• Last updated: Wed, Dec 10, 2025 Status: Published   Read paper
• European Journal of Epidemiology, October 2025
• Olof Östergren, Emelie Counil, Arizo Karimi, Tove Fall, Jonas Björk, and Karl Gauffin

Who got tested and who got sick? Sociodemographic inequalities in COVID-19 testing and hospitalization among 1.48 million individuals in Sweden

Groups with lower socioeconomic status have suffered disproportionately from severe Covid-19. However, more cases were detected among individuals in higher socioeconomic positions. These seemingly conflicting observations are in part attributed to differences in testing behavior; individuals in lower socioeconomic positions in Sweden had lower testing rates and higher positivity rates compared to those in higher positions.

The propensity to get tested can depend on several things. Some factors may motivate the individual to get tested while others can make the individual more likely to avoid taking a test. Here, we use register data to identify potential individual and structural factors that may influence testing behavior and evaluate if these contribute to socioeconomic differences in testing behavior.

Key interventions, such as isolation and contact tracing rely on detection and if individuals do not get tested, these measures cannot be applied. Determinants of testing behavior can therefore provide important insight for mitigating the spread of future pandemics, especially in early phases where vaccines are unlikely to be widely available.