How COVID has deepened inequality — in six stark graphics

Troubling data show how the pandemic has exacted an unequal toll, pushing tens of millions into poverty and having the greatest effects on already-disadvantaged groups.

Women wearing face masks and holding pots wait in a socially distanced queue on steps overlooking a slum neighbourhood in Lima

Credit: Ernesto Benavides/AFP/Getty

Credit: Ernesto Benavides/AFP/Getty

The shock waves of the COVID-19 pandemic have reverberated throughout the world. But the latest data reveal that the burden of COVID and its aftermath does not rest equally.

In six graphics, Nature details how the pandemic has worsened existing inequalities and exposed others in terms of income, health, safety and more.

The global picture

Aerial view of an informal settlement and an affluent suburban neighbourhood separated by a road in South Africa

Credit: Martin Harvey/Getty

Credit: Martin Harvey/Getty

The past two years have been particularly challenging for the world’s poorest people, and this is just the beginning. By the end of this year, at least 75 million more people will have been pushed into poverty (living on less than US$1.90 a day) than was expected before the pandemic. The war in Ukraine and rising inflation have exacerbated the effects of the pandemic, as prices for food, fuel and nearly everything else have skyrocketed.

Researchers at the World Bank have estimated how the number of people in poverty has changed over the past few years, assuming that everyone’s income rose and fell in proportion with the variation in income of an average person in their country. ‘Baseline’ estimates assume that inflation affects all demographics equally, whereas the pessimistic projections reflect the expectation that inflation will affect the lowest earners most.

In 2022, up to 677 million people could be living in extreme poverty — almost 100 million more than without the combined crises of the pandemic, inflation and the war in Ukraine.

Almost 500 million of these people could be in sub-Saharan Africa.

Projections for regions such as East Asia and the Pacific are lower — although there are not enough data to analyse poverty in some areas, such as South Asia.

Recovery is projected to take longer in the Middle East and North Africa than in many other regions.

As households adapt to higher prices, the number of people living in poverty could go down. However, if food prices continue to rise, poverty might deepen before it improves.

Source: World Bank

Another data set from the World Bank reveals how the people with the lowest incomes have had the largest financial losses. Using changes in gross domestic product as a proxy, researchers estimated how much income people have lost and how much they’ve recovered, compared with what they would have earnt had there been no pandemic. The results show that although people at all income levels lost money, the highest earners regained more than half their losses between 2020 and 2021, whereas the lowest earners have not recouped their losses compared with expected increases in earnings.

Researchers estimate that in 2021, the average incomes of people in the bottom 20% of earners were 6.7% lower than projected before the pandemic.

The situation is similar for earners in the second quintile.

Earners in the third quintile saw greater recovery, making only 5.1% less than they would have without the pandemic.

The incomes of earners in the fourth quintile are bouncing back even more quickly.

And the highest 20% of earners are doing best of all, making only 2.6% less than they would have without the pandemic.

Source: World Bank

Watch a video version of this story.

Uneven tolls

Mourners carry the coffin of a member of the Standing Rock Sioux Tribe who died after contracting COVID-19

Credit: Richard Tsong-Taatarii/Star Tribune/Getty

Credit: Richard Tsong-Taatarii/Star Tribune/Getty

In addition to causing economic shocks, COVID-19 has had unequal effects on people’s health. Data from the US Centers for Disease Control and Prevention show that death rates in the United States have been particularly high in Indigenous people: the rate is about 108% higher than that for white people and about 180% more than that for people of Asian descent. These data are age-adjusted, a statistical correction that allows for fair comparisons between demographics with different age distributions.

COVID-19 death rates vary by race and ethnicity in a US data set. The rate in Indigenous groups is double that for the white population, for instance.

Source: CDC

The state of an individual’s health often correlates with factors such as employment and housing. People living in areas that lack basic necessities such as adequate housing or education often have worse health than do those living in regions that have these essentials. The same relationship holds true for COVID-19, as a UK analysis shows. Epidemiologist William Palmer at the UK health think tank Nuffield Trust in London used data from the Office for National Statistics and the Office for Health Improvement and Disparities to compare death rates from COVID-19 and other health conditions against the Indices of Multiple Deprivation, which measure how deprived an area is on the basis of factors such as average income, employment rate, education level and crime rate.

At the peak of the first wave of COVID-19, between March and July 2020, the death rate in areas of England that scored highest for deprivation was double that of the least-deprived regions. Similar degrees of disparity were seen for some other conditions.

In England in 2020, the COVID-19 death rate in the most deprived areas was double that in the most affluent.

Sources: UK Office for National Statistics; Office for Health Improvement and Disparities

Social risk factors

Commuters wearing face masks ride the a packed bus in Rio de Janeiro, Brazil, during a COVID-19 outbreak

Credit: Andre Coelho/Bloomberg/Getty

Credit: Andre Coelho/Bloomberg/Getty

Researchers in various countries have devised other ways to measure the risk of disease in different groups. Looking at Brazil, economist Luiza Nassif Pires at the Levy Economics Institute of Bard College in Annandale-on-Hudson, New York, and her colleagues assigned each state (indicated by a dot in the graphic) a social risk factor based on metrics such as how many people own cars — alleviating the need to use public transportation — and how many live in crowded conditions. Residents of states with higher risk factors were less able to socially distance themselves. Just before the peak of the pandemic’s first wave in 2020. The team found that people in areas with higher risk factors contracted and died from COVID-19 at higher rates than did those in areas with lower scores.

The risk of catching and dying from COVID-19 correlates with social vulnerability in Brazil.

To calculate vulnerability, researchers looked at factors such as how readily people in different states could socially distance or whether they owned their own car.

Source: Levy Economics Institute of Bard College Annandale-on-Hudson

The pandemic has also had an unequal effect on other public-health problems, exacerbating violence against women, for instance.

Across 13 low- and middle-income countries, 45% of women surveyed by the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women) say that they or a woman they know has experienced violence during the pandemic. Violence can be physical, such as hitting or throwing an object at someone; verbal, such as yelling; and it can involve denying basic needs such as food or health care; or involve sexual harassment.

This graphic shows the proportion of women who think that violence against women has increased in their community since the pandemic began. The researchers surveyed at least 1,200 women in each country using phone interviews. Because they were not able to travel or have direct contact while doing the surveys, the researchers cannot compare their results directly with studies done before the pandemic.

A survey of thousands of women in 13 lower- and middle-income countries suggests that violence against women increased during the pandemic.

Source: UN Women

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