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 ◽  
...  

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.

2021 ◽  
Author(s):  
Sharmani Barnard ◽  
Paul Fryers ◽  
Justine Fitzpatrick ◽  
Sebastian Fox ◽  
Allan Baker ◽  
...  

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.


Author(s):  
Xueli Wei ◽  
Lijing Li ◽  
Fan Zhang

Pumping elephantThe COVID-19 pandemic has adversely affected the lives of people around the world in millions of ways . Due to this severe epidemic, all countries in the world have been affected by all aspects, mainly economic. It is widely discussed that the COVID-19 outbreak has affected the world economy. When considering this dimension, this study aims to examine the impact of the COVID-19 pandemic on the world economy, socio-economics, and sustainability. In addition, the research focuses on multiple aspects of social well-being during the pandemic, such as employment, poverty, the status of women, food security, and global trade. To this end, the study used time series and cross-sectional analysis of the data. The second-hand data used in this study comes from the websites of major international organizations. From the analysis of secondary data, the conclusion of this article is that the impact of the pandemic is huge. The main finding of the thesis is that the social economy is affected by the pandemic, causing huge losses in terms of economic well-being and social capital.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alex F. Martin ◽  
Sarah Denford ◽  
Nicola Love ◽  
Derren Ready ◽  
Isabel Oliver ◽  
...  

Abstract Background In December 2020, Public Health England with NHS Test and Trace initiated a pilot study in which close contacts of people with confirmed COVID-19 were given the option to carryout lateral flow device antigen tests at home, as an alternative to self-isolation for 10–14 days. In this study, we evaluated engagement with daily testing, and assessed levels of adherence to the rules relating to behaviour following positive or negative test results. Methods We conducted a service evaluation of the pilot study, examining survey responses from a subset of those who responded to an evaluation questionnaire. We used an online cross-sectional survey offered to adult contacts of confirmed COVID-19 cases who consented to daily testing. We used a comparison group of contacts who were not offered testing and instead self-isolated. Results Acceptability of daily testing was lower among survey respondents who were not offered the option of testing and among people from ethnic minority groups. Overall, 52% of respondents reported being more likely to share details of people that they had been in contact with following a positive test result, if they knew that their contacts would be offered the option of daily testing. Only 2% reported that they would be less likely to provide details of their contacts. On the days that they were trying to self-isolate, 19% of participants reported that they left the house, with no significant group differences. Following a negative test, 13% of respondents reported that they increased their contacts, but most (58%) reported having fewer risky contacts. Conclusions Our data suggest that daily testing is potentially acceptable, may facilitate sharing contact details of close contacts among those who test positive for COVID-19, and promote adherence to self-isolation. A better understanding is needed of how to make this option more acceptable for all households. The impact of receiving a negative test on behaviour remains a risk that needs to be monitored and mitigated by appropriate messaging. Future research should examine attitudes and behaviour in a context where infection levels are lower, testing is more familiar, and restrictions on activity have been reduced.


2014 ◽  
Vol 35 (4) ◽  
pp. 305-315 ◽  
Author(s):  
Panagiotis Gkorezis ◽  
Eugenia Petridou ◽  
Panteleimon Xanthiakos

Purpose – Leader-member exchange (LMX) has been proposed as a core mechanism which accounts for the impact of various antecedents on employee outcomes. As such, the purpose of this paper is to examine the mediating effect of LMX regarding the relationship between leader positive humor and employees’ perceptions of organizational cynicism. Design/methodology/approach – Data were collected from 114 public employees. In order to examine the authors’ hypotheses hierarchical regression analysis was conducted. Findings – As hypothesized, results demonstrated that LMX mediates the relationship between leader positive humor and organizational cynicism. Research limitations/implications – Data were drawn from public employees and, therefore, this may constrain the generalizability of the results. Also, the cross-sectional analysis of the data cannot directly assess causality. Originality/value – This is the first empirical study to examine the mediating effect of LMX in the relationship between leader humor and employees’ perceptions of organizational cynicism.


2018 ◽  
Author(s):  
Tyler S. Jones ◽  
Deborah Rupert

Medical student wellbeing is a topic of growing concern. Medical students experience high levels of stress and burnout and are at increased risk for depression and suicidal ideation compared to the general population. Even more concerning, medical students are disproportionately less likely to seek help for their mental health issues. Identifying and preventing these problems early can have lasting positive consequences over the course of a physician’s lifetime. We implemented a wellness program at our medical school in the spring of 2016 with the goals of decreasing burnout and depression, heightening awareness of mental health issues, and encouraging help-seeking behaviors. To analyze the impact of our program, we have implemented a quality assurance survey. Here we report lifestyle factors associated with positive screens for depression from that data and propose institutional initiatives that can be spearheaded by medical students for medical students to impact positive change.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028553 ◽  
Author(s):  
Florian Schederecker ◽  
Christoph Kurz ◽  
Jon Fairburn ◽  
Werner Maier

ObjectivesThis study aimed to assess the impact of using different weighting procedures for the German Index of Multiple Deprivation (GIMD) investigating their link to mortality rates.Design and settingIn addition to the original (normative) weighting of the GIMD domains, four alternative weighting approaches were applied: equal weighting, linear regression, maximization algorithm and factor analysis. Correlation analyses to quantify the association between the differently weighted GIMD versions and mortality based on district-level official data from Germany in 2010 were applied (n=412 districts).Outcome measuresTotal mortality (all age groups) and premature mortality (<65 years).ResultsAll correlations of the GIMD versions with both total and premature mortality were highly significant (p<0.001). The comparison of these associations using Williams’s t-test for paired correlations showed significant differences, which proved to be small in respect to absolute values of Spearman’s rho (total mortality: between 0.535 and 0.615; premature mortality: between 0.699 and 0.832).ConclusionsThe association between area deprivation and mortality proved to be stable, regardless of different weighting of the GIMD domains. The theory-based weighting of the GIMD should be maintained, due to the stability of the GIMD scores and the relationship to mortality.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029066
Author(s):  
Laure Lacoin ◽  
Michael Hurst ◽  
Nathan R Hill ◽  
Jason Gordon ◽  
Anna Maria Geretti ◽  
...  

ObjectiveTo evaluate the impact of treatment with new direct-acting antivirals (DAAs) on the prevalent hepatitis C virus (HCV) population in England.DesignA repeated cross-sectional analysis.SettingFour secondary care hospitals in England.ParticipantsPatients who, in 2015 and/or 2016, had chronic HCV infection and were alive were eligible, regardless of the type of HCV intervention received.Outcome measuresData including intravenous drug use (IVDU) status, HCV genotype, cirrhosis status, HCV treatment history, vital status and treatment outcomes were collected at two time points in 2015 and 2016 using electronic case report forms.ResultsThere were 1605 and 1355 patients with active chronic HCV in 2015 and 2016, respectively. Between 2015 and 2016, the proportion of patients with current IVDU increased (10.3% vs 14.5%, respectively), while that of patients with cirrhosis (28.2% vs 22.4%) and treatment-experienced patients (31.2% vs 27.1%) decreased. Among patients whose treatment outcome was known by 2016, high cure rates were observed, with an overall sustained virological response rate of 93.2%. From 2015 to 2016, there was a progressive increase in the proportion of treated patients who were non-cirrhotic, with current IVDU and non-liver transplant recipients.ConclusionsThe characteristics of patients with HCV remaining in contact with specialised care evolved with a changing landscape of treatment and related health policy. With increasing access to DAAs in UK, high cure rates were achieved in the study cohort.


2020 ◽  
Vol 1 ◽  
Author(s):  
Benjamin Greiner ◽  
Abraham Lee ◽  
Jake Checketts ◽  
Micah Hartwell

AbstractBackgroundPersons with rare disorders, such as tetralogy of Fallot, often feel socially isolated due to poor public awareness of the disorder. On 1 May 2017, Jimmy Kimmel aired a segment on Jimmy Kimmel Live! highlighting the impact of tetralogy of Fallot on his son and how the public can learn more about the disorder.MethodsWe tracked public interest in tetralogy of Fallot using Google Trends and Twitter after the episode and constructed an autoregressive integrated moving average algorithm to calculate search volumes had Kimmel not aired the episode.ResultsGoogle searches and the number of Tweets for tetralogy of Fallot increased by 3063.27% and 4672.62%, respectively, above expected.ConclusionsOur findings indicate that television talk shows may represent strong outlets for increasing public awareness of rare disorders.


2020 ◽  
Vol 70 (8) ◽  
pp. 570-577
Author(s):  
J C Zhang ◽  
N Carnide ◽  
L Holness ◽  
P Cram

Abstract Background Although the association of cannabis use with automobile accidents has been well-studied, the impact of cannabis on workplace safety and injuries is less clear. Aims The purpose of this study was to examine the relationship between work-related injury and cannabis use in the past year. Methods We performed a cross-sectional analysis of the Canadian Community Health Survey (2013–16) of working individuals. We used multiple logistic regression modelling to calculate the odds of experiencing a work-related injury (defined as non-repetitive strain injury) among workers who reported using cannabis more than once during the prior 12 months as compared to non-users. We repeated the analysis among participants working in high injury risk occupational groups only. Results Among the 136 536 working participants, 2577 (2%) had a work-related injury in the last 12 months. Of these 2577 who had a work-related injury, 4% also reported being a cannabis user in the same period. We found no association between past-year cannabis use and work-related injury (odds ratio for work injury among users 0.81, 95% confidence interval 0.66–0.99). The association was unchanged in the subgroup analysis limited to high injury risk occupational groups. Conclusions We found no evidence that cannabis users experienced higher rates of work-related injuries. While awaiting prospective studies, occupational medicine practitioners should take a risk-based approach to drafting workplace cannabis policies.


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