Health resilience and the global pandemic: The effect of social conditions on the COVID-19 mortality rate

Can ‘health resilience’ explain international differences in COVID-19 mortality? This paper aims to understand the significant diversity in mortality rates between countries in terms of their degree of preparedness for the crisis and the underlying health conditions of the population. We integrate COVID-19 data from the first year of the pandemic with panel data from 2009 to 2017 for 188 countries around the world in order to investigate international variation in COVID-19 mortality rates. Country-level data on health, medical, social and policy variables are compared with COVID-19 mortality rates, with further controls imposed to adjust for infection rate, population and health spending. The results show that prior health conditions, social deprivation and the demography of the country all have significant effects on the mortality rates associated with the virus. The evidence also suggests that countries with higher levels of health-related policy targets demonstrated lower levels of mortality during the crisis. Finally, we confirm that social habits such as smoking, alcohol consumption and over-eating create a highly vulnerable group of individuals who were exposed to a greater risk of mortality during the outbreak.