Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020
Abstract Background The COVID-19 pandemic has led to major shocks in mortality trends in many countries. Yet few studies have evaluated the heterogeneity of the mortality shocks at the sub-national level, rigorously accounting for the different sources of uncertainty. Methods Using death registratio...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | Archives of Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13690-022-00874-7 |
| _version_ | 1828541724389015552 |
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| author | Benjamin-Samuel Schlüter Bruno Masquelier Carlo Giovanni Camarda |
| author_facet | Benjamin-Samuel Schlüter Bruno Masquelier Carlo Giovanni Camarda |
| author_sort | Benjamin-Samuel Schlüter |
| collection | DOAJ |
| description | Abstract Background The COVID-19 pandemic has led to major shocks in mortality trends in many countries. Yet few studies have evaluated the heterogeneity of the mortality shocks at the sub-national level, rigorously accounting for the different sources of uncertainty. Methods Using death registration data from Belgium, we first assess change in the heterogeneity of districts’ standardized mortality ratios in 2020, when compared to previous years. We then measure the shock effect of the pandemic using district-level values of life expectancy, comparing districts’ observed and projected life expectancy, accounting for all sources of uncertainty (stemming from life-table construction at district level and from projection methods at country and district levels). Bayesian modelling makes it easy to combine the different sources of uncertainty in the assessment of the shock. This is of particular interest at a finer geographical scale characterized by high stochastic variation in annual death counts. Results The heterogeneity in the impact of the pandemic on all-cause mortality across districts is substantial: while some districts barely show any impact, the Bruxelles-Capitale and Mons districts experienced a decrease in life expectancy at birth of 2.24 (95% CI:1.33–3.05) and 2.10 (95% CI:0.86–3.30) years, respectively. The year 2020 was associated with an increase in the heterogeneity of mortality levels at a subnational scale in comparison to past years, measured in terms of both standardized mortality ratios and life expectancies at birth. Decisions on uncertainty thresholds have a large bearing on the interpretation of the results. Conclusion Developing sub-national mortality estimates taking careful account of uncertainty is key to identifying which areas have been disproportionately affected. |
| first_indexed | 2024-12-12T01:44:05Z |
| format | Article |
| id | doaj.art-02ea53cf1ad54561b309f7b6ba06c485 |
| institution | Directory Open Access Journal |
| issn | 2049-3258 |
| language | English |
| last_indexed | 2024-12-12T01:44:05Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Archives of Public Health |
| spelling | doaj.art-02ea53cf1ad54561b309f7b6ba06c4852022-12-22T00:42:37ZengBMCArchives of Public Health2049-32582022-05-0180111310.1186/s13690-022-00874-7Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020Benjamin-Samuel Schlüter0Bruno Masquelier1Carlo Giovanni Camarda2IACCHOS (DEMO), Catholic University of Louvain (UCLouvain)IACCHOS (DEMO), Catholic University of Louvain (UCLouvain)Mortality, Health and Epidemiology, Institut National d’Etudes Démographiques (INED)Abstract Background The COVID-19 pandemic has led to major shocks in mortality trends in many countries. Yet few studies have evaluated the heterogeneity of the mortality shocks at the sub-national level, rigorously accounting for the different sources of uncertainty. Methods Using death registration data from Belgium, we first assess change in the heterogeneity of districts’ standardized mortality ratios in 2020, when compared to previous years. We then measure the shock effect of the pandemic using district-level values of life expectancy, comparing districts’ observed and projected life expectancy, accounting for all sources of uncertainty (stemming from life-table construction at district level and from projection methods at country and district levels). Bayesian modelling makes it easy to combine the different sources of uncertainty in the assessment of the shock. This is of particular interest at a finer geographical scale characterized by high stochastic variation in annual death counts. Results The heterogeneity in the impact of the pandemic on all-cause mortality across districts is substantial: while some districts barely show any impact, the Bruxelles-Capitale and Mons districts experienced a decrease in life expectancy at birth of 2.24 (95% CI:1.33–3.05) and 2.10 (95% CI:0.86–3.30) years, respectively. The year 2020 was associated with an increase in the heterogeneity of mortality levels at a subnational scale in comparison to past years, measured in terms of both standardized mortality ratios and life expectancies at birth. Decisions on uncertainty thresholds have a large bearing on the interpretation of the results. Conclusion Developing sub-national mortality estimates taking careful account of uncertainty is key to identifying which areas have been disproportionately affected.https://doi.org/10.1186/s13690-022-00874-7Covid19MortalitySubnationalSmall-areaBelgiumBayesian models |
| spellingShingle | Benjamin-Samuel Schlüter Bruno Masquelier Carlo Giovanni Camarda Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020 Archives of Public Health Covid19 Mortality Subnational Small-area Belgium Bayesian models |
| title | Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020 |
| title_full | Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020 |
| title_fullStr | Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020 |
| title_full_unstemmed | Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020 |
| title_short | Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020 |
| title_sort | heterogeneity in subnational mortality in the context of the covid 19 pandemic the case of belgian districts in 2020 |
| topic | Covid19 Mortality Subnational Small-area Belgium Bayesian models |
| url | https://doi.org/10.1186/s13690-022-00874-7 |
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