Excess Deaths in California During the COVID-19 Pandemic, by Healthy Places Index Quartile, February 2020-April 2022.

IF 3 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Reports Pub Date : 2025-04-29 DOI:10.1177/00333549251314409

Celeste J Romano, Tiffany N Tsukuda, Rui Zhao, Joshua Quint, Seema Jain, Erin L Murray

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Abstract

Objectives: Place-based disadvantage indices have been used to assess health disparities and allocate funding and health resources. We assessed excess mortality in California during the COVID-19 pandemic by Healthy Places Index (HPI) quartile, a disadvantage index used by the California Department of Public Health to structure COVID-19 response efforts.

Methods: We estimated expected deaths from all causes during the COVID-19 pandemic by fitting a quasi-Poisson regression model to actual deaths that occurred from 2014 through 2019. We estimated ranges of excess deaths by calculating differences between actual deaths and (1) the average expected number of deaths and (2) the upper bound of the 95% prediction interval. The percentage of excess deaths equaled the number of excess deaths divided by the corresponding threshold. We reported estimates overall and across demographic groups, stratified by HPI quartile; quartile 4 indicated communities with the most advantaged social and environmental conditions.

Results: From February 2020 through April 2022, the number of excess deaths in California ranged from 81 245 to 107 806, with 93 309 deaths attributed to COVID-19. The number of excess deaths decreased across quartiles, from 27 924 to 35 615 (20.5%-28.0%) in HPI quartile 1 to 7757 to 14 477 (4.6%-9.2%) in HPI quartile 4. The Hispanic or Latine population had a disproportionate percentage of excess deaths across all quartiles, whereas American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Pacific Islander, and White (all non-Hispanic) populations had percentage excess death estimates in quartile 2 that were similar to or higher than in quartile 1.

Conclusions: Health policies should supplement the use of place-based disparity measures with other measures that support groups at high risk for adverse health outcomes residing in more socially and environmentally advantaged communities.

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2020年2月至2022年4月，按健康场所指数四分位数划分的加州COVID-19大流行期间的超额死亡人数。

目的：基于地方的劣势指数已被用于评估健康差异和分配资金和卫生资源。我们通过健康场所指数（HPI）四分位数评估了加州在COVID-19大流行期间的超额死亡率，HPI是加州公共卫生部用于构建COVID-19应对工作的劣势指数。方法：我们通过拟泊松回归模型拟合2014年至2019年发生的实际死亡人数，估计了COVID-19大流行期间所有原因的预期死亡人数。我们通过计算实际死亡人数与(1)平均预期死亡人数和(2)95%预测区间上界之间的差异来估计超额死亡人数的范围。超额死亡的百分比等于超额死亡人数除以相应的阈值。我们报告了总体和跨人口群体的估计，按HPI四分位数分层；四分位数4表示社会和环境条件最有利的社区。结果：从2020年2月到2022年4月，加州的超额死亡人数从81 245人到107 806人不等，其中93 309人死于COVID-19。超额死亡人数在各四分位数中均有所下降，从高卫生指数四分位数1的27 924例降至35 615例（20.5%-28.0%），而高卫生指数四分位数4的7757例降至14 477例（4.6%-9.2%）。西班牙裔或拉丁裔人口在所有四分位数中的超额死亡率比例不成比例，而美洲印第安人或阿拉斯加原住民、亚洲人、黑人或非裔美国人、夏威夷原住民或太平洋岛民和白人（所有非西班牙裔）人口在四分位数2中的超额死亡率估计百分比与四分位数1相似或更高。结论：卫生政策应补充使用基于地方的差距措施，并采取其他措施，支持居住在社会和环境更有利的社区的不良健康结果高风险群体。

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

Public Health Reports 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.00

自引率

6.10%

发文量

164

审稿时长

6-12 weeks

期刊介绍： Public Health Reports is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public Health. The journal is peer-reviewed and publishes original research and commentaries in the areas of public health practice and methodology, original research, public health law, and public health schools and teaching. Issues contain regular commentaries by the U.S. Surgeon General and executives of the U.S. Department of Health and Human Services and the Office of the Assistant Secretary of Health. The journal focuses upon such topics as tobacco control, teenage violence, occupational disease and injury, immunization, drug policy, lead screening, health disparities, and many other key and emerging public health issues. In addition to the six regular issues, PHR produces supplemental issues approximately 2-5 times per year which focus on specific topics that are of particular interest to our readership. The journal''s contributors are on the front line of public health and they present their work in a readable and accessible format.