Unequal impact of COVID-19 on excess deaths, life expectancy, and premature mortality in Spanish regions (2020-2021)

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria Pub Date : 2024-01-01 DOI:10.1016/j.gaceta.2024.102424

Nazrul Islam , Fernando J. García López , Dimitri A. Jdanov , Miguel Ángel Royo-Bordonada , Kamlesh Khunti , Sarah Lewington , Ben Lacey , Martin White , Eva J.A. Morris , María Victoria Zunzunegui

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引用次数: 0

Abstract

Objective

We aimed to estimate regional inequalities in excess deaths and premature mortality in Spain during 2020 and 2021, before high vaccination coverage against COVID-19.

Method

With data from the National Institute of Statistics, within each region, sex, and age group, we estimated the excess deaths, the change in life expectancy at birth (e₀) and age 65 (e₆₅) and years of life lost as the difference between the observed and expected deaths using a time series analysis of 2015-2019 data and life expectancies based on Lee-Carter forecasting using 2010-2019 data.

Results

From January 2020 to June 2021, an estimated 89,200 (men: 48,000; women: 41,200) excess deaths occurred in Spain with a substantial regional variability (highest in Madrid: 22,000, lowest in Canary Islands: −210). The highest reductions in e₀ in 2020 were observed in Madrid (men −3.58 years, women −2.25), Castile-La Mancha (−2.72, −2.38), and Castile and Leon (−2.13, −1.39). During the first half of 2021, the highest reduction in e₀ was observed in Madrid for men (−2.09; −2.37 to −1.84) and Valencian Community for women (−1.63; −1.97 to −1.3). The highest excess years of life lost in 2020 was in Castile-La Mancha (men: 5370; women: 3600, per 100 000). We observed large differences between reported COVID-19 deaths and estimated excess deaths across the Spanish regions.

Conclusions

Regions performed highly unequally on excess deaths, life expectancy and years of life lost. The investigation of the root causes of these regional inequalities might inform future pandemic policy in Spain and elsewhere.

查看原文本刊更多论文

COVID-19 对西班牙各地区超额死亡、预期寿命和过早死亡率的不平等影响（2020-2021 年）

方法我们利用国家统计局提供的数据，在每个地区、性别和年龄组中估算了超额死亡人数、出生时预期寿命（e0）和 65 岁时预期寿命（e65）的变化，并利用 2015-2019 年数据的时间序列分析和基于 2010-2019 年数据的李-卡特预期寿命预测，估算了观察到的死亡人数与预期死亡人数之差所造成的寿命损失。结果从 2020 年 1 月到 2021 年 6 月，西班牙估计有 89,200 例（男性：48,000 例；女性：41,200 例）超额死亡，地区差异很大（马德里最高：22,000 例，加那利群岛最低：-210 例）。2020 年 e0 下降幅度最大的地区是马德里（男性-3.58 岁，女性-2.25 岁）、卡斯蒂利亚-拉曼恰（-2.72，-2.38）以及卡斯蒂利亚和莱昂（-2.13，-1.39）。2021 年上半年，e0 下降幅度最大的是马德里男性（-2.09；-2.37 至-1.84）和巴伦西亚大区女性（-1.63；-1.97 至-1.3）。2020 年超额寿命损失年数最多的是卡斯蒂利亚-拉曼恰（男性：5370 年；女性：3600 年，每 10 万人）。我们观察到，西班牙各地区报告的 COVID-19 死亡人数与估计的超额死亡人数之间存在巨大差异。调查这些地区不平等的根本原因可能会为西班牙和其他地区未来的流行病政策提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gaceta Sanitaria 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.10

自引率

5.30%

发文量

审稿时长

29 days

期刊介绍： Gaceta Sanitaria (Health Gazette) is an international journal that accepts articles in Spanish and in English. It is the official scientific journal of the Sociedad Española de Salud Publica y Administración Sanitaria (Spanish Society of Public Health and Health Administration) (SESPAS). The Journal publishes 6 issues per year on different areas of Public Health and Health Administration, including: -Applied epidemiology- Health prevention and promotion- Environmental health- International health- Management and assessment of policies and services- Health technology assessments- Health economics. The editorial process is regulated by a peer review system. It publishes original works, reviews, opinion articles, field and methodology notes, protocols, letters to the editor, editorials, and debates.