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 36.60/000, 35.50/000, 34.90/000, 37.60/000 and 38.10/000. Among the areas with high levels of death rates, Vidin stands out with very low availability of hospital beds for active and intensive treatment - 37.8 0/000, 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.
