ArticleThe International journal of health planning and management2021
The density paradox: Are densely-populated regions more vulnerable to Covid-19?
Article in The International journal of health planning and management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effects of the built environment and human factors on the spread of COVID-19: A systematic literature review.The Science of the total environment · 2022Pooled it
- No Place to Hide? Regional Resilience and Vulnerability to Global Catastrophic Risk.Global challenges (Hoboken, NJ) · 2026Review
- Epidemiological shifts in 23 acute infectious diseases in Southwest China (2005-2024): trends and implications for surveillance.BMC public health · 2025Article
- Epidemiological Survey of Enterovirus Infections in Taiwan From 2011 to 2020: Retrospective Study.JMIR public health and surveillance · 2024Article
- Transmission of SARS-CoV-2 among underserved pastoralist communities in Kajiado County, Kenya: 2020-2022.PloS one · 2024Article
- Article
- Impact of urbanisation and environmental factors on spatial distribution of COVID-19 cases during the early phase of epidemic in Singapore.Scientific reports · 2022Article
- Spatial disparities of self-reported COVID-19 cases and influencing factors in Wuhan, China.Sustainable cities and society · 2022Article
- The density paradox: Are densely-populated regions more vulnerable to Covid-19?The International journal of health planning and management · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The "density paradox" refers to the observation that some highly populated cities and countries have recorded a smaller number of Covid-19 cases than regions that are sparsely populated. We present empirical evidence on the role played by population density in spreading the coronavirus, based on cross-sectional data covering 172 countries (obtained from several sources, including the European Centre for Disease Prevention and Control, the World Bank and the Center for Health Security). The results, obtained by using the techniques of extreme bounds analysis (EBA) and variable addition tests, show that population density has a significantly positive effect on the number of cases but not the number of deaths, as the latter is better explained by measures of preparedness. Plausible explanations are presented for the results to conclude that the "density paradox" is not really a paradox. This paper makes a contribution by shedding more light on a frequently debated issue by using a completely different, and more robust, statistical techniques and by providing results that may be helpful for health and urban planners.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.