Net effect of wealth on health for COVID-19 – worldwide state comparison
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health economics
health economic threshold
joinpoint regression
net effect of affluence
regional studies

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Żółtaszek, A., & Olejnik, A. (2024). Net effect of wealth on health for COVID-19 – worldwide state comparison. Rozwój Regionalny I Polityka Regionalna, 18(68), 157–171.


The wealth-health relationship is not unambiguous and constant. Indeed, a higher level of wealth affects individual and population health in two opposite ways. Increased risk factors raise the probability of some diseases. Conversely, better healthcare and awareness reduce the chances of developing these diseases or raise the likelihood of treatment and cure. Therefore, the overall impact on health or the “net effect” of wealth (positive or negative) may be challenging to determine. Moreover, this effect may not be fixed for different income groups. Thus, it states to reason that there may exist an “affluence point” changing the predominant impact of wealth (positive/negative), which we will refer to as the “health economic threshold”.

This paper aims to assess and quantify the hard-to-grasp overall impact of prosperity on the prevalence and mortality of COVID-19. In particular, we attempt to estimate both the net effect of affluence and the health economic threshold by applying a dedicated analytical tool and problem-specific forecasting methods. Namely, we employ the existing idea of joinpoint regression to produce a specification that models the relationship between GDP and prevalence or mortality which is allowed to exhibit non-constant monotonicity. Finally, we calculate the numerical value of the net effect of affluence through extrapolation.

Our results show that for COVID-19 morbidity and mortality, up to a certain level of GDP, the richer the country, the higher the prevalence. After exceeding this threshold, the number of cases stabilises at a very high level, while mortality decreases along with the prosperity of countries. It turned out that the countries of Western and Northern Europe used their wealth effectively, significantly reducing mortality. Unfortunately, in CEE the net effect of wealth was insignificant. Therefore, even with relatively high levels of prosperity compared to the rest of the world, governments and health systems have not risen to the challenge.
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Bilal M., Khan M.I., Nazir M.S., Ahmed I., Iqbal H.M.N. 2020. Coronaviruses and ­COVID-19 – Complications and Lessons Learned for the Future. Journal of Pure and Applied Microbiology,14 (suppl 1): 725-731. DOI:

Danaei G., Singh G.M., Paciorek K.J., Lin J.K., Cowan M.J., Finucane M.M., Farzadfa F., Stevens G.A., Riley L.M., Lu, Y., Rao M., Ezzati M. 2013. The Global Cardiovascular Risk Transition: Associations of Four Metabolic Risk Factors with Macroeconomic Variables in 1980 and 2008. Circulation, 127: 1493-1502. DOI:

Dyvesether S., Nordentoft M., Forman J., Erlangsen A. 2018. Joinpoint regression analysis of suicides in Denmark during 1980-2015. Danish Medical Journal, 65(4): 1-5.

Eurostat Database (; accessed: 15.02.2021).

Farrell C. 2010. Mental Disorders. ABDO Publishing Company, North Mankato, Minnesota.

Hinkley D.V. 1971. Inference in Two-Phase Regression. Journal of the American Statistical Association, 66(336): 736-743. DOI:

Kampmark B. 2020. The pandemic surveillance state: an enduring legacy of ­COVID-19. Journal of Global Faultlines, 7, 1: 59-70. DOI:

Kim D., Chen Z., Zhou L-F., Huang S-X. 2018. Air pollutants and early origins of respiratory diseases. Chronic Diseases and Translational Medicine, 4: 75-94. DOI:

Labarthe D. 2010. Epidemiology and Prevention of Cardiovascular Diseases: A Global Challenge. Jones & Bartlett Publishers, Sundbury, Massachusetts.

Li Z., Chen Y., Yang B., Song H., Chen W., Zhou H. 2021. Successful recovery of a patient with multiple myeloma from severe coronavirus disease 2019 (COVID-19) pneumonia during the first chemotherapy cycle: A case report. Experimental and Therapeutic Medicine, 4: 392. DOI:

Link K. 2007. Understanding New, Resurgent, and Resistant Diseases: How Man and Globalization Create and Spread Illness. Greenwood Publishing Group, Westport, London.

Manzoor S., Rehman R.A., Ijaz S., Paracha S., Rakha A. 2020. Novel coronavirus (2019-NCOV) outbreak: a mini review. Biomedica, 36 (COVID19-S2): 110-113. DOI:

Mohamadi M., Fattahi N., Goodarzi A., Alizadeh-Khoei M., Miri S., Hekmat H., Bodaghabadi M., Nikkhah F.A. 2021. Comprehensive Review on ­COVID-19 Infection and Comorbidities of Various Organs. Acta Med. Iran., 59(1): 4-14. DOI:

Offer A. 2006. The Challenge of Affluence: Self-Control and Well-Being in the United States and Britain Since 1950. Oxford University Press, Oxford.

Olejnik A., Żółtaszek A. 2023. The net effect of wealth on health – Investigating noncommunicable diseases mortality in the context of regional affluence. PLoS ONE, 18(11): e0293887. DOI:

Read J.M., Bridgen J.R.E., Cummings D.A.T., Ho A., Jewell C.P. 2021. Novel coronavirus 2019-nCoV (COVID-19): early estimation of epidemiological parameters and epidemic size estimates. Phil. Trans. R. Soc. B, 376: 20200265. DOI:

Rendana M., Idris W.M.R., Abdul Rahim S. 2021. Spatial distribution of ­COVID-19 cases, epidemic spread rate, spatial pattern, and its correlation with meteorological factors during the first to the second waves. Journal of Infection and Public Health, 14(10): 1340-1348. DOI:

Smeester L., Yosim A.E., Fry R.C. 2015. Chemical hazards, from: Routledge Handbook of Water and Health. Routledge.

The World Bank Data (; accessed: 1.07.2021).

Tomescu-Dumitrescu C., Mihai E.A. 2020. Statistical Analysis Of The Situation Determined By COVID 19 In Romania. Annals – Economy Series, Constantin Brancusi University, Faculty of Economics, 3: 5-12.

Vanitallie T.B. 2002. Stress: A risk factor for serious illness. Metabolism, 51, 6, B: 40-45. DOI:

WHO Coronavirus (COVID-19) Dashboard (; accessed: 1.07.2021).

WHO ­COVID-19 policy briefs (; accessed: 22.10.2022).

WHO. 2020. Estimating mortality from ­COVID-19. Scientific brief (; accessed: 22.10.2022).

WHO Factsheet for World Mental Health Day 2018. Regional Office for Europe. 2018. (; accessed: 2.11.2019).

WHO Factsheet: Mental health: Fact sheet. Regional Office for Europe. 2019 (; accessed: 2.11.2019).

WHO Report: Global action plan for the prevention and control of non-communicable diseases 2013-2020. 2013. World Health Organization, Geneva.

WHO Report: Climate change and human health: risks and responses. 2003 (; accessed: 2.11.2019).

WHO Report: Improving mental health through integration with NCD management and prevention. Regional Office for Europe. 2019 (; accessed: 2.11.2019).

WHO. Unknown author. 2010. The weight of affluence. Bulletin of the World Health Organization, 88(2): 86-87. World Health Organization. DOI:

Wolf J., Prüss-Ustün A., Ivanov I., Mudgal S., Corvalán C., Bos R. et al. 2018. Preventing disease through a healthier and safer workplace. World Health Organization, Geneva.