Economic inequality and corruption as social determinants of health: An empirical analysis across 136 countries (2001–2020)

This study examines the compounded effects of corruption and economic inequality on public health outcomes across 136 countries from 2001 to 2020. By employing panel regression analysis with fixed effects on data from Transparency International's Corruption Perceptions Index, the World Inequality Database's post-tax income Gini coefficient, and health indicators from the World Bank, the study reveals that corruption and inequality independently worsen health outcomes. More importantly, their interaction exacerbates these effects, highlighting a structural synergy that restricts access to essential health resources and disproportionately harms already vulnerable populations. The findings indicate that this compounded impact is most severe in low- and lower-middle-income countries, where systemic governance failures intersect with structural inequities to undermine health systems. Robustness checks using alternative health indicators and econometric methods strengthen the validity of the conclusions. By emphasizing the systemic interplay between governance and economic structures, this study challenges reductionist approaches to public health that overlook broader structural determinants. The results underscore the urgent need for integrated policy interventions targeting both corruption and inequality to mitigate health disparities and advance global health equity. These findings call for a global rethinking of governance and economic priorities in addressing structural health inequities. • Corruption amplifies economic inequality's harm on global health outcomes. • Combined deprivation worsens infant mortality and lowers life expectancy. • Interaction of corruption and inequality significantly impacts health indicators. • Fixed-effects regression reveals corruption exacerbates inequality's health effects. • Findings stress tackling corruption and inequality to improve public health.