Excess mortality in England and Scotland in 2022: The long shadow of austerity and the return to an unacceptable pre-pandemic baseline
DOI:
https://doi.org/10.55016/8kkpa186Keywords:
Mortality, Excess mortality, Austerity, Health inequalities, COVID-19Abstract
Concerns exist that mortality remains elevated after COVID-19 peaks. This study examined whether mortality in England and Scotland in 2022 exceeded predictions from austerity-era (2012–2019) and pre-austerity (2001–2010) trends. Time trend analysis was conducted using data from 2001–2022. The outcomes were observed and expected age- and sex-standardised mortality rates (ASMRs). Expected 2022 ASMRs were calculated from austerity-era and pre-austerity trends. Excess deaths were estimated by comparing observed and expected ASMRs. Observed ASMRs were higher than austerity-era predictions and substantially higher than pre-austerity predictions. In England, excesses for females were 4.4% (4.0–4.8) and 38.2% (95% CI: 37.7–38.7), and 7.2% (6.8–7.6) and 57.0% (56.4–57.6) for males. In Scotland, excesses for females were 3.4% (2.2–4.5) and 26.6% (25.2–28.0), and 2.6% (1.5–3.8) and 45.2% (43.6–46.9) for males. COVID-19 accounted for 5.3–6.5% of deaths in 2022 and explained much of the excess compared to austerity-era trends. ASMRs were 1.68–1.94 times higher in the most versus least deprived areas. Deaths attributable to COVID-19 explain much of the excess compared to austerity-era trends. However, 879,430 excess deaths relative to pre-austerity trends, even excluding COVID-19 deaths, highlights the devastating impacts of austerity on public health.
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