Variability in excess deaths across countries with different vulnerability during 2020-2023

Area of Science:

• Demography
• Epidemiology
• Public Health

Background:

• Excess deaths are key indicators of major crises like the COVID-19 pandemic.
• Accurate death registration and population data are crucial for assessing pandemic impact.
• Vulnerability indicators can help explain disparities in crisis outcomes.

Purpose of the Study:

• To evaluate excess death trajectories across countries.
• To assess the relationship between country vulnerability and excess deaths.
• To analyze excess mortality patterns by age strata.

Main Methods:

• Utilized the Human Mortality Database for 34 countries (2020-2023).
• Calculated excess deaths using 2017-2019 as reference, adjusted for 5 age strata.
• Categorized countries into 'less' and 'more' vulnerable based on GDP, income inequality (Gini), and poverty rates.

Main Results:

• Excess deaths showed inverse correlation with GDP (r=-0.60) and positive correlation with poverty (r=0.66).
• More vulnerable countries had a higher incidence rate ratio for deaths (1.062).
• Mean excess deaths were significantly higher in more vulnerable countries (7.0% and 7.2% for age groups 0-64 and >65) compared to less vulnerable ones (-0.8% and 0.4%).

Conclusions:

• Country vulnerability, defined by economic and social factors, ultimately dominated the cumulative impact of the pandemic.
• While pandemic onset varied, socioeconomic factors determined the severity of excess mortality.
• Half of the analyzed countries faced substantial excess deaths, highlighting global disparities in pandemic impact.