scholarly journals Effect of COVID-19 on inequalities in premature mortality in England: an analysis of excess mortality by deprivation and ethnicity

2021 ◽  
Author(s):  
Sharmani Barnard ◽  
Paul Fryers ◽  
Justine Fitzpatrick ◽  
Sebastian Fox ◽  
Allan Baker ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Minority Groups ◽  
Premature Mortality ◽  
Direct And Indirect Effects ◽  
Ethnic Minority Groups ◽  
Death Registration ◽  
Registration Data ◽  
Expected Mortality ◽  
The Impact ◽  
Excess Deaths

Objectives: To examine the impact of the COVID-19 pandemic on inequalities in premature mortality in England by deprivation and ethnicity. Design: A statistical model to estimate increased mortality in population sub-groups during the COVID-19 pandemic by comparing observed with expected mortality in each group based on trends over the previous five years. Setting: Information on deaths registered in England since 2015 was used, including age, sex, area of residence, and cause of death. Ethnicity was obtained from Hospital Episode Statistics (HES) records linked to death registration data. Participants: Population study of England, including all 569,824 deaths from all causes registered between 21 March 2020 and 26 February 2021. Main outcome measures: Excess mortality in each sub-group over and above the number expected based on trends in mortality in that group over the previous five years. Results: The gradient in excess mortality by deprivation was greater in the under 75s (most deprived had 1.25 times as many deaths as expected, least deprived 1.14) than in all ages (most deprived had 1.24 times as many deaths as expected, least deprived 1.20). Among the Black and Asian groups, all deprivation quintiles had significantly larger excesses than the most deprived White group and there were no clear gradients across quintiles. Among the White group, only the most deprived had more excess deaths than deaths directly involving COVID-19. Among the Black group all deprivation quintiles experienced more excess deaths than deaths directly involving COVID-19. Conclusion: The COVID-19 pandemic has widened inequalities in premature mortality by deprivation. Among those under 75, the direct and indirect effects of the pandemic on deaths have disproportionately impacted ethnic minority groups irrespective of deprivation, and the most deprived White group. Statistics limited to deaths directly involving COVID-19 understate the pandemic's impact on inequalities by deprivation and ethnic group at younger ages.

scholarly journals Inequalities in excess premature mortality in England during the COVID-19 pandemic: a cross-sectional analysis of cumulative excess mortality by area deprivation and ethnicity

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052646
Author(s):  
Sharmani Barnard ◽  
Paul Fryers ◽  
Justine Fitzpatrick ◽  
Sebastian Fox ◽  
Zachary Waller ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Minority Groups ◽  
Premature Mortality ◽  
Area Deprivation ◽  
Cross Sectional ◽  
Expected Mortality ◽  
Sectional Analysis ◽  
The Impact ◽  
Death Data ◽  
Deprived Areas

ObjectivesTo examine magnitude of the impact of the COVID-19 pandemic on inequalities in premature mortality in England by deprivation and ethnicity.DesignA statistical model to estimate increased mortality in population subgroups during the COVID-19 pandemic by comparing observed with expected mortality in each group based on trends over the previous 5 years.SettingInformation on deaths registered in England since 2015 was used, including age, sex, area of residence and cause of death. Ethnicity was obtained from Hospital Episode Statistics records linked to death data.ParticipantsPopulation study of England, including all 569 824 deaths from all causes registered between 21 March 2020 and 26 February 2021.Main outcome measuresExcess mortality in each subgroup over and above the number expected based on trends in mortality in that group over the previous 5 years.ResultsThe gradient in excess mortality by area deprivation was greater in the under 75s (the most deprived areas had 1.25 times as many deaths as expected, least deprived 1.14) than in all ages (most deprived had 1.24 times as many deaths as expected, least deprived 1.20). Among the black and Asian groups, all area deprivation quintiles had significantly larger excesses than white groups in the most deprived quintiles and there were no clear gradients across quintiles. Among the white group, only those in the most deprived quintile had more excess deaths than deaths directly involving COVID-19.ConclusionThe COVID-19 pandemic has widened inequalities in premature mortality by area deprivation. Among those under 75, the direct and indirect effects of the pandemic on deaths have disproportionately impacted ethnic minority groups irrespective of area deprivation, and the white group the most deprived areas. Statistics limited to deaths directly involving COVID-19 understate the pandemic’s impact on inequalities by area deprivation and ethnic group at younger ages.

scholarly journals Human costs of the first wave of the COVID-19 pandemic in the major epicentres in Italy

2021 ◽  
Author(s):  
Simone Ghislandi ◽  
Raya Muttarak ◽  
Markus Sauerberg ◽  
Benedetta Scotti
Keyword(s):  
Life Expectancy ◽  
Excess Mortality ◽  
National Level ◽  
Death Registration ◽  
Substantial Impact ◽  
Registration Data ◽  
Life Expectancy At Birth ◽  
Human Costs ◽  
The Impact ◽  
Excess Deaths

Deaths from COVID-19 can be miscounted due to under-reporting and inaccurate death registration. Mortality is often reported at the national level, which can result in the underestimation of the true scale of the impact of the pandemic since outbreaks tend to be localised. This study exploits all-cause daily death registration data provided by the Italian Statistical Office (ISTAT) from 1 January to 31 October to estimate the excess mortality and the corresponding changes in life expectancy during the first wave of the COVID-19 pandemic. Focusing on the five most severely hit provinces in Italy (Bergamo, Brescia, Cremona, Lodi and Piacenza), we calculate the excess mortality in 2020 compared to the average mortality of the years 2015 to 2019. Moreover, we estimate the excess mortality in the first quadrimester of 2020, and the annual life expectancy at birth. The estimated excess deaths show that during this period, mortality was significantly higher than the official mortality statistics for COVID-19. According to our estimates for the first quadrimester, life expectancy in the five provinces declined by 5.4 to 8.1 for men and by 4.1 to 5.8 years for women. In addition, we find that annual life expectancy decreased by 2.4 to 4.1 years for men and by 1.9 to 2.8 years for women compared to the 2015–2019 average. Thus, we conclude that the first wave of the COVID-19 pandemic had a substantial impact on population health in the hardest hit areas in Italy.

scholarly journals Excess Deaths associated with the COVID-19 Pandemic in Ukraine in 2020

2021 ◽  
Author(s):  
Neil K. Mehta ◽  
Ihor Honchar ◽  
Olena Doroshenko ◽  
Igor Brovchenko ◽  
Khrystyna Pak ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Age Groups ◽  
European Countries ◽  
List Type ◽  
Younger Age ◽  
Influenza Activity ◽  
Expected Mortality ◽  
The Impact ◽  
Excess Deaths

AbstractCOVID-19 related mortality has been understudied in Ukraine. As part of a World Bank project, we estimated excess mortality in Ukraine during 2020. Data on all deaths registered in government-controlled Ukraine from 2016-2020 (N=2,946,505) were utilized. We predicted deaths in 2020 by five-year age groups, sex, and month and calculated the number of deaths that deviated from expected levels (excess deaths). We compared excess deaths with the number of recorded COVID-19 deaths on death certificates and with published estimates for 30 European countries. We estimated 38,095 excess deaths in 2020 (6% of all deaths). Death rates were above expected levels in February and from June-December and lower in January and March-May. From June-December, we estimated 52,124 excess deaths with a peak in November (16,891 deaths). COVID-19 recorded deaths were approximately one-third of excess deaths in June-December (18,959 vs. 52,124). Higher than expected mortality was detected for all age groups 40-44 years and above and for those ages 0-4, 15-19, and 20-24. Ukraine’s excess mortality was about average compared to 30 other European countries. Excess deaths may be attributed directly to SARS-COV2 infection or indirectly to death causes associated with social and economic upheavals resulting in from the pandemic. Lower than expected mortality during the early part of 2020 is consistent with low influenza activity and reductions in deaths from restricted movement. Further studies are required to examine the causes of death that have contributed to positive excess mortality, particularly among younger aged groups.Key MessagesUkraine has experienced sizeable changes in its recent demography and the impact of the COVID-19 pandemic on the country’s aggregate mortality patterns is understudiedBased on recent death trends, we found that Ukraine experienced lower than expected mortality during the early part of 2020 and consistently higher than expected mortality from June-December with peak levels occurring in NovemberPositive excess mortality was observed for all age groups beginning at ages 40-44 as well as some younger age groups.

scholarly journals Estimation of Excess Mortality and Years of Life Lost to COVID-19 in Norway and Sweden between March and November 2020

2021 ◽  
Vol 18 (8) ◽  
pp. 3913
Author(s):  
Martin Rypdal ◽  
Kristoffer Rypdal ◽  
Ola Løvsletten ◽  
Sigrunn Holbek Sørbye ◽  
Elinor Ytterstad ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Age Groups ◽  
Years Of Life Lost ◽  
Regressive Model ◽  
Epidemic Period ◽  
All Cause Mortality ◽  
Auto Regressive ◽  
Expected Mortality ◽  
Auto Regressive Model ◽  
Excess Deaths

We estimate the weekly excess all-cause mortality in Norway and Sweden, the years of life lost (YLL) attributed to COVID-19 in Sweden, and the significance of mortality displacement. We computed the expected mortality by taking into account the declining trend and the seasonality in mortality in the two countries over the past 20 years. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. We found that excess all-cause mortality over the epidemic year, July 2019 to July 2020, was 517 (95%CI = (12, 1074)) in Norway and 4329 [3331, 5325] in Sweden. There were 255 COVID-19 related deaths reported in Norway, and 5741 in Sweden, that year. During the epidemic period of 11 March–11 November, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. We estimated that the number of YLL attributed to COVID-19 in Sweden was 45,850 [13,915, 80,276] without adjusting for mortality displacement and 43,073 (12,160, 85,451) after adjusting for the displacement accounted for by the auto-regressive model. In conclusion, we find good agreement between officially recorded COVID-19 related deaths and all-cause excess deaths in both countries during the first epidemic wave and no significant mortality displacement that can explain those deaths.

scholarly journals Excess mortality in Guadeloupe and Martinique, islands of the French West Indies, during the chikungunya epidemic of 2014

2018 ◽  
Vol 146 (16) ◽  
pp. 2059-2065 ◽  
Author(s):  
A. R. R. Freitas ◽  
P. M. Alarcón-Elbal ◽  
M. R. Donalisio
Keyword(s):  
Strong Correlation ◽  
Excess Mortality ◽  
Pearson Correlation ◽  
Age Groups ◽  
Epidemiological Data ◽  
Mortality Data ◽  
Surveillance Systems ◽  
Mortality And Morbidity ◽  
The Impact ◽  
Excess Deaths

AbstractIn some chikungunya epidemics, deaths are not completely captured by traditional surveillance systems, which record case and death reports. We evaluated excess deaths associated with the 2014 chikungunya virus (CHIKV) epidemic in Guadeloupe and Martinique, Antilles. Population (784 097 inhabitants) and mortality data, estimated by sex and age, were accessed from the Institut National de la Statistique et des Études Économiques in France. Epidemiological data, cases, hospitalisations and deaths on CHIKV were obtained from the official epidemiological reports of the Cellule de Institut de Veille Sanitaire in France. Excess deaths were calculated as the difference between the expected and observed deaths for all age groups for each month in 2014 and 2015, considering the upper limit of 99% confidence interval. The Pearson correlation coefficient showed a strong correlation between monthly excess deaths and reported cases of chikungunya (R= 0.81,p< 0.005) and with a 1-month lag (R= 0.87,p< 0.001); and a strong correlation was also observed between monthly rates of hospitalisation for CHIKV and excess deaths with a delay of 1 month (R= 0.87,p< 0.0005). The peak of the epidemic occurred in the month with the highest mortality, returning to normal soon after the end of the CHIKV epidemic. There were excess deaths in almost all age groups, and excess mortality rate was higher among the elderly but was similar between male and female individuals. The overall mortality estimated in the current study (639 deaths) was about four times greater than that obtained through death declarations (160 deaths). Although the aetiological diagnosis of all deaths associated with CHIKV infection is not always possible, already well-known statistical tools can contribute to the evaluation of the impact of CHIKV on mortality and morbidity in the different age groups.

scholarly journals Excess mortality among the elderly in 12 European countries, February and March 2012

2012 ◽  
Vol 17 (14) ◽  
Author(s):  
A Mazick ◽  
B Gergonne ◽  
J Nielsen ◽  
F Wuillaume ◽  
M J Virtanen ◽  
...  
Keyword(s):  
Preliminary Data ◽  
Influenza A ◽  
Excess Mortality ◽  
The Elderly ◽  
European Countries ◽  
H3n2 Virus ◽  
All Cause Mortality ◽  
Cold Snap ◽  
The Impact ◽  
Excess Deaths

In February and March 2012, excess deaths among the elderly have been observed in 12 European countries that carry out weekly monitoring of all-cause mortality. These preliminary data indicate that the impact of influenza in Europe differs from the recent pandemic and post-pandemic seasons. The current excess mortality among the elderly may be related to the return of influenza A(H3N2) virus, potentially with added effects of a cold snap.

scholarly journals Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Ariel Karlinsky ◽  
Dmitry Kobak
Keyword(s):  
New Zealand ◽  
Excess Mortality ◽  
Mortality Data ◽  
Objective Indicator ◽  
Death Toll ◽  
The World ◽  
All Cause Mortality ◽  
Expected Mortality ◽  
The Impact ◽  
Annual Mortality

Comparing the impact of the COVID-19 pandemic between countries or across time is difficult because the reported numbers of cases and deaths can be strongly affected by testing capacity and reporting policy. Excess mortality, defined as the increase in all-cause mortality relative to the expected mortality, is widely considered as a more objective indicator of the COVID-19 death toll. However, there has been no global, frequently-updated repository of the all-cause mortality data across countries. To fill this gap, we have collected weekly, monthly, or quarterly all-cause mortality data from 94 countries and territories, openly available as the regularly-updated World Mortality Dataset. We used this dataset to compute the excess mortality in each country during the COVID-19 pandemic. We found that in several worst-affected countries (Peru, Ecuador, Bolivia, Mexico) the excess mortality was above 50% of the expected annual mortality. At the same time, in several other countries (Australia, New Zealand) mortality during the pandemic was below the usual level, presumably due to social distancing measures decreasing the non-COVID infectious mortality. Furthermore, we found that while many countries have been reporting the COVID-19 deaths very accurately, some countries have been substantially underreporting their COVID-19 deaths (e.g. Nicaragua, Russia, Uzbekistan), sometimes by two orders of magnitude (Tajikistan). Our results highlight the importance of open and rapid all-cause mortality reporting for pandemic monitoring.

scholarly journals Assessing the Impact of the Covid-19 Pandemic on US Mortality: A County-Level Analysis

2020 ◽  
Author(s):  
Andrew C Stokes ◽  
Dielle J Lundberg ◽  
Katherine Hempstead ◽  
Irma T Elo ◽  
Samuel H Preston
Keyword(s):  
Causes Of Death ◽  
Excess Mortality ◽  
Structural Characteristics ◽  
County Level ◽  
Structural Racism ◽  
All Cause Mortality ◽  
Black Residents ◽  
The Impact ◽  
Level Analysis ◽  
Excess Deaths

Covid-19 excess deaths refer to increases in mortality over what would normally have been expected in the absence of the Covid-19 pandemic. In this study, we take advantage of spatial variation in Covid-19 mortality across US counties to estimate its relationship with all-cause mortality. We then examine how the extent of excess mortality not assigned to Covid-19 varies across subsets of counties defined by demographic and structural characteristics. We estimate that 26.3% [95% CI, 20.1% to 32.5%] of excess deaths between February 1 and September 23, 2020 were ascribed to causes of death other than Covid-19 itself. Excess deaths not assigned to Covid-19 were even higher than predicted by our model in counties with high income inequality, low homeownership, and high percentages of Black residents, showing a pattern related to socioeconomic disadvantage and structural racism. The standard deviation of mortality across counties increased by 9.5% as a result of excess deaths directly assigned to Covid-19 and an additional 5.3% as a result of excess deaths not assigned to Covid-19. Our work suggests that inequities in excess deaths attributable to Covid-19 may be even greater than revealed by data reporting deaths assigned to Covid-19 alone.

Racial/Ethnic and Age Differences in the Direct and Indirect Effects of the COVID-19 Pandemic on US Mortality

2022 ◽  
Vol 112 (1) ◽  
pp. 154-164
Author(s):  
Lauren C. Zalla ◽  
Grace E. Mulholland ◽  
Lindsey M. Filiatreau ◽  
Jessie K. Edwards
Keyword(s):  
Public Health ◽  
Native Americans ◽  
Indirect Effects ◽  
Excess Mortality ◽  
The United States ◽  
Direct And Indirect Effects ◽  
Public Health Response ◽  
Health Response ◽  
Race Ethnicity ◽  
Expected Mortality

Objectives. To estimate the direct and indirect effects of the COVID-19 pandemic on overall, race/ethnicity‒specific, and age-specific mortality in 2020 in the United States. Methods. Using surveillance data, we modeled expected mortality, compared it to observed mortality, and estimated the share of “excess” mortality that was indirectly attributable to the pandemic versus directly attributed to COVID-19. We present absolute risks and proportions of total pandemic-related mortality, stratified by race/ethnicity and age. Results. We observed 16.6 excess deaths per 10 000 US population in 2020; 84% were directly attributed to COVID-19. The indirect effects of the pandemic accounted for 16% of excess mortality, with proportions as low as 0% among adults aged 85 years and older and more than 60% among those aged 15 to 44 years. Indirect causes accounted for a higher proportion of excess mortality among racially minoritized groups (e.g., 32% among Black Americans and 23% among Native Americans) compared with White Americans (11%). Conclusions. The effects of the COVID-19 pandemic on mortality and health disparities are underestimated when only deaths directly attributed to COVID-19 are considered. An equitable public health response to the pandemic should also consider its indirect effects on mortality. (Am J Public Health. 2022;112(1):154–164. https://doi.org/10.2105/AJPH.2021.306541 )

scholarly journals Excess Mortality in England during the 2019 Summer Heatwaves

Climate ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 14
Author(s):  
Natasha Rustemeyer ◽  
Mark Howells
Keyword(s):  
Public Health ◽  
United Kingdom ◽  
Excess Mortality ◽  
Summer Period ◽  
The Public ◽  
National Statistics ◽  
The United Kingdom ◽  
The Impact ◽  
Excess Deaths ◽  
Related Mortality

There is increasing evidence that rising temperatures and heatwaves in the United Kingdom are associated with an increase in heat-related mortality. However, the Public Health England (PHE) Heatwave mortality monitoring reports, which use provisional death registrations to estimate heat-related mortality in England during heatwaves, have not yet been evaluated. This study aims to retrospectively quantify the impact of heatwaves on mortality during the 2019 summer period using daily death occurrences. Second, using the same method, it quantifies the heat-related mortality for the 2018 and 2017 heatwave periods. Last, it compares the results to the estimated excess deaths for the same period in the PHE Heatwave mortality monitoring reports. The number of cumulative excess deaths during the summer 2019 heatwaves were minimal (161) and were substantially lower than during the summer 2018 heatwaves (1700 deaths) and summer 2017 heatwaves (1489 deaths). All findings were at variance with the PHE Heatwave mortality monitoring reports which estimated cumulative excess deaths to be 892, 863 and 778 during the heatwave periods of 2019, 2018 and 2017, respectively. Issues are identified in the use of provisional death registrations for mortality monitoring and the reduced reliability of the Office for National Statistics (ONS) daily death occurrences database before 2019. These findings may identify more reliable ways to monitor heat mortality during heatwaves in the future.

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