head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2024, vol. 30, issue1
Subject Area:Public Health
DOI: 10.5272/jimab.2024301.5375
Published online: 16 February 2024

Original article
J of IMAB. 2024 Jan-Mar;30(1):5375-5380
Dima TsanovaORCID logoCorresponding Autoremail, Eleonora Mineva-DimitrovaORCID logo, Borislava IvanovaORCID logo,
Department of Social Medicine and Health Management, Faculty of Public Health, Medical University – Pleven, Bulgaria.

Purpose: The study aims to analyze regional health and socioeconomic inequalities in Bulgaria.
Methods: An ecological epidemiological study was conducted. The 28 regions in Bulgaria were compared according to death rates due to COVID-19, the share of people 65+, availability of physicians, hospital beds for active and intensive care per 10,000 people, and the average annual salary of employed people /2021/. Data were statistically processed with SPSS v.26, the Pearson coefficient was used.
Results: The death rates due to COVID-19 in Bulgaria vary widely, and the regions with the highest rates in 2021 are Kyustendil /642.440/0000/, Vidin /591.150/0000/, Montana /533.980/0000/, Gabrovo /533.480/0000/ and Vratsa /531.900/0000/. All five regions have ageing rates higher than the national average of the availability of physicians per population - lower than the average, respectively 36.60/0000, 35.50/0000, 34.90/0000, 37.60/0000 and 38.10/0000. Among the areas with high levels of death rates, Vidin stands out with very low availability of hospital beds for active and intensive treatment - 37.80/0000, but Gabrovo and Montana have higher. A moderate correlation was found between the death rate due to COVID-19 and the ageing of the population, but for other factors, no correlation was established.
Conclusions: Reducing regional health inequalities in Bulgaria is one of the possible ways to control and reduce the death rate in the country, especially due to COVID-19.

Keywords: inequalities, COVID-19, Bulgaria, ageing, hospital care,

pdf - Download FULL TEXT /PDF 1345 KB/
Please cite this article as: Tsanova D, Mineva-Dimitrova E, Ivanova B. COVID-19 and Regional Health Inequalities in Bulgaria. J of IMAB. 2024 Jan-Mar;30(1):5375-5380. [Crossref - 10.5272/jimab.2024301.5375]

Corresponding AutorCorrespondence to: Dima Tsanova, Department of Social Medicine and Health Management, Faculty of Public Health, Medical University – Pleven; 1, Sv. Kliment Ohridski Str. 5800 Pleven, Bulgaria; E-mail: dima.tsanova@mu-pleven.bg

1. Executive summary. World Inequalities Report 2022. [Internet]
2. Balabanova D, McKee M. Access to health care in a system transition: the case of Bulgaria. Int J Health Plann Manage. 2002 Oct-Dec;17(4):377-95. [PubMed]
3 Bulgaria. Health Inequalities portal. [Internet]
4. Satariano WA. Poverty, Inequality, and Health: An International Perspective. Am J Epidemiol. 2001 Sep 15;154(6):588–589. [Crossref]
5. Capper B, Ford J, Kelly M. Has the pandemic resulted in a renewed and improved focus on heath inequalities in England? A discourse analysis of the framing of health inequalities in national policy. Public Health Pract (Oxf). 2023 Apr 6;5:100382. [ PubMed ]
6. A deadly virus: 5 shocking facts about global extreme inequality. OXFAM Int. 12 Jan 2017. [Internet]
7. Keim-Klärner S, Adebahr P, Brandt S, Gamper M, Klärner A, Knabe A, et al. Social inequality, social networks, and health: a scoping review of research on health inequalities from a social network perspective. Int J Equity Health. 2023 Apr 25;22(1):74. [PubMed]
8. Health inequities and their causes. WHO. Feb 22, 2018. [Internet]
9. Kostov L. Inequalities and political populism: The case of Bulgaria. SEER. 2020; 2:233-244. [Crossref]
10. Gonchev V. [Inequalities in health care - problems in the European Union and Bulgaria.] [in Bulgarian] Scientific works of the University of Ruse. 2013; 52(series 8.3):37-41. [Internet]
11. Tolchkov V. [Demographic consequences caused by the COVID pandemic in Bulgaria.] [in Bulgarian]  Medical Management and Health Policy. 2022; 53(1):30-31. [Internet]
12. Rohova M, Atanasova E, Dimova A. [Socioeconomic health inequalities in the use of health services in Bulgaria.] [in Bulgarian] Varna Medical Forum. 2017; 6(1):184-190. [Crossref]
13. Popivanov P. [Inequalities and injustices in health and health costs in Bulgaria.] [in Bulgarian] General Medicine. 2014; 16(1):9-19.  [Internet]
14. Death rate, crude (per 1,000 people). The World Bank. 2022. [Internet]
15. Population by statistical regions, age, place of residence and sex. NSI. 31.12.2022. [Internet]
16. care. A brief statistical guide '23. in Bulgarian NCPHA. Sofia, 2023. [Internet]

Received: 26 July 2023
Published online: 16 February 2024

back to Online Journal