Has COVID-19 increased inequality in mortality by income in the Netherlands?

Background In the Netherlands in 2020, COVID-19 deaths were more concentrated among individuals with a lower income. At the same time, COVID-19 was a new cause that also displaced some deaths from other causes, potentially reducing income-related inequality in non-COVID deaths. Our aim is to estimate the impact of the COVID-19 pandemic on the income-related inequality in total mortality and decompose this into the inequality in COVID-attributed deaths and changes in the inequality in non-COVID causes. Methods We estimate excess deaths (observed minus trend-predicted deaths) by sex, age and inc... Mehr ...

Verfasser: Wouterse, Bram
Geisler, Joana
Bär, Marlies
van Doorslaer, Eddy
Dokumenttyp: Artikel
Erscheinungsdatum: 2023
Reihe/Periodikum: Journal of Epidemiology and Community Health ; volume 77, issue 4, page 244-251 ; ISSN 0143-005X 1470-2738
Verlag/Hrsg.: BMJ
Schlagwörter: Public Health / Environmental and Occupational Health / Epidemiology
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27217720
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1136/jech-2022-219845

Background In the Netherlands in 2020, COVID-19 deaths were more concentrated among individuals with a lower income. At the same time, COVID-19 was a new cause that also displaced some deaths from other causes, potentially reducing income-related inequality in non-COVID deaths. Our aim is to estimate the impact of the COVID-19 pandemic on the income-related inequality in total mortality and decompose this into the inequality in COVID-attributed deaths and changes in the inequality in non-COVID causes. Methods We estimate excess deaths (observed minus trend-predicted deaths) by sex, age and income group for the Netherlands in 2020. Using a measure of income-related inequality (the concentration index), we decompose the inequality in total excess mortality into COVID-19 versus non-COVID causes. Results Cause-attributed COVID-19 mortality exceeded total excess mortality by 12% for the 65–79 age group and by about 35% for 80+ in the Netherlands in 2020, implying a decrease in the number of non-COVID deaths compared with what was predicted. The income-related inequality in all-cause mortality was higher than predicted. This increase in inequality resulted from the combination of COVID-19 mortality, which was more unequally distributed than predicted total mortality, and the inequality in non-COVID causes, which was less unequal than predicted. Conclusion The COVID-19 pandemic has led to an increase in income-related inequality in all-cause mortality. Non-COVID mortality was less unequally distributed than expected due to displacement of other causes by COVID-19 and the potentially unequal broader societal impact of the pandemic.