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Testing the socioeconomic determinants of COVID-19 pandemic hypothesis with aggregated Human Development Index
  1. Andreas Y Troumbis
  1. Correspondence to Professor Andreas Y Troumbis, Department of the Environment, University of the Aegean, Mytilene, Greece; atro{at}

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Khalatbari-Soltani et al 1 emphasised the need to complement WHO standard COVID-19 case reports with measures of socioeconomic position (SEP) factors of infected individuals. Their argument develops the idea that WHO’s clinical report is concentrated on age, gender, locations of diagnosis and residency, whereas additional factors of the social environment such as occupation, income or education might preventively uncover high-risk SEP disadvantaged individuals and populations. The importance of ‘non-medical’ data becoming ‘clinical’ predictors is extensively reviewed in the literature.2

Although currently infeasible to palliate backwards such data deficiencies at an individual level, this critical information gap might be indirectly approached through country-sensitive aggregated socioeconomic indexes as independent variables predicting cumulative COVID-19 official statistics (eg, total cases or total deaths per million). The yearly published aggregated Human Development Index (HDI) fits the needs of this …

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  • Contributors This letter is an attempt to indirectly test predictions of a paper to this journal, by Khalatbari-Soltani et al (2020), emphasising the need for SEP factors inclusion in standard WHO’s COVID-19 case reports. We introduce the idea of using UNDP/HDI as predictor of intercountry comparisons of public health performance. Results as is do not confirm the original hypothesis, alternative explanations are proposed. The final conclusion is however that the initial SEP hypothesis should be taken into consideration in the future.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.