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Community factors and excess mortality in the COVID-19 pandemic in England, Italy and Sweden

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Title: Community factors and excess mortality in the COVID-19 pandemic in England, Italy and Sweden
Authors: Parkes, B
Stafoggia, M
Fecht, D
Davies, B
Bonander, C
De' Donato, F
Michelozzi, P
Piel, F
Stromberg, U
Blangiardo, M
Item Type: Journal Article
Abstract: Background: Analyses of COVID-19 suggest specific risk factors make communities more or less vulnerable to pandemic related deaths within countries. What is unclear is whether the characteristics affecting vulnerability of small communities within countries produce similar patterns of excess mortality across countries with different demographics and public health responses to the pandemic. Our aim is to quantify community-level variations in excess mortality within England, Italy and Sweden and identify how such spatial variability was driven by community-level characteristics. Methods: We applied a two-stage Bayesian model to quantify inequalities in excess mortality in people aged 40 years and older at the community level in England, Italy and Sweden during the first year of the pandemic (March 2020–February 2021). We used community characteristics measuring deprivation, air pollution, living conditions, population density and movement of people as covariates to quantify their associations with excess mortality. Results: We found just under half of communities in England (48.1%) and Italy (45.8%) had an excess mortality of over 300 per 100,000 males over the age of 40, while for Sweden that covered 23.1% of communities. We showed that deprivation is a strong predictor of excess mortality across the three countries, and communities with high levels of overcrowding were associated with higher excess mortality in England and Sweden. Conclusion: These results highlight some international similarities in factors affecting mortality that will help policy makers target public health measures to increase resilience to the mortality impacts of this and future pandemics.
Issue Date: 1-Jun-2023
Date of Acceptance: 17-Apr-2023
URI: http://hdl.handle.net/10044/1/104077
DOI: 10.1093/eurpub/ckad075
ISSN: 1101-1262
Publisher: Oxford University Press
Start Page: 695
End Page: 703
Journal / Book Title: European Journal of Public Health
Volume: 33
Issue: 4
Copyright Statement: The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Publication Status: Published
Online Publication Date: 2023-06-01
Appears in Collections:Faculty of Medicine
Imperial College London COVID-19
School of Public Health

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