The advantages of being poor during COVID-19 pandemic
The daily traumas created by the seemingly random character of the coronavirus disease (COVID-19) pandemic, stretching from sophisticated crowded cities in the US to bursts of new cases in migrant worker dormitories throughout Asia and Africa, force a global realization that infection and death may emerge without warning. For some time now, it has been speculated that Yemen would suffer a far greater COVID-19 crisis than other nations, even those of similar poverty and lack of health infrastructure. The reasons were given as the particular poverty of Yemen in clean water supply and distribution, devastations caused by five years of warfare and consequent blockages of food, medical and humanitarian supplies, and exhaustion from years of battling with previous disease attacks, from dengue fever to cholera.
Yet so far, although Yemen has been so ravaged, the total cases at the time of writing numbered only 1,526, and the deaths per million amounted to only 12. Yemen was relatively late to this attack: Until April 19, only one case was registered, by June 7 the number was 482, multiplying threefold to the present day. Given the world averages of 1,648 cases per million and 72.8 deaths per million, Yemen’s record so far looks less hopeless than is acknowledged in the Western media.
And it is time to strike a note of hope, for — as measured by registered infection and mortality cases — the region as a whole has been far less devastated than much of the world. This needs some detailing.
If we take the nations bordering Yemen (Oman and Saudi Arabia) and those nations most proximate to the Arabian Desert (Jordan, Syria, Iraq, Kuwait and Bahrain), then these eight countries, containing some 138 million people, provide clear evidence of an emerging demographic and locational advantage over wealthy regions such as Europe or the US, with their much higher levels of contagion and mortality. At the time of writing, these two richest regions of our world have suffered about 6.5 million cases of COVID-19, with a mortality rate (deaths as a proportion of cases) of 5.8 percent, compared to a world average of 4.4 percent. Omitting the two richest continents, the mortality rate of the rest of the world is 2.9 percent — exactly half that of the rich nations.
This is a global statement that measures the difference (by and large) between rich and poor, suggesting that, presently, poor nations fare far better than rich nations in a stark COVID-19 world.
Our big data on the Arab Middle East reinforces this, but also points to the reasons behind what seems to be a counter-intuitive global trend. Given their superior incomes and health systems, their huge transport, medical and knowledge infrastructures, and their enormous governance, administration and policy systems, why do the rich do so badly?
At the time of writing, our eight nations had registered about 450,000 cases of COVID-19 since its arrival in Iraq, Kuwait, Oman and Bahrain in late February. In total, the group averages 38.2 deaths per million, about half the world average, and a mortality rate of 4.7 percent, which is about 80 percent of the world average. But there is much more to it than this.
Of the eight nations, the four poorest (Yemen, Iraq, Jordan and Syria) together have an average per capita income of $8,100 at purchasing power parity, compared to about $54,000 for the four wealthiest. This tremendous income disparity within the group aligns directly with the COVID-19 statistics: The poorest four nations average 19,538 cases and 22 deaths per million, compared to the richest four’s 92,676 cases and 54 deaths per million.
So, within this Middle Eastern group of eight nations, extreme poverty does not mean disaster in terms of COVID-19 cases or mortality; in fact, it means quite the opposite. The poorest nation of the group (Yemen, where we began), with its starvation-level per capita income of $2,600, has a deaths-per-million people figure of nine to 12, and it has hovered around that level for a month or more. Kuwait, the richest nation with an income per capita of $73,000, has 90 deaths per million people. Saudi Arabia is by far the largest nation of this group and it is the second richest; it has reported more than 230,000 cases and 63 deaths per million people.
These figures really do show a difference between rich and poor and lead to conclusions that seem far from global common sense. Rich, especially small and rich, nations should have a multitude of advantages in facing the COVID-19 invasion, from sheer income effects associated strongly with good food and health, to high levels of public expenditure on the miscellany of infrastructure that should have become weapons against virus attack. So, what is the explanation?
The key lies in age distributions. The poorest nations have the largest number of young people and the smallest numbers of older people in their populations. With increased incomes (especially when this is part of a transition from real poverty to reasonable sustenance), richer countries’ older folk eat better and live longer. The COVID-19 virus leaves young folk mostly unharmed, but does fasten on to the elderly, who are more likely to die of infection. As poor nations have far more young people and far fewer old people, then they also have far less infection and much less mortality.
This is measured precisely in the data for our eight nations. The four poorest have an average of more than 38 percent of their populations in the 0-14 age group, while the wealthier four have only 22 percent. This alone would explain most of the divergence in COVID-19 experience between them. At a global level, the 19 wealthy nations with the highest virus incidence and mortality have an average of only 18 percent of their populations in the 0-14 age group. Whereas the eight Middle Eastern nations have only 3.1 percent of their populations in the 65-plus age group, the same 19 richest nations have 17.6 percent of their population in that older group. This explains most of the COVID-19 differences between the eight nations and the richer nations of the world.
Extreme poverty does not mean disaster in terms of COVID-19 cases or mortality; in fact, it means quite the opposite.
Prof. Ian Inkster
Wealth and its associated institutions clearly do not compensate for this stark demographic factor. Thus, if we match the eight Middle East nations against the UN Human Development Index (HDI, where globally the highest nation on the index is rated 0.94 out of 1), then we find that our four poorest nations rank on average about 0.5 and our four wealthier nations rank about 0.8. The HDI is designed to capture income and social infrastructure in its ranking, and it now seems clear that, within these eight nations, a higher HDI ranking provides no insurance whatsoever against the COVID-19 virus.
The outcome of this statistical exercise is very hopeful, certainly optimistic. For the eight nations as a whole, relative lack of wealth and social infrastructures is being compensated for by the age distributions of their populations. This is a principal explanation of low incidence and mortality of COVID-19 in comparison to wealthy regions such as Europe and North America. But, within the group, the four poorest nations show the most exaggerated age distribution effects, and so shall probably weather the storm of COVID-19 marginally better than their wealthier neighbors.
- Prof. Ian Inkster is a global historian and political economist who has taught and researched at universities in Britain, Australia, Taiwan and Japan. His forthcoming books are “Distraction Capitalism: The World Since 1971,” and “Invasive Technology and Indigenous Frontiers: Case Studies of Accelerated Change in History,” with David Pretel.