Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Drivers of COVID-19 policy stringency in 175 countries and territories: COVID-19 cases and deaths, gross domestic products per capita, and health expenditures
Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Jönköping University, Jönköping International Business School, JIBS, Statistics. Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.ORCID iD: 0000-0003-2733-4441
Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Show others and affiliations
2022 (English)In: Journal of Global Health, ISSN 2047-2978, E-ISSN 2047-2986, Vol. 12, article id 05049Article in journal (Other academic) Published
Sustainable development
Sustainable Development
Abstract [en]

Background: New data on COVID-19 may influence the stringency of containment policies, but these potential effect are not understood. We aimed to understand the associations of new COVID-19 cases and deaths with policy stringency globally and regionally.

Methods: We modelled the marginal effects of new COVID-19 cases and deaths on policy stringency (scored 0-100) in 175 countries and territories, adjusting for gross domestic product (GDP) per capita and health expenditure (% of GDP), and public expenditure on health. The time periods examined were March to August 2020, September 2020 to February 2021, and March to August 2021.

Results: Policy response to new cases and deaths was faster and more stringent early in the COVID-19 pandemic (March to August 2020) compared to subsequent periods. New deaths were more strongly associated with stringent policies than new cases. In an average week, one new death per 100 000 people was associated with a stringency increase of 2.1 units in the March to August 2020 period, 1.3 units in the September 2020 to February 2021 period, and 0.7 units in the March to August 2021 period. New deaths in Africa and the Western Pacific were associated with more stringency than in other regions. Higher health expenditure as a percentage of GDP was associated with less stringent policies. Similarly, higher public expenditure on health by governments was mostly associated with less stringency across all three periods. GDP per capita did not have consistent patterns of associations with stringency.

Conclusions: The stringency of COVID-19 policies was more strongly associated with new deaths than new cases. Our findings demonstrate the need for enhanced mortality surveillance to ensure policy alignment during health emergencies. Countries that invest less in health or have a lower public expenditure on health may be inclined to enact more stringent policies. This new empirical understanding of COVID-19 policy drivers can help public health officials anticipate and shape policy responses in future health emergencies.

Place, publisher, year, edition, pages
International Society of Global Health (ISoGH) , 2022. Vol. 12, article id 05049
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hj:diva-59279DOI: 10.7189/jogh.12.05049PubMedID: 36527269Scopus ID: 2-s2.0-85144586053Local ID: GOA;intsam;59279OAI: oai:DiVA.org:hj-59279DiVA, id: diva2:1723339
Available from: 2023-01-03 Created: 2023-01-03 Last updated: 2023-01-03Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records

Zeebari, Zangin

Search in DiVA

By author/editor
Zeebari, Zangin
By organisation
JIBS, Statistics
In the same journal
Journal of Global Health
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 43 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf