scholarly journals EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN AND ITS MOST AFFECTED REGION

2020 ◽  
Author(s):  
Karin Modig ◽  
Anders Ahlbom ◽  
Marcus Ebeling
Keyword(s):  
Causes Of Death ◽  
Excess Mortality ◽  
National Level ◽  
Mortality Rates ◽  
Regional Level ◽  
Death Rates ◽  
Excess Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Age And Sex

Abstract Background Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic. Methods By estimating weekly age- and sex-specific death rates during 2020 and during the preceding five years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm. Results Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by less than 1 year for Sweden and 1.5 years for Stockholm compared to 2019. Conclusions The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.

scholarly journals EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN.

2020 ◽  
Author(s):  
Karin Modig ◽  
Marcus Ebeling
Keyword(s):  
Life Expectancy ◽  
Excess Mortality ◽  
Total Population ◽  
Total Mortality ◽  
Death Rates ◽  
Excess Death ◽  
Relative Risks ◽  
All Cause Mortality ◽  
The Difference ◽  
Age And Sex

Objectives: Mortality from Covid-19 is monitored in detail both within as well as between countries with different strategies against the virus. However, death counts and relative risks based on crude numbers can be misleading. Instead, age specific death rates should be used for comparability. Given the difficulty of ascertainment of Covid-19 specific deaths, excess all-cause mortality is currently more appropriate for comparisons. By estimating age- and sex-specific death rates we aim to get more accurate estimates of the excess mortality attributed to Covid-19, as well as the difference between men and women in Sweden. Design: We make use of Swedish register data about total weekly deaths, total population at risk, and estimate age- and sex-specific weekly death rates for 2020 and the 5 previous years. The data is provided by Statistics Sweden. Results: From the first week of April and onwards, the death rates at all ages above 60 are higher than those in previous years in Sweden. Persons above age 80 are dis-proportionally more affected, and men suffer higher levels of excess mortality than women at all ages with 75% higher death rates for males and 50% higher for females. Current excess mortality corresponds to a decline in remaining life expectancy of 3 years for men and 2 years for women. Conclusion: The Covid-19 pandemic has so far had a clear and consistent effect on total mortality in Sweden, with male death rates being comparably more affected. What consequences the pandemic will eventually have on mortality and life expectancy will depend on the progression of the pandemic, the extent that some of the deaths would have occurred in the absence of the pandemic, only somewhat later, the consequences for other health conditions, as well as the health care sector at large.

scholarly journals Geospatial Variability in Excess Death Rates during the COVID-19 Pandemic in Mexico: Examining Socio Demographic and Population Health Characteristics

2021 ◽  
Author(s):  
Sushma Dahal ◽  
Ruiyan Luo ◽  
Monica H Swahn ◽  
Gerardo Chowell
Keyword(s):  
Population Health ◽  
Excess Mortality ◽  
Health Indicators ◽  
Mortality Rates ◽  
Household Size ◽  
P Value ◽  
Death Rates ◽  
Excess Death ◽  
Average Household Size ◽  
Aging Index

Background: Mexico has suffered one of the highest COVID-19 mortality rates in the world. In this study we examined how socio-demographic and population health characteristics shape the geospatial variability in excess mortality patterns during the COVID-19 pandemic in Mexico. Methods: Weekly all-cause mortality time series for all 32 Mexican states, from January 4, 2015 to April 10, 2021, were analyzed to estimate the excess mortality rates using Serfling regression models. The association between socio-demographic, health indicators and excess mortality rates were determined using multiple linear regression analyses. Finally, we used functional data analysis to characterize clusters of states with distinct mortality growth rate curves. Results: The overall all-cause excess deaths rate during the COVID-19 pandemic in Mexico until April 10, 2021 was estimated at 39.66 per 10 000 population. The lowest excess death rates were observed in southeastern states including Chiapas (12.72), Oaxaca (13.42) and Quintana Roo (19.41) whereas Mexico City had the highest excess death rate (106.17), followed by Tlaxcala (51.99) and Morelos (45.90). We found a positive association of excess mortality rates with aging index (P value<.0001), marginalization index (P value<.0001), and average household size (P value=0.0003) in the final adjusted model (Model R2=76%). We identified four distinct clusters with qualitatively similar excess mortality curves. Conclusion: Central states exhibited the highest excess mortality rates whereas the distribution of aging index, marginalization index, and average household size explained the variability in excess mortality rates across Mexico. Our findings can help tailor interventions to mitigate the mortality impact of the pandemic.

scholarly journals A first analysis of excess mortality in Switzerland in 2020

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253505
Author(s):  
Isabella Locatelli ◽  
Valentin Rousson
Keyword(s):  
Life Expectancy ◽  
Excess Mortality ◽  
The Elderly ◽  
Mortality Rates ◽  
Loss Of Life ◽  
Key Indicator ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Standardized Mortality Rate ◽  
Official Data

Objective To quantify excess all-cause mortality in Switzerland in 2020, a key indicator for assessing direct and indirect consequences of the COVID-19 pandemic. Methods Using official data on deaths in Switzerland, all-cause mortality in 2020 was compared with that of previous years using directly standardized mortality rates, age- and sex-specific mortality rates, and life expectancy. Results The standardized mortality rate was 8.8% higher in 2020 than in 2019, returning to the level observed 5–6 years before, around the year 2015. This increase was greater for men (10.6%) than for women (7.2%) and was statistically significant only for men over 70 years of age, and for women over 75 years of age. The decrease in life expectancy in 2020 compared to 2019 was 0.7%, with a loss of 9.7 months for men and 5.3 months for women. Conclusions There was an excess mortality in Switzerland in 2020, linked to the COVID-19 pandemic. However, as this excess only concerned the elderly, the resulting loss of life expectancy was restricted to a few months, bringing the mortality level back to 2015.

Transformation of Mortality by Sex in the Four Biggest Cities in Ukraine

2021 ◽  
pp. 60-79
Author(s):  
N. O. RYNGACH ◽  
P. E. SHEVCHUK
Keyword(s):  
Heart Disease ◽  
Comparative Analysis ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Death Rates ◽  
Large Cities ◽  
Undetermined Intent ◽  
Specific Mortality

Large cities concentrate a substantial part of the educated, highly qualified, and economically active populations. Such social “selection” with the peculiarities of lifestyle determines the distinctive characteristics of the level and structure of mortality. Even though data on deaths by causes of death for the large cities are available in Ukraine, very few studies have analyzed cause-specific mortality in these cities. The objective of the study is to make a comparative analysis of mortality from the most influential causes of death in large cities. The novelty lies in the comparative analysis done for Dnipro, Kyiv, Lviv, Odesa, and Kharkiv for the first time. The study uses the direct method of standardization to calculate standardized death rates by sex in 2005-2019. The results indicate lower all-cause mortality rates for the large city residents compared to the corresponding average country-level indicators. Kyiv, Lviv, and Odesa have lower death rates compared to Dnipro and Kharkiv. In Kyiv and Lviv, this is attributed to lower mortality from almost all major causes of death, while in Odesa this mainly resulted from the extremely low ischemic heart disease mortality. Relatively high mortality from circulatory diseases is observed in Kharkiv and Dnipro. However, in Dnipro, this is associated with a high death rate from coronary heart disease and a very low contribution of cerebrovascular disease, whereas in Kharkiv coronary and cerebrovascular disease death rates are quite high. Mortality rates from diseases of the digestive system in the large cities are found to be the closest to the average in Ukraine (except for Lviv). The neoplasms are the only large group of diseases with a mortality rate that exceeds the average level in Ukraine, in particular for women. Overall, the death rates from most of the causes of death in the large cities demonstrated a positive trend in 2005-2019, with some exceptions. External causes and infectious diseases showed the most decrease while mortality from AIDS and ill-defined causes increased. Also, there were uncertain dynamics of deaths due to suicide and injuries with undetermined intent. Given some specific mortality differences between the cities, some concerns have been raised over the accuracy of the coding of diagnoses. In particular, unusually low mortality from ischemic heart disease was found in Odesa and from cerebrovascular disease in Dnipro, very rare deaths from alcoholic liver disease in Odesa, accidental alcohol poisoning in Kyiv, and a group of other liver diseases in Dnipro. We also assume misclassification of suicides as injuries with undetermined intent in Kharkiv. Our findings highlight the importance of the implementation of automated coding and selection of causes of death that can minimize the number of subjective decisions made by coders and lead to significant improvements in the quality of data.

scholarly journals Mortality in Norway and Sweden before and after the Covid-19 outbreak: a cohort study

2020 ◽  
Author(s):  
Frederik E Juul ◽  
Henriette C Jodal ◽  
Ishita Barua ◽  
Erle Refsum ◽  
Ørjan Olsvik ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Mortality Rates ◽  
List Type ◽  
School Closures ◽  
Epidemic Period ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Before And After ◽  
Rate Ratios ◽  
Expected Mortality

AbstractObjectivesNorway and Sweden are similar countries regarding ethnicity, socioeconomics and health care. To combat Covid-19, Norway implemented extensive measures such as school closures and lock-downs, while Sweden has been criticised for relaxed measures against Covid-19. We compared the effect of the different national strategies on all-cause and Covid-19 associated mortality.DesignRetrospective cohort.SettingThe countries Norway and Sweden.ParticipantsAll inhabitants.Main outcome measuresWe calculated weekly mortality rates (MR) with 95% confidence intervals (CI) per 100,000 individuals as well as mortality rate ratios (MRR) comparing the epidemic year (29th July, 2019 to 26th July, 2020) to the four preceding years (July 2015 to July 2019). We also compared Covid-19 associated deaths and mortality rates for the weeks of the epidemic in Norway and Sweden (16th March to 26th July, 2020).ResultsIn Norway, mortality rates were stable during the first three 12-month periods of 2015/16; 2016/17 and 2017/18 (MR 14.8 to 15.1 per 100,000), and slightly lower in the two most recent periods including during epidemic period (2018/19 and 2019/20; 14.5 per 100,000). In Sweden, all-cause mortality was stable during the first three 12-month periods of 2015/16; 2016/17 and 2017/18 (MR 17.2 to 17.5 per 100,000), but lower in the year 2018/19 immediately preceding the epidemic (16.2 per 100,000). Covid-19 associated mortality rates were 0.2 per 100,000 (95%CI 0.1 to 0.4) in Norway and 2.9 (95%CI 1.9 to 3.9) in Sweden. The increase in mortality was confined to individuals in 70 years or older.ConclusionsAll-cause mortality remained unaltered in Norway. In Sweden, the observed increase in all-cause mortality during Covid-19 was partly due to a lower than expected mortality preceding the epidemic and the observed excess mortality, was followed by a lower than expected mortality after the first Covid-19 wave. This may suggest mortality displacement.Strengths and limitations of this studyCompares two similar contries in all aspects but the handling of the Covid-19 epidemicEvaluates the mortality for several years before and during the epidemicProvides a possible explanation of the observed mortality changesDiscusses the socioeconomic effects of the different strategies in the two countriesDoes not evaluate cause-specific mortality

scholarly journals All-cause and cause-specific mortality during and following incarceration in Brazil: A retrospective cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (9) ◽  
pp. e1003789
Author(s):  
Yiran E. Liu ◽  
Everton Ferreira Lemos ◽  
Crhistinne Cavalheiro Maymone Gonçalves ◽  
Roberto Dias de Oliveira ◽  
Andrea da Silva Santos ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Communicable Diseases ◽  
Violent Death ◽  
Insufficient Data ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Over Time

Background Mortality during and after incarceration is poorly understood in low- and middle-income countries (LMICs). The need to address this knowledge gap is especially urgent in South America, which has the fastest growing prison population in the world. In Brazil, insufficient data have precluded our understanding of all-cause and cause-specific mortality during and after incarceration. Methods and findings We linked incarceration and mortality databases for the Brazilian state of Mato Grosso do Sul to obtain a retrospective cohort of 114,751 individuals with recent incarceration. Between January 1, 2009 and December 31, 2018, we identified 3,127 deaths of individuals with recent incarceration (705 in detention and 2,422 following release). We analyzed age-standardized, all-cause, and cause-specific mortality rates among individuals detained in different facility types and following release, compared to non-incarcerated residents. We additionally modeled mortality rates over time during and after incarceration for all causes of death, violence, or suicide. Deaths in custody were 2.2 times the number reported by the national prison administration (n = 317). Incarcerated men and boys experienced elevated mortality, compared with the non-incarcerated population, due to increased risk of death from violence, suicide, and communicable diseases, with the highest standardized incidence rate ratio (IRR) in semi-open prisons (2.4; 95% confidence interval [CI]: 2.0 to 2.8), police stations (3.1; 95% CI: 2.5 to 3.9), and youth detention (8.1; 95% CI: 5.9 to 10.8). Incarcerated women experienced increased mortality from suicide (IRR = 6.0, 95% CI: 1.2 to 17.7) and communicable diseases (IRR = 2.5, 95% CI: 1.1 to 5.0). Following release from prison, mortality was markedly elevated for men (IRR = 3.0; 95% CI: 2.8 to 3.1) and women (IRR = 2.4; 95% CI: 2.1 to 2.9). The risk of violent death and suicide was highest immediately post-release and declined over time; however, all-cause mortality remained elevated 8 years post-release. The limitations of this study include inability to establish causality, uncertain reliability of data during incarceration, and underestimation of mortality rates due to imperfect database linkage. Conclusions Incarcerated individuals in Brazil experienced increased mortality from violence, suicide, and communicable diseases. Mortality was heightened following release for all leading causes of death, with particularly high risk of early violent death and elevated all-cause mortality up to 8 years post-release. These disparities may have been underrecognized in Brazil due to underreporting and insufficient data.

scholarly journals Covid-19 and excess mortality rates not comparable across countries

2021 ◽  
Author(s):  
Gabrielle E Kelly ◽  
Stefano Petti ◽  
Norman Noah
Keyword(s):  
Excess Mortality ◽  
Spatial Clustering ◽  
Mortality Rates ◽  
Mortality Data ◽  
Published Data ◽  
Death Rates ◽  
Government Response ◽  
Health Measures ◽  
Specific Mortality ◽  
Excess Deaths

Abstract: Evidence that more people in some countries and fewer in others are dying because of the pandemic, than is reflected by reported Covid-19 mortality rates, is derived from mortality data. Worldwide, mortality data is used to estimate the full extent of the effects of the Covid-19 pandemic, both direct and indirect; the possible short fall in the number of cases reported to the WHO; and to suggest explanations for differences between countries. Excess mortality data is largely varying across countries and is not directly proportional to Covid-19 mortality. Using publicly available databases, deaths attributed to Covid-19 in 2020 and all deaths for the years 2015-2020 were tabulated for 36 countries together with economic, health, demographic, and government response stringency index variables. Residual death rates in 2020 were calculated as excess deaths minus death rates due to Covid-19 where excess deaths were observed deaths in 2020 minus the average for 2015-2019. For about half the countries, residual deaths were negative and for half, positive. The absolute rates in some countries were double those in others. In a regression analysis, the stringency index (p=0.026) was positively associated with residual mortality. There was no evidence of spatial clustering of residual mortality. The results show that published data on mortality from Covid-19 cannot be directly comparable across countries, likely due to differences in Covid-19 death reporting. In addition, the unprecedented public health measures implemented to control the pandemic may have produced either increased or reduced excess deaths due to other diseases. Further data on cause-specific mortality is required to determine the extent to which residual mortality represents non-Covid-19 deaths and to explain differences between countries.

scholarly journals Longitudinal variability in mortality predicts Covid-19 deaths

2020 ◽  
Author(s):  
Jon O. Lundberg ◽  
Hugo Zeberg
Keyword(s):  
Population Density ◽  
Excess Mortality ◽  
Viral Disease ◽  
Mortality Rates ◽  
European Countries ◽  
Death Rates ◽  
All Cause Mortality ◽  
Current Outbreak ◽  
Longitudinal Variability ◽  
Influenza Vaccinations

AbstractWithin Europe, death rates due to covid-19 vary greatly, with some countries being hardly hit while others to date are almost unaffected. It would be of interest to pinpoint the factors that determine a country’s susceptibility to a pandemic such as covid-19.Here we present data demonstrating that mortality due to covid-19 in a given country could have been largely predicted even before the pandemic hit Europe, simply by looking at longitudinal variability of all-cause mortality rates in the years preceding the current outbreak. The variability in death rates during the influenza seasons of 2015-2019 correlate to excess mortality caused by covid-19 in 2020 (R2=0.48, p<0.0001). In contrast, we found no correlation between such excess mortality and age, population density, degree of urbanization, latitude, GNP, governmental health spendings or rates of influenza vaccinations.These data may be of some relevance when discussing the effectiveness of acute measures in order to limit the spread of the disease and ultimately deaths. They suggest that in some European countries there is an intrinsic susceptibility to fatal respiratory viral disease including covid-19; a susceptibility that was evident long before the arrival of the current pandemic.

Mortality by Causes of Death in Metropolices of Ukraine

2021 ◽  
pp. 38-59
Author(s):  
N. M. LEVCHUK ◽  
P. E. SHEVCHUK
Keyword(s):  
Heart Disease ◽  
Comparative Analysis ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Death Rates ◽  
Large Cities ◽  
Undetermined Intent ◽  
Specific Mortality

Large cities concentrate a substantial part of the educated, highly qualified, and economically active populations. Such social “selection” with the peculiarities of lifestyle determines the distinctive characteristics of the level and structure of mortality. Even though data on deaths by causes of death for the large cities are available in Ukraine, very few studies have analyzed cause-specific mortality in these cities. The objective of the study is to make a comparative analysis of mortality from the most influential causes of death in large cities. The novelty lies in the comparative analysis done for Dnipro, Kyiv, Lviv, Odesa, and Kharkiv for the first time. The study uses the direct method of standardization to calculate standardized death rates by sex in 2005-2019. The results indicate lower all-cause mortality rates for the large city residents compared to the corresponding average country-level indicators. Kyiv, Lviv, and Odesa have lower death rates compared to Dnipro and Kharkiv. In Kyiv and Lviv, this is attributed to lower mortality from almost all major causes of death, while in Odesa this mainly resulted from the extremely low ischemic heart disease mortality. Relatively high mortality from circulatory diseases is observed in Kharkiv and Dnipro. However, in Dnipro, this is associated with a high death rate from coronary heart disease and a very low contribution of cerebrovascular disease, whereas in Kharkiv coronary and cerebrovascular disease death rates are quite high. Mortality rates from diseases of the digestive system in the large cities are found to be the closest to the average in Ukraine (except for Lviv). The neoplasms are the only large group of diseases with a mortality rate that exceeds the average level in Ukraine, in particular for women. Overall, the death rates from most of the causes of death in the large cities demonstrated a positive trend in 2005-2019, with some exceptions. External causes and infectious diseases showed the most decrease while mortality from AIDS and ill-defined causes increased. Also, there were uncertain dynamics of deaths due to suicide and injuries with undetermined intent. Given some specific mortality differences between the cities, some concerns have been raised over the accuracy of the coding of diagnoses. In particular, unusually low mortality from ischemic heart disease was found in Odesa and from cerebrovascular disease in Dnipro, very rare deaths from alcoholic liver disease in Odesa, accidental alcohol poisoning in Kyiv, and a group of other liver diseases in Dnipro. We also assume misclassification of suicides as injuries with undetermined intent in Kharkiv. Our findings highlight the importance of the implementation of automated coding and selection of causes of death that can minimize the number of subjective decisions made by coders and lead to significant improvements in the quality of data.

scholarly journals Excess mortality in the United States in the 21st century

2021 ◽  
Vol 118 (16) ◽  
pp. e2024850118
Author(s):  
Samuel H. Preston ◽  
Yana C. Vierboom
Keyword(s):  
United States ◽  
Excess Mortality ◽  
The United States ◽  
Mortality Rates ◽  
Years Of Life Lost ◽  
Death Rates ◽  
Loss Of Life ◽  
The Us ◽  
Specific Mortality ◽  
Excess Deaths

We use three indexes to identify how age-specific mortality rates in the United States compare to those in a composite of five large European countries since 2000. First, we examine the ratio of age-specific death rates in the United States to those in Europe. These show a sharp deterioration in the US position since 2000. Applying European age-specific death rates in 2017 to the US population, we then show that adverse mortality conditions in the United States resulted in 400,700 excess deaths that year. Finally, we show that these excess deaths entailed a loss of 13.0 My of life. In 2017, excess deaths and years of life lost in the United States represent a larger annual loss of life than that associated with the COVID-19 epidemic in 2020.

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