The widespread and exponential growth of Covid-19 in “advanced” countries compared to “developing” counties contradicts the conventional literature on social determinants of health (henceforth, SHD) such as income, life expectancy, health system, governance among others. This article quantitively explores the association between cases and deaths of COVID-19 and SHD; using available country-level data of the pandemic until 6 May 2020. It highlights two different narratives to explain the breakout of the pandemic in the “advanced” counties: The first one assumes major shortcomings in the conventional analytical framework that led to a failure of capturing key determinants of health; while the second one assumes, that the SHD framework is still valid, thus it is a matter of time to witness the second wave of COVID-19 that will hit mainly the “developing” countries.   


The conventional consensus in the literature on SDH refers to the role of wealth, living conditions, equality, inclusive and effective institutions, and social integration in better health outcomes; an efficient and just health system plays an intermediate role in preventing, protecting, and caring for the morbidity burden (WHO, 2008). In the case of a pandemic, Lowcock et al. (2012) concluded that SDH (namely less education and poor material conditions) are key factors that were associated with severe pandemic H1N1 in 2009.[1] Bloom and Canning concluded that prosperous societies have better health during and better protection against epidemics. They suggested that the prevention of epidemics is possible through improving health systems by investing in necessary health infrastructure, having strong quarantine measures ready to be employed to prevent an incipient epidemic, and preparation for a comprehensive mobilization of actors and resources to counter the epidemic consequences. However, they highlighted a key political obstacle as the politicians “are often influenced by short-term political considerations, causing them to pay too little heed to important longer-term realities” (Bloom and Canning, 2006).

Furthermore, Madhav and others pointed to the progress that….. To continue reading this article please Navigate to Website by clicking here.

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