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Excess years of life lost to COVID-19 and other causes of death by sex, neighbourhood deprivation, and region in England and Wales during 2020: A registry-based study.
Kontopantelis, Evangelos; Mamas, Mamas A; Webb, Roger T; Castro, Ana; Rutter, Martin K; Gale, Chris P; Ashcroft, Darren M; Pierce, Matthias; Abel, Kathryn M; Price, Gareth; Faivre-Finn, Corinne; Van Spall, Harriette G C; Graham, Michelle M; Morciano, Marcello; Martin, Glen P; Sutton, Matt; Doran, Tim.
  • Kontopantelis E; Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, England.
  • Mamas MA; NIHR School for Primary Care Research, University of Oxford, Oxford, England.
  • Webb RT; Health Organisation, Policy and Economics (HOPE) Research Group, University of Manchester, Manchester, England.
  • Castro A; Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, England.
  • Rutter MK; Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, England.
  • Gale CP; Department of Cardiology, Jefferson University, Philadelphia, Pennsylvania, United States of America.
  • Ashcroft DM; Centre for Mental Health & Safety, Division of Psychology & Mental Health, University of Manchester and Manchester Academic Health Sciences Centre (MAHSC), England.
  • Pierce M; NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, England.
  • Abel KM; Department of Health Sciences, University of York, England.
  • Price G; Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, England.
  • Faivre-Finn C; Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, England.
  • Van Spall HGC; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, England.
  • Graham MM; Leeds Institute for Data Analytics, University of Leeds, Leeds, England.
  • Morciano M; Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, England.
  • Martin GP; NIHR School for Primary Care Research, University of Oxford, Oxford, England.
  • Sutton M; NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, England.
  • Doran T; Division of Pharmacy & Optometry, University of Manchester, Manchester, England.
PLoS Med ; 19(2): e1003904, 2022 02.
Article in English | MEDLINE | ID: covidwho-1686090
ABSTRACT

BACKGROUND:

Deaths in the first year of the Coronavirus Disease 2019 (COVID-19) pandemic in England and Wales were unevenly distributed socioeconomically and geographically. However, the full scale of inequalities may have been underestimated to date, as most measures of excess mortality do not adequately account for varying age profiles of deaths between social groups. We measured years of life lost (YLL) attributable to the pandemic, directly or indirectly, comparing mortality across geographic and socioeconomic groups. METHODS AND

FINDINGS:

We used national mortality registers in England and Wales, from 27 December 2014 until 25 December 2020, covering 3,265,937 deaths. YLLs (main outcome) were calculated using 2019 single year sex-specific life tables for England and Wales. Interrupted time-series analyses, with panel time-series models, were used to estimate expected YLL by sex, geographical region, and deprivation quintile between 7 March 2020 and 25 December 2020 by cause direct deaths (COVID-19 and other respiratory diseases), cardiovascular disease and diabetes, cancer, and other indirect deaths (all other causes). Excess YLL during the pandemic period were calculated by subtracting observed from expected values. Additional analyses focused on excess deaths for region and deprivation strata, by age-group. Between 7 March 2020 and 25 December 2020, there were an estimated 763,550 (95% CI 696,826 to 830,273) excess YLL in England and Wales, equivalent to a 15% (95% CI 14 to 16) increase in YLL compared to the equivalent time period in 2019. There was a strong deprivation gradient in all-cause excess YLL, with rates per 100,000 population ranging from 916 (95% CI 820 to 1,012) for the least deprived quintile to 1,645 (95% CI 1,472 to 1,819) for the most deprived. The differences in excess YLL between deprivation quintiles were greatest in younger age groups; for all-cause deaths, a mean of 9.1 years per death (95% CI 8.2 to 10.0) were lost in the least deprived quintile, compared to 10.8 (95% CI 10.0 to 11.6) in the most deprived; for COVID-19 and other respiratory deaths, a mean of 8.9 years per death (95% CI 8.7 to 9.1) were lost in the least deprived quintile, compared to 11.2 (95% CI 11.0 to 11.5) in the most deprived. For all-cause mortality, estimated deaths in the most deprived compared to the most affluent areas were much higher in younger age groups, but similar for those aged 85 or over. There was marked variability in both all-cause and direct excess YLL by region, with the highest rates in the North West. Limitations include the quasi-experimental nature of the research design and the requirement for accurate and timely recording.

CONCLUSIONS:

In this study, we observed strong socioeconomic and geographical health inequalities in YLL, during the first calendar year of the COVID-19 pandemic. These were in line with long-standing existing inequalities in England and Wales, with the most deprived areas reporting the largest numbers in potential YLL.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: PLoS Med Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pmed.1003904

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: PLoS Med Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pmed.1003904