Press Release • 31.07.2024Excess Mortality: Large Regional Differences across Europe

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To do this, the researchers used past trends to estimate how average life expectancy at birth would have developed in 2020 and 2021 without the pandemic. These values were compared with the actual measured life expectancy. With surprising results: While there was a sharp excess mortality in some regions, mortality in some areas remained virtually unchanged. In total, the study includes data for 569 regions in 25 European countries.

In the first year of the pandemic, the researchers recorded high excess mortality mainly in northern Italy, southern Switzerland, central Spain and Poland. “At its peak, life expectancy was more than two and a half years below the expected value in the regions where the first major European COVID-19 outbreaks occurred, namely northern Italy and central Spain,” says co-author Dr. Michael Mühlichen from BiB. Using Italy as an example, the study shows how strong regional differences were in some countries: For example, regions such as Bergamo and Cremona in the Milan conurbation had an excess mortality of just over 4 years in terms of life expectancy in 2020. In some southern Italian provinces, on the other hand, there was no measurable increase in mortality. In parts of northern and western Germany, Denmark, western and southern France, Norway and Sweden, under-mortality was even recorded in 2020.

High Excess Mortality in 2021, Especially in Eastern Europe

Over time, the patterns of excess mortality changed: “While 362 regions recorded significant excess mortality in the first year of the pandemic, this figure rose to 440 in the following year,” reports co-author Dr. Pavel Grigoriev, head of the Mortality Research Group at BiB. From a regional perspective, excess mortality in 2021 shifted strongly towards Eastern Europe and affected men more than women. In Slovakia, Lithuania, Latvia, Hungary and parts of Poland and the Czech Republic, life expectancy was more than 2.5 years below the expected value. Compared to Eastern Europe, many Western European regions showed lower excess mortality in 2021, although this was also mostly higher there than in the previous year. “The reasons for the large regional differences are complex and can be traced back to the different proportions of vulnerable people, among other things,” explains Mühlichen. “The extent to which relevant pre-existing conditions are regionally widespread depends on the age structure and risk behaviour of the population, which in turn are influenced by socio-economic conditions.”

A considerable east-west divide was also visible within Germany in 2021. Excess mortality in Thuringia, in the south and east of Saxony and in the south of Saxony-Anhalt and Brandenburg was 1.5 to 2 years. In the former federal territory – with the exception of some Bavarian areas – it was less than one year.

Pandemic Spread from the City to the Countryside

The study also shows that the pandemic initially affected urban areas with high international connectivity. From there, it then spread to less connected and more peripheral areas. “In-depth regional analyses enable a differentiated assessment of the differences in excess mortality, which often remain hidden when analysed at country level,” says Grigoriev, emphasising the practical benefits of the study. “These findings will help us to better understand excess mortality during the pandemic and incorporate this into preventive measures for future pandemics.”

Background Information on the Study and the Methodology

The extent of the excess mortality and under-mortality determined depends on what the life expectancy recorded during the coronavirus pandemic in 2020 and 2021 is compared with. For this study, the long-term development of life expectancy in each region analysed before 2020 was included. Based on this, the most probable values for life expectancy in 2020 and 2021 were ‘predicted’ using a statistical estimation method. The deviation between these expected values and the actual measured values indicates the excess or shortfall in mortality in the respective region.

The press release is based on this article:
Bonnet, Florian; Grigoriev, Pavel; Sauerberg, Markus; Alliger, Ina; Mühlichen, Michael; Camarda, Carlo-Giovanni (2024): Spatial disparities in the mortality burden of the covid-19 pandemic across 569 European regions (2020–2021). Nature Communications 15(4246).