COVID-19 and the city: Did urbanized countries suffer more fatalities?

Wim Naudé; Paula Nagler

doi:10.1016/j.cities.2022.103909

COVID-19 and the city: Did urbanized countries suffer more fatalities?

Cities. 2022 Dec:131:103909. doi: 10.1016/j.cities.2022.103909. Epub 2022 Aug 8.

Authors

Wim Naudé^{1

2}, Paula Nagler³

Affiliations

¹ Department of Economics, University College Cork, Ireland.
² RWTH Aachen University, Germany.
³ Institute for Housing and Urban Development Studies, Erasmus University Rotterdam, the Netherlands.

Abstract

In this paper we derive a theoretical model of the spread of a viral infection which we use as basis for an estimation strategy to test four interrelated hypotheses on the relationship between country-level COVID-19 mortality rates and the extent of urban development. Using data covering 81 countries we find evidence that countries with a higher population density, a higher share of the urban population living in the largest city, and countries with a higher urbanization rate had on average the same or fewer COVID-19 fatalities compared to less urbanized countries in 2020. Even though COVID-19 spreads faster in cities, fatalities may be lower, conditional on economic development, trust in government, and a well-functioning health care system. Generally, urbanization and city development are associated with economic development: with the resources urbanized countries have, it is easier for them to manage and maintain stricter lockdowns, and to roll out effective pharmaceutical interventions.

Keywords: COVID-19; Demographics; Health; Pandemics; Urbanization.