Impact of Economic Factor, Percent Vaccination, Healthcare Quality, and Population Density on Coronavirus Disease 2019 (COVID-19) Mortality Rates: A Global Analysis in 2023

The coronavirus disease 2019(COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), emerged as a global health crisis in late 2019, triggering unprecedented government actions worldwide. COVID-19 mortality varied based on many factors, with this study focusing on socioeconomic status and healthcare quality across 95 countries. Countries were classified by gross national income (GNI) per capita into high-income (HI), upper-middle-income (UMI), lower-middle-income (LMI), and low-income (LI) countries. Data were collected from databases in 2023, including gross domestic product (GDP) per capita, percent vaccination, infant mortality rate (IMR), and population density. The findings revealed that HI and UMI countries experienced significantly higher mortality rates compared to LMI and LI groups. Economic status, measured by GDP per capita, demonstrated a strong negative correlation with mortality in HI countries (Spearman's <i>r</i>=-0.562; <i>p</i><0.001) but a strong positive correlation in LMI countries (Spearman's <i>r</i>=0.629; <i>p</i>=0.002). Vaccination coverage showed a significant strong negative correlation with mortality in HI countries (Spearman's <i>r</i>=-0.551; <i>p</i><0.001), underscoring the importance of widespread vaccination in reducing mortality. IMR exhibited a very strong negative correlation with mortality in LMI countries (Spearman's <i>r</i>=-0.704; <i>p</i><0.001), an unexpected finding warranting further investigation. No such correlation was observed in other groups. Population density showed no significant impact on mortality rates across all income groups (<i>p</i>≥0.05). These results highlight the importance of economic resources and vaccination efforts in reducing COVID-19 mortality, while population density showed no impact. Our research provides insights to guide future public health responses.