Estimated impact of the 2020 economic downturn on under-5 mortality for 129 countries.

Alison Gemmill,David M. Bishai,Wen-Wei Sung,Marcelo Cardona,Joseph Millward,Katelyn Jison Yoo

doi:10.1371/journal.pone.0263245

Abstract

In low- and middle-income countries (LMICs), economic downturns can lead to increased child mortality by affecting dietary, environmental, and care-seeking factors. This study estimates the potential loss of life in children under five years old attributable to economic downturns in 2020. We used a multi-level, mixed effects model to estimate the relationship between gross domestic product (GDP) per capita and under-5 mortality rates (U5MRs) specific to each of 129 LMICs. Public data were retrieved from the World Bank World Development Indicators database and the United Nations World Populations Prospects estimates for the years 1990-2020. Country-specific regression coefficients on the relationship between child mortality and GDP were used to estimate the impact on U5MR of reductions in GDP per capita of 5%, 10%, and 15%. A 5% reduction in GDP per capita in 2020 was estimated to cause an additional 282,996 deaths in children under 5 in 2020. At 10% and 15%, recessions led to higher losses of under-5 lives, increasing to 585,802 and 911,026 additional deaths, respectively. Nearly half of all the potential under-5 lives lost in LMICs were estimated to occur in Sub-Saharan Africa. Because most of these deaths will likely be due to nutrition and environmental factors amenable to intervention, countries should ensure continued investments in food supplementation, growth monitoring, and comprehensive primary health care to mitigate potential burdens.

Highlights

Economic downturns have occurred in almost all countries as a result of COVID-19
Because Eq 1 might omit other factors that are closely related to changes in the under-5 mortality rate, we extend our model presented in Eq 1 to include other country-specific factors that could affect the relationship between gross domestic product (GDP) and under-5 mortality rates (U5MRs), as shown in Eq 2 below: logU5mrj;t 1⁄4 aj þ b1;jlogGDPj;t þ b2Zj;t þ b3Hj;t þ j;t ð2Þ
The results from fitting models of U5MR and GDP for each country are shown in S3–S5 Appendices

Summary

Introduction

Economic downturns have occurred in almost all countries as a result of COVID-19. We know from prior research that these economic downturns have a disproportionate effect on child health and mortality in low- and middle-income countries (but not high-income countries) and that these effects are likely independent of whether or not children acquire COVID19 disease. Impact of the economic downturn on under-5 mortality.

Methods

Results

Conclusion