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Do Old Age and Comorbidity via Non-Communicable Diseases Matter for COVID-19 Mortality? A Path Analysis
Gour Gobinda Goswami1, Mausumi Mahapatro2, A R M Mehrab Ali3
1Department of Economics, North South University, Dhaka, Bangladesh.
Insights
Elderly populations and those with non-communicable diseases face higher COVID-19 mortality risks. Prioritizing vaccinations for these groups, especially in South America and Europe, is crucial for reducing global deaths.
Area of Science:
- Epidemiology
- Public Health
- Global Health
Background:
- The COVID-19 pandemic has caused significant global mortality.
- Understanding demographic and health factors influencing mortality is critical for targeted interventions.
Purpose of the Study:
- To investigate the impact of age structure and non-communicable disease comorbidity on COVID-19 mortality.
- To identify high-risk regions and demographic groups for COVID-19 mortality.
Main Methods:
- Utilized Our World data for COVID-19 metrics, age structure, and non-communicable diseases.
- Employed a cross-sectional path model analysis for 117 countries as of September 23, 2021.
- Incorporated regional variations to analyze mortality determinants.
Main Results:
- Old age and comorbidity via non-communicable diseases are primary drivers of COVID-19 mortality.
- Increased proportion of individuals over 65, 70, or of median age significantly raised mortality.
- South America and Europe exhibited alarmingly high regional mortality intensity, particularly for elderly and comorbid populations.
Conclusions:
- Vaccination prioritization for the elderly and individuals with non-communicable diseases (heart disease, cancer, respiratory disease, diabetes) is recommended.
- Enhanced public health interventions and resources are needed for South America and Europe due to their high COVID-19 mortality rates.
Abstract:
This paper used Our World data for coronavirus disease-2019 (COVID-19) death count, test data, stringency, and transmission count and prepared a path model for COVID-19 deaths. We augmented the model with age structure-related variables and comorbidity via non-communicable diseases for 117 countries of the world for September 23, 2021, on a cross-section basis. A broad-based global quantitative study incorporating these two prominent channels with regional variation was unavailable in the existing literature. Old age and comorbidity were identified as two prime determinants of COVID-19 mortality. The path model showed that after controlling for these factors, one SD increase in the proportion of persons above 65, above 70, or of median age raised COVID-19 mortality by more than 0.12 SDs for 117 countries. The regional intensity of death is alarmingly high in South America, Europe, and North America compared with Oceania. After controlling for regions, the figure was raised to 0.213, which was even higher. For old age, the incremental coefficient was the highest for South America (0.564), and Europe (0.314), which were substantially higher than in Oceania. The comorbidity channel via non-communicable diseases illustrated that one SD increase in non-communicable disease intensity increased COVID-19 mortality by 0.132 for the whole sample. The regional figure for the non-communicable disease was 0.594 for South America and 0.358 for Europe compared with the benchmark region Oceania. The results were statistically significant at a 10% level of significance or above. This suggested that we should prioritize vaccinations for the elderly and people with comorbidity via non-communicable diseases like heart disease, cancer, chronic respiratory disease, and diabetes. Further attention should be given to South America and Europe, which are the worst affected regions of the world.
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