TY - JOUR
T1 - Towards closing socio-economic status disparities in COVID-19 premature mortality
T2 - a nationwide and trend analysis in Chile
AU - Maureira, Lea
AU - Urquidi, Cinthya
AU - Sepúlveda-Peñaloza, Alejandro
AU - Soto-Marchant, Mario
AU - Matus, Patricia
N1 - Publisher Copyright:
© The Author(s) 2024; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
PY - 2024/2/1
Y1 - 2024/2/1
N2 - Background: Socio-economic status (SES) disparities in coronavirus disease 2019 (COVID-19) mortality have been reported but complete information and time trends are scarce. In this study, we analysed the years of life lost (YLL) due to COVID-19 premature mortality during the pandemic in Chile and its evolution according to SES and sex compared with a counterfactual scenario [cerebrovascular accidents (stroke)]. Method: We used Chile’s national mortality databases from 2020 to 2022. YLL and age-standardized YLL and mortality rates by sex and by epidemic waves were determined. The 346 communes were stratified into SES groups according to their poverty index quintile. Negative binomial regression models were used to test trends. Results: In >2 years of the pandemic, the COVID-19 YLL was 975 937, corresponding to 61 174 deaths. The YLL rate per 100 000 inhabitants was 1027 for males and 594 for females. There was a heterogeneous distribution of YLL rates and the regional level. Communes in the most advantaged SES quintile (Q5) had the highest YLL during the first wave compared with those in the lowest SES quintile (Q1) (P < 0.001) but the opposite was true during the second wave. COVID-19 YLL trends declined and differences between Q1 and Q2 vs Q5 converged from the second to the fourth waves (0.33 and 0.15, Ptrend < 0.001 and Ptrend ¼ 0.024). YLL declined but differences persisted in stroke (–0.002, Ptrend ¼ 0.979). Conclusions: COVID-19 deaths resulted in a higher impact on premature death in Chile, especially in men, with a heterogeneous geographic distribution along the territory. SES and sex disparities in COVID-19 premature mortality had narrowed by the end of the pandemic.
AB - Background: Socio-economic status (SES) disparities in coronavirus disease 2019 (COVID-19) mortality have been reported but complete information and time trends are scarce. In this study, we analysed the years of life lost (YLL) due to COVID-19 premature mortality during the pandemic in Chile and its evolution according to SES and sex compared with a counterfactual scenario [cerebrovascular accidents (stroke)]. Method: We used Chile’s national mortality databases from 2020 to 2022. YLL and age-standardized YLL and mortality rates by sex and by epidemic waves were determined. The 346 communes were stratified into SES groups according to their poverty index quintile. Negative binomial regression models were used to test trends. Results: In >2 years of the pandemic, the COVID-19 YLL was 975 937, corresponding to 61 174 deaths. The YLL rate per 100 000 inhabitants was 1027 for males and 594 for females. There was a heterogeneous distribution of YLL rates and the regional level. Communes in the most advantaged SES quintile (Q5) had the highest YLL during the first wave compared with those in the lowest SES quintile (Q1) (P < 0.001) but the opposite was true during the second wave. COVID-19 YLL trends declined and differences between Q1 and Q2 vs Q5 converged from the second to the fourth waves (0.33 and 0.15, Ptrend < 0.001 and Ptrend ¼ 0.024). YLL declined but differences persisted in stroke (–0.002, Ptrend ¼ 0.979). Conclusions: COVID-19 deaths resulted in a higher impact on premature death in Chile, especially in men, with a heterogeneous geographic distribution along the territory. SES and sex disparities in COVID-19 premature mortality had narrowed by the end of the pandemic.
KW - COVID-19
KW - Ompact
KW - Premature mortality
KW - Socio-economic status disparities
KW - Years of life lost
UR - http://www.scopus.com/inward/record.url?scp=85184794498&partnerID=8YFLogxK
U2 - 10.1093/ije/dyad183
DO - 10.1093/ije/dyad183
M3 - Article
C2 - 38224273
AN - SCOPUS:85184794498
SN - 0300-5771
VL - 53
SP - 1
EP - 8
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 1
M1 - dyad183
ER -