New research shows that the COVID-19 pandemic widened existing health inequalities across England and Wales, causing higher mortality rates in more deprived areas


The impact of COVID-19 widened existing health inequalities across England and Wales, resulting in substantially higher rates of mortality in the most deprived areas compared with the most affluent, a new analysis has found.

According to the study, published in the open access journal PLOS Medicine, that there were 11 times as many excess deaths in people aged 15–44 years in the most socio-economically disadvantaged regions during the first year of the pandemic compared to the most affluent ones.

Researchers from the University of Manchester said their findings could help policy makers to refine future strategies to manage pandemics, and influence decisions about vaccination roll-out by taking regional and socio-economic factors into account.

Excess years of life lost

The study analysed national mortality registers in England and Wales from December 2014 to December 2020, covering nearly 3.3 million deaths. From these, they estimated expected years of life lost during 2020 by sex, geographical region, and deprivation.

Between March and December 2020, there were an estimated 763,550 excess years of life lost in England and Wales, equivalent to a 15% increase compared to the same period the previous year, before the pandemic began.

Excess years of life lost per 100,000 of the population ranged from 916 for the least deprived areas to 1645 for the most deprived.

Of the excess deaths, 646,518 (84.7%) were directly attributed to COVID-19 or other respiratory diseases, and 117,032 (15.3%) were attributed to other causes.

The researchers estimated that mortality linked to COVID-19 and other respiratory factors was 1066 per 100,000 population. However, this varied greatly by region, from 438 per 100,000 in the South West of England to 1529 per 100,000 in the North West.

Younger age groups hit

The impact of deprivation on mortality was greatest in younger people. For all-cause mortality, there 480 excess deaths among 15–44 year olds in the most deprived areas, compared with 42 in the most affluent.

Adjusting for population sizes, ratios of all-cause excess deaths ranged from 2.7 in 15–44 year olds to 1.6 in those aged 85 years or over.

A mean of 9.1 years per death were lost in the least deprived areas, compared to 10.8 in the most deprived. 

For COVID-19 and other respiratory deaths, the mean was 8.9 years per death in the least deprived areas, and 11.2 in the most deprived.

Evan Kontopantelis, Professor of Data Science and Health Services at the University of Manchester, who led the study, said: ‘The pandemic widened pre-existing health inequalities across England and Wales: regions and social groups with the highest baseline mortality rates experienced the greatest impact on years of life lost.

‘Linked to this, we think the impact of the pandemic may have been higher than previously thought on the most deprived areas of England and Wales, with more younger people dying directly or indirectly from COVID-19 in these areas.’

Co-investigator Professor Tim Doran from the University of York said: ‘Our findings support the notion that years of life lost can be more informative for determining unmet needs and informing policy for this or future pandemics.

‘In particular, it could provide vital information to aid the targeting of vaccines, financial aid, and social support during this and future pandemics.’

This article originally appeared on Medscape, part of the Medscape Professional Network.


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