Research articles
ScienceAsia 47 (2021): 211-219 |doi:
10.2306/scienceasia1513-1874.2021.031
Association between COVID-19 incidence and outcome
and national development levels: An ecologic analysis
Chunbao Moa,?, Xiaoting Mob,?, Tingyu Maic,?, Jiansheng Caib, Xia Xub, Chuntao Nongb,
Dechan Tanc, Shuzhen Liub, Min Xub, Huaxiang Lub, Tingyu Luoc, You Lic, Jian Qinb,?,
Zhiyong Zhangb,c,*
ABSTRACT: This study aimed to evaluate the association between COVID-19 incidence and outcome and national
development level. Spearman correlation analysis method was performed to analyze the relationship between COVID-
19 incidence, mortality, and recovery rates as of 27 August 2020 and Human Development Index (HDI) and Inequalityadjusted Human Development Index (IHDI) from 177 countries. The pandemic situation varied obviously from country
to country, and the most cases mainly concentrated in few countries with very high or high HDI, such as United
States and Brazil. The incidence rates of COVID-19 were significantly positively correlated with HDI and IHDI, but the
correlation among mortality, recovery rates, HDI, and IHDI were not significant. In the stratified analysis, the incidence
rate in countries with low IHDI and the recovery rate in countries with medium IHDI were significantly positively
correlated with IHDI. In countries with very high HDI, the mortality rate was significantly positively correlated with
HDI. The findings provide new insights into the relationship between COVID-19 and social determinants of health
and inspire policy makers to adjust prevention and control strategies for reducing damages caused by this epidemic.
Nevertheless, long-term observation and follow-up studies are necessary to be implemented continuously in the future.
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| a |
Department of Pathophysiology, Faculty of Basic Medical Sciences, Guilin Medical University, Guilin
541004 China |
| b |
Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical
University, Nanning 530021 China |
| c |
Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin
Medical University, Guilin 541004 China |
* Corresponding author, E-mail: qinjian@gxmu.edu.cn, rpazz@163.com
Received 22 Oct 2020, Accepted 3 Feb 2021
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