Insights Into Excess Mortality During the First Months of the COVID-19 Pandemic From a Rural, Demographic Surveillance Site in Bangladesh

Background: Coronavirus disease 2019 (COVID-19) has spread globally, and the government of each affected country is publishing the number of deaths every day. This official figure is an underestimate as it excludes anybody who did not die in a hospital, who did not test positive, who had a false result, or those who recovered on their own without a test.Objective: This study aimed to measure the community level excess mortality using health and demographic surveillance in a rural area of Bangladesh.Method: The study was conducted in Matlab, in a rural area of Bangladesh, with a Health and Demographic Surveillance System (HDSS) covering a population of 239,030 individuals living in 54,823 households in 142 villages. We examined the mortality in January-April from 2015 to 2020 and compared the mortality in 2020 with the historical trend of 2015–2019. Between 2015 and 2020, we followed 276,868 people until migration or death, whichever occurred first. We analyzed mortality using crude mortality rate ratio (MRR) and adjusted MRR (aMRR) from a Cox proportional hazard model. Mortality was analyzed according to age, sex, and period.Results: During follow-up, 3,197 people died. The mortality rate per 1,000 person-years increased from 10 in 2019 to 12 in 2020. Excess mortality was observed among the elderly population (aged 65 years and above). The elderly mortality rate per 1,000 person-years increased from 80 in 2019 to 110 in 2020, and the aMRR was 1.40 (95% CI: 1.19–1.64). Although an increasing tendency in mortality was observed between 2015 and 2019, it was statistically insignificant.Conclusions: The study reported a 28% increase in excess deaths among the elderly population during the first months of the pandemic. This all-cause mortality estimation at the community level will urge policymakers, public health professionals, and researchers to further investigate the causes of death and the underlying reasons for excess deaths in the older age-group.

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COVID-19 and excess mortality: Was it possible to lower the number of deaths in Slovenia?

Stanovnistvo ◽

10.2298/stnv2101017j ◽

2021 ◽

Vol 59 (1) ◽

pp. 17-30

Author(s):

Damir Josipovic

Keyword(s):

Mortality Rate ◽

Acute Respiratory Infection ◽

Elderly Population ◽

Excess Mortality ◽

Age Groups ◽

The Elderly ◽

Mortality Pattern ◽

Severe Acute Respiratory Infection ◽

High Share ◽

Excess Deaths

This paper presents new data on the age structure of hospitalised SARI (severe acute respiratory infection) patients, with or without COVID-19, broken down by gender, place of infection, and region. The leading hypothesis that COVID-19 deaths are overestimated despite the high share of excess deaths was confirmed, bringing to light the important issue of the demographic breakdown of the population at risk. Thus, the main reason for the decreasing number of COVID-19 deaths is to be sought within the exhausted demographic pool of the elderly population in 2020, when the mortality rate was 19% higher compared to the previous five-year period (2015-2019). Demographic disparities across regions are immense and statistically explain the differences in the ?infected versus deceased? ratio. The excess mortality in 2020 was unusually high, but the projected value for 2020 based on the mortality pattern across age groups from 2015 to 2019 contributed up to one-third of the surplus. So, for one-quarter of alleged COVID-19 deaths (roughly 600 out of some 3,300 in 2020), death was expected to take place in 2020 anyway.

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Gendered Articulations of Control and Care on Social Media During the COVID-19 Pandemic in Hungary

Frontiers in Political Science ◽

10.3389/fpos.2021.656731 ◽

2021 ◽

Vol 3 ◽

Author(s):

Katinka Linnamäki

Keyword(s):

Health Care ◽

Health Care Workers ◽

Elderly Population ◽

The Elderly ◽

System Of Care ◽

Care Work ◽

Unpaid Care ◽

Work Related ◽

Care Workers ◽

The Government

The purpose of this paper is to examine the Hungarian Fidesz-KDNP government´s discursive practices of control and care during the first wave of the COVID-19 pandemic. The paper researches the Hungarian government’s communication on the official Hungarian COVID-19 Facebook page during the first wave of the pandemic. Its aim is to answer the question how the Hungarian government articulated control and care to reinforce sedimented gendered division of care work and institutions of control to tackle the potential disruption of the system of care before the widespread vaccination of the elderly population was available in the country. The paper argues that the pandemic has allowed the government to exert control in areas, such as the crisis in the workforce market and health care system, as well as in the destabilized system of care work. The main finding is that in the material the government performs control over care work, whose intensified discussion during the pandemic could lead to a potential disruption within the illiberal logic on two different levels. First, physical care work related to immediate physical needs, like hunger, clothing, pain enacted by female shoppers, female health care workers and female social workers, is newly defined during the pandemic as local, family-bound and a naturally female task. Second, the government articulates care work, either as potentially harmful (for the elderly population and thus indirectly to the government’s familialist politics), or as vulnerable and in need of protection from outside influences (portrayed through the interaction of health care workers and “hospital commanders”). This enables the government to perform full state control over care workers through the mobilization of police and military masculinity and to strengthen and re-naturalize the already existing hierarchies between traditional gender roles from a new perspective during the pandemic. This state of affairs highlights the vulnerability both of the elderly population, on whom its familialism builds, and of the system of informal care work, which builds on the unpaid care work of female citizens, who paradoxically are also articulated as potential harm for the elderly and for the system.

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A QUALITATIVE ANALYSIS OF AWARENESS AND UTILIZATION OF SOCIAL SECURITY MEASURES AMONG THE ELDERLY IN KOCHI CORPORATION

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i4.1085 ◽

2020 ◽

Vol 4 (4) ◽

Author(s):

Charutha Retnakumar ◽

Leyanna Susan George ◽

Maya Chacko

Keyword(s):

Social Security ◽

Health Workers ◽

The Elderly ◽

Community Level ◽

Financial Security ◽

Security Measures ◽

Effective Utilization ◽

Public Health Workers ◽

The Government ◽

Depth Interviews

Background: As per Census 2011, nearly 104 million people in India are above the age of 60 years. While in Kerala, 12.6 % of the population is elderly. The government of India has launched various social security schemes and concessions for the elderly. Hence, objective of this research is to study the awareness & utilization of social security measures. It also aimed to understand the motivators & barriers for utilization of social security measures among the elderly. Methodology: A qualitative study was carried out in 5 geriatric care centres in the 65th division of Kochi. 7 FGDs were conducted in each of the geriatric clubs and 7 In-depth interviews were conducted among the Anganwadi workers, medical officers, public health workers, and welfare officers. The data was translated, transcribed, Coded, thematically analysed and conclusions were drawn after data triangulation. Results: The awareness & utilization of various social security measures were found to be poor among the elderly. This was attributed to the lack of awareness among the community level workers regarding same. Pensions, railway concessions, and vayomitram project were the most popular schemes. Financial security among the pensioners through the schemes was a major motivator. While, the lack of awareness regarding the schemes and delay in processing the applications were the barriers identified. Conclusion: Proper channelization of knowledge is important for the awareness generation among elderly and community level workers. This can further lead to effective utilization of the benefits provided.

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Association between all-cause mortality and insurance status transition among the elderly population in a rural area in Korea: Kangwha Cohort Study

Health Policy ◽

10.1016/j.healthpol.2014.10.012 ◽

2015 ◽

Vol 119 (5) ◽

pp. 680-687 ◽

Cited By ~ 4

Author(s):

Sung-In Jang ◽

Sang-Wook Yi ◽

Jae-Woong Sull ◽

Eun-Cheol Park ◽

Jae-Hyun Kim ◽

...

Keyword(s):

Cohort Study ◽

Rural Area ◽

Elderly Population ◽

The Elderly ◽

Insurance Status ◽

Status Transition ◽

All Cause Mortality

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Chronic subdural hematoma in the elderly: not a benign disease

Journal of Neurosurgery ◽

10.3171/2010.8.jns10298 ◽

2011 ◽

Vol 114 (1) ◽

pp. 72-76 ◽

Cited By ~ 154

Author(s):

Lucas Bernardes Miranda ◽

Ernest Braxton ◽

Joseph Hobbs ◽

Matthew R. Quigley

Keyword(s):

Mortality Rate ◽

Median Survival ◽

Subdural Hematoma ◽

Excess Mortality ◽

Chronic Subdural Hematoma ◽

The Elderly ◽

Benign Disease ◽

Twist Drill ◽

Chi Square Analysis

Object Chronic subdural hematoma (CSDH) is perceived to be a “benign,” easily treated condition in the elderly, but reported follow-up periods are brief, usually limited to acute hospitalization. Methods The authors conducted a retrospective review of data obtained in a prospectively identified consecutive series of adult patients admitted to their institution between September 2000 and February 2008 and in whom there was a CT diagnosis of CSDH. Survival data were compared to life-table data. Results Of the 209 cases analyzed, 63% were men and the mean age was 80.6 years (range 65–96 years). Primary surgical interventions performed were bur holes in 21 patients, twist-drill closed-system drainage in 44, and craniotomies in 72. An additional 72 patients were simply observed. Reoperations were recorded in 5 patients—4 who had previously undergone twist-drill drainage and 1 who had previously undergone a bur hole procedure (p = 0.41, chi-square analysis). Thirty-five patients (16.7%) died in hospital, 130 were discharged to rehabilitation or a skilled care facility, and 44 returned home. The follow-up period extended to a maximum of 8.3 years (median 1.45 years). Six-month and 1-year mortality rates were 26.3% and 32%, respectively. In the multivariate analysis (step-wise logistic regression), the sole factor that predicted in-hospital death was neurological status on admission (OR 2.1, p = 0.02, for each step). Following discharge, the median survival in the remaining cohort was 4.4 years. In the Cox proportional hazards model, only age (hazard ratio [HR] 1.06/year, p = 0.02) and discharge to home (HR 0.24, p = 0.01) were related to survival, whereas the type of intervention, whether surgery was performed, size of subdural hematoma, amount of shift, bilateral subdural hematomas, and anticoagulant agent use did not affect the long- or short-term mortality rate. Comparison of postdischarge survival and anticipated actuarial survival demonstrated a markedly increased mortality rate in the CSDH group (median survival 4.4 vs 6 years, respectively; HR 1.94, p = 0.0002, log-rank test). This excess mortality rate was also observed at 6 months postdischarge with evidence of normalization only at 1 year. Conclusions In this first report of the long-term outcome of elderly patients with CSDH the authors observed persistent excess mortality up to 1 year beyond diagnosis. This belies the notion that CSDH is a benign disease and indicates it is a marker of other underlying chronic diseases similar to hip fracture.

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

Eurosurveillance ◽

10.2807/ese.17.14.20138-en ◽

2012 ◽

Vol 17 (14) ◽

Cited By ~ 1

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.

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Decoupling of Elderly Healthcare Demand and Expenditure in China

Healthcare ◽

10.3390/healthcare9101346 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1346

Author(s):

Shangguang Yang ◽

Danyang Wang ◽

Wenhui Li ◽

Chunlan Wang ◽

Xi Yang ◽

...

Keyword(s):

Health Insurance ◽

Elderly Population ◽

The Elderly ◽

Health Condition ◽

Medical Expenditure ◽

Linear Regression Models ◽

Healthy Longevity ◽

The Government ◽

Elderly Healthcare ◽

Significant Factors

This study examined the changing trajectory and factors that influenced the health and medical expenditure of the Chinese elderly population over the past two decades. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018, inferential and multiple linear regression models were constructed. The key finding is that China has experienced a decoupling of healthcare demand (HCD) and healthcare expenditure (HCE) since around 2014, when HCE began to decline despite the fact that HCD continued to rise. This is a promising sign, suggesting that the government’s health insurance policy is working. Furthermore, participating in health insurance schemes can significantly reduce the elderly’s HCD and HCE, demonstrating that health insurance can effectively affect the elderly’s decision to seek medical treatment and improve their health condition. We also found that age, region, basic old-age insurance, and care by the government and institutions were significant factors that influenced the healthcare demand and expenditure of the elderly population.

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Suicide in the elderly: an epidemiologic study

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2019026603694 ◽

2021 ◽

Vol 55 ◽

Author(s):

Mariana Cristina Lobato dos Santos ◽

Barbara Bartuciotti Giusti ◽

Clarissa Ayri Yamamoto ◽

Suely Itsuko Ciosak ◽

Regina Szylit

Keyword(s):

Retrospective Study ◽

Mortality Rate ◽

General Population ◽

Elderly Population ◽

Epidemiologic Study ◽

The Elderly ◽

Cross Sectional ◽

The Mean ◽

Elderly Suicide ◽

High Place

ABSTRACT Objective: To analyze the incidence and means of elderly suicide in Brazil. Method: Epidemiologic, cross-sectional, quantitative, and retrospective study. The data were obtained in a platform maintained by the Ministry of Health and analyzed. The mortality rate was calculated and means and percentages regarding the employed means of suicide were obtained. Results: In this period, 8,977 suicides took place among the population over 60 years. The highest suicide rates were concentrated in the population over 80, which presented a mean 8.4/100,000 for this period, and between 70 and 79 years, with a mean rate of 8.2/100,000. Considering the total elderly population over 60 years, this value reached 7.8/100,000, whereas in the general population this was 5.3/100,000. The values are always higher among the elderly population: the mean rate in the last five years among the elderly is 47.2% higher than the mean for the general population. The main mean of suicide was hanging (68%), followed by firearm (11%), self-intoxication (9%), falling from a high place (5%), and undefined or undetermined means (6%). Conclusion: Epidemiologic analyses bring visibility to the dyad aging and suicide, corroborating the pertinence of this theme.

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The Status of Elderly People in Nepal

Patan Pragya ◽

10.3126/pragya.v5i1.30432 ◽

2019 ◽

Vol 5 (1) ◽

pp. 11-18

Author(s):

Gokarna Raj Aryal

Keyword(s):

Developing Countries ◽

Elderly People ◽

Elderly Population ◽

National Development ◽

The Elderly ◽

Developed Countries ◽

Ageing Population ◽

The Status ◽

Present Context ◽

The Government

Elderly citizens are the sources of knowledge, experiences and collections of different ideas in every society or nation. If we use their ability, long experiences and their conscience, our society or nation will be benefitted to reform national development and prosperity. Ageing population is a global phenomenon and the number is rapidly increasing in developing countries as compared to developed countries. The government of Nepal has declared that people with 60 years or more are elderly citizens. The growth rate of the elderly population is faster than that of the total population in Nepal. The observation shows that the proportion of elderly population is high in mountain and hilly regions as compared to Terai. However, it is noted that female elderly population is the highest among three ecological regions. The growing numbers of ageing population is a major concern in most of the developing countries like Nepal. The social, economic and demographic impacts of ageing population possess both opportunities and challenges to every society. In this situation, the Government of Nepal should attempt to enhance the self-reliance and provide social security of its elderly people to facilitate their continuous participation in society. The Government of Nepal has introduced the universal old aged allowances program since 1994/95 as a non-contributing social assistance to elderly citizens with 70 years or more. The starting allowances are nominal. At present context, it is not a sufficient amount for the elderly citizens but they have little support to health care, medicine, entertainment and desired foods and fruits. Likewise, the Government should establish old age homes, day care and ageing centers and parks for entertainment.

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Excess mortality in Poland during the COVID-19 pandemic in 2020

Wiadomości Statystyczne. The Polish Statistician ◽

10.5604/01.3001.0015.0351 ◽

2021 ◽

Vol 66 (7) ◽

pp. 7-23

Author(s):

Radosław Murkowski

Keyword(s):

Time Series ◽

Mortality Rate ◽

Excess Mortality ◽

Temporal Variations ◽

Virus Infections ◽

Seasonal Fluctuations ◽

The World ◽

Its Regions ◽

Causes Of Deaths ◽

Excess Deaths

The outbreak of the COVID-19 pandemic began in China in November 2019, and spread to most countries around the world in the early 2020, causing a large increase in deaths. The aim of the study described in this paper is to estimate and analyse the geographical and temporal variations in excess mortality during the COVID-19 pandemic in 2020 in Poland and its regions. The study took into consideration variables such as sex, age and the stage of the pandemic in correlation with the reported number of COVID-19 deaths and the reported number of SARS-CoV-2 virus infections. The standard weekly mortality rate in Poland in 2020 was calculated using the method of time series analysis taking into account weekly seasonal fluctuations in the mortality rate throughout the year, indicated with data reported by registry offices and published by Statistics Poland. The obtained results showed that in 2020, there were approximately 71,000 deaths above the standard number in Poland, most of which, i.e. about 91%, were the deaths of people aged 60 and over. Out of them, only less than 30,000 deaths were reported as deaths caused by COVID-19, which was only about 41% of all excess deaths in this period. The number of excess deaths peaked in the 45th week of 2020, which was the time when the largest number of cases of COVID-19 infection were reported, and not when the largest number of deaths from COVID-19 occurred (which was three weeks later). However, it has not been established yet whether the reason for this situation was an imperfect way of determining the causes of deaths at the beginning of the pandemic, or the excessive burden hospitals were subjected to that caused the increase in deaths from other causes.

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