Better to be rich and healthy than poor and sick: Francis Blanche’s sentence, even spoken with a smile, has taken on the appearance of a saying. Could the actor have imagined that a few decades later, a nasty virus would give his joke the seriousness of a scientific result? Four French economists have indeed shown that the Covid-19 kills first, and particularly importantly, the most modest. By combining mortality data, municipal income and deconfinement areas, they highlight, for the first time, through a systematic study, the excess mortality caused by the epidemic in the municipalities with the lowest income. . His work has just been made public, in prepublication, on the HAL open archive site.
It is by listening to a radio column suggesting that the Covid-19 strongly resembled “a disease of the poor” that the four labor economists, from the Paris School of Economics (PSE), from the Study Center Employment and Labor and the Norwegian School of Economics, were bitten to the quick. “There had been studies in several countries showing the overrepresentation of minorities among the sick, but nothing systematic on wealth inequalities, underlines Simon Briole, researcher at PSE and at the European branch of J-PAL, the laboratory of Nobel Prize winner Esther Duflo specializing in the fight against poverty. However, in France, INSEE provides exceptional statistical data, unique in the world, which should enable us to provide proof. ”
It was still necessary to choose the right data. To study the impact of the disease, the test results – notoriously insufficient in France – could not be adequate. Not even the deaths attributed to the coronavirus, which may ignore the presence of the virus in some dead, especially those who did not go through the hospital. On the other hand, INSEE provides raw mortality data every week at the municipal level, and more particularly the excess mortality in 2020 compared to 2018 and 2019. “It is this data that we crossed with the median income of each municipality located in urban area”, says Simon Briole.
Dazzling difference
Their result is spectacular. On the one hand, three quarters of the municipalities of French territory, considered to be the richest, experience an average excess of mortality, due to Covid-19, of 50% for the year 2020. On the other, in the quarter of the poorest municipalities, it reaches 88%. “We wondered if the excess mortality could not come from other causes, in particular confinement”, says the researcher. He and his colleagues therefore compared the results in areas with low circulation of the virus – the famous green areas of deconfinement – and in the most infected areas (red). The difference has again appeared striking: in the green areas, which have nevertheless experienced seven weeks of strict confinement, the rich and poor municipalities are recording a limited and close excess mortality. Conversely, in the red zones, the tribute paid by the poor is incomparably higher.
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