for inequity appears unlikely to abate.
Amid such gloom, it’s hard not to marvel at the alternative. Across the developing world, where inequality is less pronounced and quality of life improving, countries from Africa to Asia to the Middle East have managed the health crisis better than their developed counterparts. In the UAE (Gini coefficient: 32.5), strict quarantine measures and vast testing regimes helped slow the spread of the virus spread and is aiding in recoveries. In Taiwan (Gini: 35), decisive action by the government has kept the virus in check for months. And in Thailand (Gini: 36.4), a country of 69.4 million, new daily cases of Covid-19 are counted in single digits.
When all is said and done, this pandemic may force a change in how we view the world and whether “developed” countries really deserve the moniker. At the very least, it should force a change in how the most unequal countries view themselves.
Greg C Bruno is the author of “Blessings from Beijing: Inside China’s Soft-Power War on Tibet.” He was a term member of the Council on Foreign Relations in New York and is a former opinion editor at The National in Abu Dhabi and Project Syndicate in Prague.