Widening of inequalities in COVID-19 years of life lost from 2020 to 2021: a Scottish Burden of Disease Study.

Grant M A Wyper, Eilidh Fletcher, Ian Grant, Oliver Harding, Maria Teresa de Haro Moro, Gerry McCartney, Diane L Stockton
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Abstract

Background: Previous studies have highlighted the large extent of inequality in adverse COVID-19 health outcomes. Our aim was to monitor changes in overall, and inequalities in, COVID-19 years of life lost to premature mortality (YLL) in Scotland from 2020 and 2021.

Methods: Cause-specific COVID-19 mortality counts were derived at age group and area deprivation level using Scottish death registrations for 2020 and 2021. YLL was estimated by multiplying mortality counts by age-conditional life expectancy from the Global Burden of Disease 2019 reference life table. Various measures of absolute and relative inequality were estimated for triangulation purposes.

Results: There were marked inequalities in COVID-19 YLL by area deprivation in 2020, which were further exacerbated in 2021; confirmed across all measures of absolute and relative inequality. Half (51%) of COVID-19 YLL was attributable to inequalities in area deprivation in 2021, an increase from 41% in 2020.

Conclusion: Despite a highly impactful vaccination programme in preventing mortality, COVID-19 continues to represent a substantial area of fatal population health loss for which inequalities have widened. Tackling systemic inequalities with effective interventions is required to mitigate further unjust health loss in the Scottish population from COVID-19 and other causes of ill-health and mortality.

2020 年至 2021 年 COVID-19 生命损失年数不平等的扩大:苏格兰疾病负担研究。
背景:先前的研究强调了 COVID-19 健康不良后果的严重不平等。我们的目的是监测 2020 年和 2021 年苏格兰 COVID-19 因过早死亡而损失的生命年数(YLL)的总体变化和不平等情况:方法:利用 2020 年和 2021 年苏格兰死亡登记,按年龄组和地区贫困程度得出特定病因 COVID-19 死亡率计数。将死亡率乘以 2019 年全球疾病负担参考寿命表中的年龄条件预期寿命,即可估算出 YLL。出于三角测量的目的,对绝对和相对不平等的各种衡量标准进行了估算:2020 年,按贫困地区划分的 COVID-19 YLL 存在明显的不平等,到 2021 年,这种不平等进一步加剧;所有绝对和相对不平等指标均证实了这一点。2021 年,一半(51%)的 COVID-19 YLL 可归因于贫困地区的不平等,比 2020 年的 41% 有所上升:结论:尽管疫苗接种计划在预防死亡方面产生了巨大影响,但 COVID-19 仍是致命人口健康损失的一个重要领域,其中的不平等现象有所扩大。需要通过有效的干预措施来解决系统性不平等问题,以减少 COVID-19 及其他疾病和死亡原因给苏格兰人口造成的更多不公正的健康损失。
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