Institutions and the uneven geography of the first wave of the COVID-19 pandemic.

Andrés Rodríguez‐Pose,Chiara Burlina

doi:10.1111/jors.12541

Abstract

This paper examines the uneven geography of COVID‐19‐related excess mortality during the first wave of the pandemic in Europe, before assessing the factors behind the geographical differences in impact. The analysis of 206 regions across 23 European countries reveals a distinct COVID‐19 geography. Excess deaths were concentrated in a limited number of regions—expected deaths exceeded 20% in just 16 regions—with more than 40% of the regions considered experiencing no excess mortality during the first 6 months of 2020. Highly connected regions, in colder and dryer climates, with high air pollution levels, and relatively poorly endowed health systems witnessed the highest incidence of excess mortality. Institutional factors also played an important role. The first wave hit regions with a combination of weak and declining formal institutional quality and fragile informal institutions hardest. Low and declining national government effectiveness, together with a limited capacity to reach out across societal divides, and a frequent tendency to meet with friends and family were powerful drivers of regional excess mortality.

Highlights

In the first half of 2020 most of Europe became ravaged by the deadliest pandemic since the 1918 Great Flu
In this paper we have aimed to address these shortcomings by examining the uneven regional geography of COVID-19 excess mortality in Europe and connecting it to the distinct variations in formal and informal institutions in evidence across the continent
The most ravaged regions of Europe by COVID-19 were those with a combination of weak and declining formal institutional quality and brittle informal institutions

Summary

Introduction

In the first half of 2020 most of Europe became ravaged by the deadliest pandemic since the 1918 Great Flu. In many other regions of Europe the incidence and lethality of COVID-19 was far lower In some regions, such as North Holland, excess mortality was concentrated around week 15 of the year, but more subdued than in other regions with a similar population size and density (Figure 4). Bridging social capital is at the heart of civic engagement (Putnam, 1993), which is of crucial importance for the acceptance by the population of the tough responses needed during a pandemic All these institutional factors have featured far less prominently than agglomeration, density, ageing, health readiness, climate, or pollution in COVID-19-related research. A greater habit of regularly meeting family and friends in celebrations could have been a factor driving up mortality in Mediterranean countries relative to the Nordics

Data and method

Findings

Analysis of results

Conclusions