A QU Study Reveals the Hidden Impact of Income Inequality during the COVID-19 Pandemic in the Middle East

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A recent study conducted by the Department of Public Health at Qatar University (QU)'s College of Health Sciences (CHS), in collaboration with the University of Newcastle, UK, has revealed important insights into the relationship between income inequality and the impact of the COVID-19 pandemic in the Eastern Mediterranean Region (EMR). The study, which was recently published in the British Medical Journal of Global Health (BMJ), is the first of its kind in the region, and confirms a significant link between pre-existing income inequality and the observed increase in cases and deaths caused by the pandemic.

Researchers studied COVID-19 in 22 Eastern Mediterranean countries from March 2020 to October 2021, gathering monthly case and death data from Worldometer, the European Centre for Disease Control (ECDC), and the World Bank, totaling 16,638,061 cases and 306,907 deaths. To understand income inequality, the researchers used the Gini coefficient, a tool used to measure income or wealth inequality in a society, on a scale from 0 to 100. A coefficient of 0 indicates perfect equality, where everyone has the same income. Conversely, a coefficient of 100 signifies extreme inequality, where one person possesses all the wealth or income, leaving others with nothing. Using the Gini coefficient, the researchers explored income inequality's link to COVID-19 outcomes, revealing significant disparities.

Dr. Fasih Alam, Associate Professor from the Department of Public Health at the College of Health Sciences, who is at the forefront of this study, provided insights, stating, "Socioeconomic disparities are evident across many EMR countries. The COVID-19 pandemic has worsened existing social, economic, and geographic inequities, leading to higher infection and fatality rates in communities with greater income inequality. With ongoing conflicts and disparities, healthcare systems in the region faced significant challenges during the pandemic. Addressing socioeconomic inequalities is crucial, especially during such crises, as highlighted by the study."

The study showed a consistent association between income inequality and COVID-19 outcomes, even excluding conflict zones. Notably, Yemen's low death rate contrasted with Tunisia's high rate, influenced by factors like testing limitations and poverty. The Gini coefficient ranged from 26.0 in the UAE and Qatar to 45.9 in Saudi Arabia, indicating varying levels of income inequality across EMR countries, with Qatar having a lower coefficient.
Dean of the College of Health Sciences at QU, and co-author of the study, Dr. Hanan Abdulrahim, shared, "COVID-19 has worsened existing health inequities in our region. With healthcare systems already strained by conflicts and economic challenges, addressing these disparities is not only morally crucial but also a wise investment for the future. By targeting interventions towards vulnerable populations, we can build more resilient systems to tackle future crises."

Socio-economic disparities reveal government systems are not fully prepared for tackling health disasters like pandemics. As quoted by the international collaborator of the study, Prof. John Wildman, "Our research highlights the critical need to address socioeconomic inequalities. These disparities impact communities' readiness to cope with major crises, including global pandemics. Vulnerable populations and fragile systems leave governments unprepared for the challenges faced by the world, particularly in the Eastern Mediterranean region."
Key Findings and Implications:

• Socioeconomic Disparities: The study emphasizes the vulnerability of disadvantaged groups during the pandemic, linking income inequality to failures in critical social and public infrastructure, including education, transportation, and healthcare.

• Expatriate Population: Eastern Mediterranean countries, including those in the GCC region, have a notable expatriate population. This group may face challenges accessing healthcare, which may have contributed to the higher vulnerability of certain communities during the pandemic.

• Impact of Income Inequality: The research identifies a substantial and statistically significant association between higher income inequality and increased COVID-19 cases and deaths, even after considering confounding factors like war, conflicts, life expectancy at birth, GDP per capita, and the prevalence of diabetes.

• Global Relevance: The findings align with global evidence, showcasing that regions with persistent income inequality, such as the Middle East, experience heightened vulnerability during health crises. The study underscores the importance of addressing socioeconomic disparities and strengthening healthcare systems for an effective pandemic response.

The study suggests targeted interventions in areas with high income inequalities to combat pandemics effectively. For Qatar and the EMR, tailored interventions are vital to assist vulnerable populations and enhance public health resilience. Policymakers should prioritize support for vulnerable communities and bolster public health systems. Despite limitations such as testing disparities and data availability during vaccination, the study underscores the urgent need to address income inequality in the Middle East for better pandemic management. Understanding the link between economic disparities and COVID-19 is crucial for developing interventions, improving healthcare access, and ensuring a fair recovery for all.

For further information, please contact Dr. Mohammed Fasihul Alam, Associate Professor, Department of Public Health, College of Health Sciences, QU Health, at [email protected].

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