Inequalities in regional excess mortality and life expectancy during the COVID-19 pandemic in Europe

Hajdu, Tamás; Krekó, Judit; Tóth, Csaba G.

doi:10.1038/s41598-024-54366-5

Cited by 6 publications

(1 citation statement)

References 52 publications

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“…To our knowledge, only two peer-reviewed studies allow for a simultaneous comparison of regional excess mortality in several European countries for 2020 28 , 29 . Another peer-reviewed study covers 200 NUTS 2 European regions for the years 2020 to 2022 but does not estimate excess mortality in regions of Germany, the UK, Ireland or Sweden 30 . The ONS has also published on its website a report 31 on weekly excess mortality between the end of 2019 and mid-2022 by region in Europe.…”

Section: Introductionmentioning

confidence: 99%

Spatial disparities in the mortality burden of the covid-19 pandemic across 569 European regions (2020-2021)

Bonnet,

Grigoriev,

Sauerberg

et al. 2024

Nat Commun

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Since its emergence in December 2019, the COVID-19 pandemic has resulted in a significant increase in deaths worldwide. This article presents a detailed analysis of the mortality burden of the COVID-19 pandemic across 569 regions in 25 European countries. We produce age and sex-specific excess mortality and present our results using Age-Standardised Years of Life Lost in 2020 and 2021, as well as the cumulative impact over the two pandemic years. Employing a forecasting approach based on CP-splines that considers regional diversity and provides confidence intervals, we find notable losses in 362 regions in 2020 (440 regions in 2021). Conversely, only seven regions experienced gains in 2020 (four regions in 2021). We also estimate that eight regions suffered losses exceeding 20 years of life per 1000 population in 2020, whereas this number increased to 75 regions in 2021. The contiguity of the regions investigated in our study also reveals the changing geographical patterns of the pandemic. While the highest excess mortality values were concentrated in the early COVID-19 outbreak areas during the initial pandemic year, a clear East-West gradient appeared in 2021, with regions of Slovakia, Hungary, and Latvia experiencing the highest losses. This research underscores the importance of regional analyses for a nuanced comprehension of the pandemic’s impact.

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Section: Introductionmentioning

confidence: 99%

Spatial disparities in the mortality burden of the covid-19 pandemic across 569 European regions (2020-2021)

Bonnet,

Grigoriev,

Sauerberg

et al. 2024

Nat Commun

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Beyond Borders: Spatial Disparities in the Mortality Burden of the Covid-19 pandemic across 569 European Regions (2020-2021)

Bonnet,

Grigoriev,

Sauerberg

et al. 2023

Preprint

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This article presents a detailed analysis of the global mortality burden of the COVID-19 pandemic across 569 regions in 25 European countries. We produce sex-specific excess mortality and present our results using Age-Standardised Years of Life Lost (ASYLL) in 2020 and 2021, as well as the cumulative impact over the two pandemic years. Employing a robust forecasting approach that considers regional diversity and provides confidence intervals, we find notable losses in 362 regions in 2020 (440 regions in 2021). Conversely, only seven regions experienced gains in 2020 (four regions in 2021). Most importantly, we estimate that eight regions suffered losses exceeding 20 years of life per 1,000 population in 2020, whereas this number increased to 75 regions in 2021. The contiguity of the regions investigated in our study also reveals the changing geographical patterns of the pandemic. While the highest excess mortality values were concentrated in the early COVID-19 outbreak areas during the initial pandemic year, a clear East-West gradient appeared in 2021, with regions of Slovakia, Hungary, and Latvia experiencing the highest losses. This research underscores the importance of regional analyses for a nuanced comprehension of the pandemic’s impact.

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Patterns and drivers of excess mortality during the COVID-19 pandemic in 13 Western European countries

Galmiche,

Coustaury,

Charniga

et al. 2024

BMC Global Public Health

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Background Important differences in excess mortality between European countries during the COVID-19 pandemic have been reported. Understanding the drivers of these differences is essential to pandemic preparedness. Methods We examined patterns in age- and sex-standardized cumulative excess mortality in 13 Western European countries during the first 30 months of the COVID-19 pandemic and the correlation of country-level characteristics of interest with excess mortality. Results In a timeline analysis, we identified notable differences in seeding events, particularly in early 2020 and when the Alpha variant emerged, likely contributing to notable differences in excess mortality between countries (lowest in Denmark during that period). These differences were more limited from July 2021 onwards. Lower excess mortality was associated with implementing stringent non-pharmaceutical interventions (NPIs) when hospital admissions were still low in 2020 (correlation coefficient rho = 0.65, p = 0.03) and rapid rollout of vaccines in the elderly in early 2021 (rho = − 0.76, p = 0.002). Countries which implemented NPIs while hospital admissions were low tended to experience lower gross domestic product (GDP) losses in 2020 (rho = − 0.55, p = 0.08). Structural factors, such as high trust in the national government (rho = − 0.77, p = 0.002) and low ratio of population at risk of poverty (rho = 0.55, p = 0.05), were also associated with lower excess mortality. Conclusions These results suggest the benefit of early implementation of NPIs and swift rollout of vaccines to the most vulnerable. Further analyses are required at a more granular level to better understand how these factors impacted excess mortality and help guide pandemic preparedness plans. Supplementary Information The online version contains supplementary material available at 10.1186/s44263-024-00103-z.

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Inequalities in regional excess mortality and life expectancy during the COVID-19 pandemic in Europe

Cited by 6 publications

References 52 publications

Spatial disparities in the mortality burden of the covid-19 pandemic across 569 European regions (2020-2021)

Spatial disparities in the mortality burden of the covid-19 pandemic across 569 European regions (2020-2021)

Beyond Borders: Spatial Disparities in the Mortality Burden of the Covid-19 pandemic across 569 European Regions (2020-2021)

Patterns and drivers of excess mortality during the COVID-19 pandemic in 13 Western European countries

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