Study reveals worrying disparity in excess deaths during pandemic

Posted on 7 June 2021

A new study has revealed strong disparities in rates of excess deaths in England and Wales during the first 30 weeks of the COVID-19 pandemic.

The study showed that there were 62,321 excess deaths in England and Wales in the first 30 weeks of the pandemic.

The research – led by the Universities of York and Manchester - showed the highest excess mortality rates were in the West Midlands, the North East, and the North West. The lowest rates were in the South West of England and Wales.

According to the research team, deaths compared with those expected from historical trends were unequally distributed, both geographically and socioeconomically.

The study showed that there were 62,321 excess deaths in England and Wales in the first 30 weeks of the pandemic. Of these, 46,221 were attributable to respiratory causes, including COVID-19, and 16,100 to other causes.

Deprived

Rates of death varied widely across the regions, from 78 excess deaths per 100,000 people in the South West of England and in Wales to 130 per 100,000 in the West Midlands.

And 93 excess deaths per 100,000 people occurred in the most affluent fifth of areas, whereas there were 124 per 100,000 in the most deprived areas.

The study also found:

There were 6,887 excess cardiovascular & diabetes, and 1,668 excess cancer deaths over the study period.
There were fewer than expected cancer deaths in hospitals (-6,655), hospices (-2,186), and care homes (-917), but more in private homes (10,665).
The overall excess mortality rate for England and Wales directly attributed to COVID-19 infection or respiratory causes was 77 per 100,000 population

Senior author, Professor Tim Doran from the Department of Health Sciences said: “These results emphasise that regional and socioeconomic variations are relevant to decisions about future pandemic planning, including current and future phases of vaccination roll-out.

“Immediate and longer-term recovery planning for communities and their health and social services should reflect historical disparities as well as the COVID-19 related patterns described in this study.”

Deaths

Lead author, Professor Evan Kontopantelis from The University of Manchester said: “The models demonstrate that the COVID-19 pandemic has caused many more deaths than would have been expected during the same time-period.

“But for England and Wales, these deaths were not evenly distributed across the population, with rates varying markedly by region, and between deprived and less deprived neighbourhoods.”

The analysis was carried out using Office of National Statistics weekly mortality data from December 2014 to October 2020 for England and Wales.

In England and Wales, a fifth of excess deaths during the first wave of the pandemic - from 7 March to 8 May 2020 - were attributable to causes other than COVID-19.

Health conditions

Delayed responses to acute health conditions and exacerbations of pre-existing health conditions led to substantial increases in mortality for cardiovascular disease, diabetes and other conditions.

However, mortality rates for some health conditions, including other infectious respiratory diseases, fell.

The researchers say the variation in rates reflects population susceptibility, in terms of age and pre-existing disease as well as local factors such as housing density, transport infrastructure and air quality.

But a population’s occupational mix and ability and willingness to engage in public health measures such as social distancing and the capacity and quality of local public health, social and healthcare services could also play a part.