Institute of Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians University Munich, Munich, Germany.
PLoS One. 2021 May 13;16(5):e0251366. doi: 10.1371/journal.pone.0251366. eCollection 2021.
It is of interest to explore the variability in how the COVID-19 pandemic evolved geographically during the first twelve months. To this end, we apply inequality indices over regions to incidences, infection related mortality, and infection fatality rates. If avoiding of inequality in health is an important political goal, a metric must be implemented to track geographical inequality over time.
The relative and absolute Gini index as well as the Theil index are used to quantify inequality. Data are taken from international data bases. Absolute counts are transformed to rates adjusted for population size.
Comparing continents, the absolute Gini index shows an unfavorable development in four continents since February 2020. In contrast, the relative Gini as well as the Theil index support the interpretation of less inequality between European countries compared to other continents. Infection fatality rates within the EU as well as within the U.S. express comparable improvement towards more equality (as measured by both Gini indices).
The use of inequality indices to monitor changes in geographic inequality over time for key health indicators is a valuable tool to inform public health policies. The absolute and relative Gini index behave complementary and should be reported simultaneously in order to gain a meta-perspective on very complex dynamics.
探索 COVID-19 大流行在最初 12 个月期间在地理上的变化方式很有意义。为此，我们在各地区应用不平等指数来评估发病率、与感染相关的死亡率和感染病死率。如果避免健康方面的不平等是一个重要的政治目标，那么必须实施一种指标来跟踪随时间推移的地理不平等。
使用相对基尼系数和绝对基尼系数以及 Theil 指数来量化不平等。数据取自国际数据库。绝对计数转换为按人口规模调整后的比率。
从大陆层面比较，自 2020 年 2 月以来，四个大陆的绝对基尼系数显示出不利的发展。相比之下，相对基尼系数和 Theil 指数支持这样的解释，即与其他大陆相比，欧洲国家之间的不平等程度较低。欧盟和美国内部的感染病死率都朝着更加平等（用基尼系数衡量）的方向表达了类似的改善。
使用不平等指数来监测关键健康指标的地理不平等随时间的变化是为公共卫生政策提供信息的一个有价值的工具。绝对基尼系数和相对基尼系数具有互补性，应同时报告，以便从更复杂的动态中获得元视角。
