No clear association emerges between intergenerational relationships and COVID-19 fatality rates from macro-level analyses

Abstract

The severe acute respiratory syndrome coronavirus 2 originated in Wuhan, China at the end of 2019 and rapidly spread in more than 100 countries. Researchers in different fields have been working on finding explanations for the unequal impact of the virus and deaths from the associated coronavirus disease 2019 (COVID-19) across geographical areas. Demographers and other social scientists have hinted at the importance of demographic factors, such as age structure and intergenerational relationships. Our aim is to reflect on the possible link between intergenerational relationships and spread and lethality of COVID-19 in a critical way. We show that with available aggregate data it is not possible to draw robust evidence to support these links. In fact, despite a higher prevalence of intergenerational coresidence and contacts that is broadly positively associated with COVID-19 case fatality rates at the country level, the opposite is generally true at the subnational level. While this inconsistent evidence demonstrates neither the existence nor the absence of a causal link between intergenerational relationships and the severity of COVID-19, we warn against simplistic interpretations of the available data, which suffer from many shortcomings. We conclude by arguing that intergenerational relationships are not only about physical contacts between family members. Theoretically, different forms of intergenerational relationships may have causal effects of opposite sign on the diffusion of COVID-19. Policies should also take into account that intergenerational ties are a source of instrumental and emotional support, which may favor compliance to the lockdown and "phase-2" restrictions and may buffer their negative consequences on mental health.

Keywords: COVID-19; coresidence; coronavirus; intergenerational contacts; intergenerational relationships.