Unequal cost of COVID-19 deaths laid bare by study

The impact of deprivation on mortality was greatest in younger people: for all-cause mortality in the most deprived areas, 15 to 44 year olds were estimated to have had 480 excess deaths, compared to 42 in the most affluent, or over 11 times as many. Adjusting for population sizes, ratios of all-cause excess deaths ranged from 2.7 in 15 to 45 year olds to 1.6 in those aged 85 or over.

For mortality caused directly by COVID-19 and respiratory illness, in the most deprived areas, 15 to 44 year olds were estimated to have had 268 excess deaths, compared to 51 in the most affluent, over 5 times as many. Adjusting for population size, ratios of Covid-19 excess deaths ranged from 5 in 15 to 45 year olds to 1.6 (again) in those aged 85 or over.

More years of life were lost for men on average, 10.5 in COVID/respiratory deaths and 10.8 in all-cause deaths, compared to 9.5 and 8.2 for women, respectively.

The pandemic exacerbated longstanding socioeconomic inequalities, with the ratio of observed years of life lost for the most deprived fifth of areas compared to the most affluent increasing from 1.56 in 2019 to 1.64 in 2020.

Professor Evan Kontopantelis from The University of Manchester said: “The pandemic widened pre-existing health inequalities across England and Wales: regions and social groups with the highest baseline mortality rates experienced the greatest impact on years of life lost.

“Linked to this, we think the impact of the pandemic may have been higher than previously thought on the most deprived areas of England and Wales, with more younger people dying directly or indirectly from COVID-19 in these areas.”

Professor Tim Doran from the University of York said: “Our findings support the notion that Years of Life Lost can be more informative for determining unmet needs and informing policy for this or future pandemics.

“In particular, it could provide vital information to aid the targeting of vaccines, financial aid and social support during this and future pandemics.”

The paper Excess years of life lost to COVID-19 and other causes of death by sex, neighbourhood deprivation and region in England & Wales during 2020: a registry is published in PLOS Medicine

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