Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factors.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Archives of Public Health Pub Date : 2025-01-23 DOI:10.1186/s13690-025-01499-2

Laura Van den Borre, Brecht Devleesschauwer, Sylvie Gadeyne, Katrien Vanthomme, Didier Willaert

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引用次数: 0

Abstract

Background: This study aims to investigate how pre-existing health status and social background contribute to excess mortality during the COVID-19 crisis in Belgium.

Methods: The study population consists of almost 1.4 million adult members of Solidaris, the second largest health insurance fund in Belgium. Pre-existing health status was identified using health care reimbursement data, including medication use. Social characteristics included a proxy for low socio-economic status, nationality of origin, and living arrangement. Excess mortality during the COVID-19 crisis was measured by computing the relative difference between all-cause mortality in 2020 or 2021 and the average yearly mortality in 2015-2019. Directly Standardised Mortality Rates (DSMRs) were calculated to investigate absolute mortality inequalities. Mortality Rate Ratios (MRRs) were computed using Poisson regression analyses to investigate relative mortality inequalities.

Results: DSMRs show that persons with no previous disease experienced significant excess mortality in 2020, like men with one, two or three diseases and women with various numbers of pre-existing diseases. Results by specific disease show heterogenous results. After adjusting for age, sex and social characteristics, persons with cancer experienced a significant mortality deficit of 17% in 2020 and of 9% in 2021. For persons with cancer and asthma or COPD, significant mortality deficits of 10% and 3% were observed in 2020 and 2021, respectively.

Conclusion: The study provides insights into the complex dynamics of mortality during the COVID-19 crisis, emphasising the need to consider individual-level information on pre-existing health and social background jointly.

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来源期刊

Archives of Public Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

4.80

自引率

3.00%

发文量

244

审稿时长

16 weeks

期刊介绍： rchives of Public Health is a broad scope public health journal, dedicated to publishing all sound science in the field of public health. The journal aims to better the understanding of the health of populations. The journal contributes to public health knowledge, enhances the interaction between research, policy and practice and stimulates public health monitoring and indicator development. The journal considers submissions on health outcomes and their determinants, with clear statements about the public health and policy implications. Archives of Public Health welcomes methodological papers (e.g., on study design and bias), papers on health services research, health economics, community interventions, and epidemiological studies dealing with international comparisons, the determinants of inequality in health, and the environmental, behavioural, social, demographic and occupational correlates of health and diseases.