Income Inequality and Adverse COVID-19 Outcomes in US Counties

Abstract

This paper exploits US county-level variations in income inequality and a variety of demographic factors to test the empirical association between inequalities and COVID-19 health outcomes between January and December 2020. The results suggest that the distribution of income is a robust and statistically significant predictor of adverse health outcomes, which is consistent with the most recent literature. In addition, this paper argues that inequality ten years prior to the pandemic is a better predictor of confirmed cases and mortality, implying that causal pathways present with a lag. Furthermore, this effect is mitigated for counties that experienced a decrease in inequality and amplified for counties that have become more unequal, suggesting that public policy aimed at addressing inequality will directly and/or indirectly improve health outcomes, including for COVID-19.