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New Article in “Journal of Epidemiology and Global Health” | 04.08.2023Cause-Specific Excess Mortality across German Regions
A new paper has been published by Michael Mühlichen, Markus Sauerberg and Pavel Grigoriev from our REDIM team in the “Journal of Epidemiology and Global Health”, analysing the cause-specific, spatial and seasonal mortality effects attributable to the COVID-19 pandemic in Germany in 2020.
Evaluating mortality effects of the COVID-19 pandemic using all-cause mortality data for national populations is inevitably associated with the risk of masking important subnational differentials and hampering targeted health policies. Therefore, this study assessed simultaneously cause-specific, spatial and seasonal mortality effects attributable to the pandemic in Germany in 2020.
Using official cause-of-death statistics consisting of 5.65 million individual death records reported for the German population during 2015–2020, the authors conducted differential mortality analyses by age, sex, cause, month and district (N = 400). Based on decomposition and standardisation methods, they compared each strata of the mortality level observed in 2020 with its expected value. In addition, they applied spatial regression techniques to explore the association of excess mortality with pre-pandemic indicators.
The spatial analyses of excess mortality reveal a very heterogenous pattern, even within federal states. The coastal areas in the north were least affected, while the south of eastern Germany experienced the highest levels. Excess mortality in the most affected districts, with standardised mortality ratios reaching up to 20%, is driven widely by older ages and deaths reported in December, particularly from COVID-19 but also from cardiovascular and mental/nervous diseases.
The results suggest that increased psychosocial stress influenced the outcome of excess mortality in the most affected areas during the second lockdown, thus hinting at possible adverse effects of strict policy measures. The authors conclude that it is essential to accelerate the collection of detailed mortality data to provide policymakers earlier with relevant information in times of crisis.
Mühlichen, Michael; Sauerberg, Markus; Grigoriev, Pavel (2023): Evaluating spatial, cause-specific and seasonal effects of excess mortality associated with the COVID-19 pandemic: the case of Germany, 2020. Journal of Epidemiology and Global Health (online first).