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Explanations for higher-than-expected all-cause mortality from April 2021: A scoping review.
F Scott1, G McCartney2, D Walsh3
1Public Health Scotland, Edinburgh, UK.
Public Health
|December 6, 2024
Summary
Excess deaths persist beyond the initial Covid-19 pandemic wave. This review identifies proposed explanations, prioritizing research on direct COVID-19 impacts, its sequelae, health service strain, and socioeconomic factors.
Area of Science:
- Public Health
- Epidemiology
- Mortality Studies
Background:
- Many countries report elevated mortality rates post the initial COVID-19 pandemic peaks.
- Understanding sustained excess mortality is crucial for public health policy.
Purpose of the Study:
- To identify and categorize proposed explanations for higher-than-expected mortality beyond the first year of the COVID-19 pandemic.
- To prioritize research areas for sustained excess mortality in high-income countries.
Main Methods:
- A scoping review of English-language literature and grey sources was conducted.
- Searches focused on hypotheses for excess mortality from April 2021 onwards.
- Results were narratively synthesized, and research priorities were identified using existing frameworks.
Main Results:
- Seventy eligible papers were identified, predominantly opinion pieces or trend analyses.
- Proposed explanations included direct COVID-19, post-infection sequelae, health service impacts, and socioeconomic factors.
- Hypotheses related to direct COVID-19, sequelae, health service, and socioeconomic factors were prioritized for further investigation.
Conclusions:
- Evidence-informed policy requires a clear understanding of excess mortality causes.
- This review highlights research priorities, acknowledging their context-specific nature.
- In the UK, pandemic's socioeconomic impacts likely worsened pre-existing trends in life expectancy stagnation.
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