Publication:
Assessing educational disparities in COVID-19 related excess mortality in Spain: a population register-linked mortality study

Date

2024-08-27

Authors

Pulido, José
Donat, Marta
Politi, Julieta
Cea-Soriano, Lucía
Sordo, Luis
Mateo-Urdiales, Alberto
Ronda, Elena
Belza, María José
Barrio, Gregorio

Director

Publisher

Frontiers Media
Acceso abierto / Sarbide irekia
Artículo / Artikulua
Versión publicada / Argitaratu den bertsioa

Project identifier

Abstract

Introduction: data on the increase in mortality during the COVID-19 pandemic based on individuals' socioeconomic positions are limited. This study examines this increase in mortality in Spain during the epidemic waves of 2020 and 2021. Methods: we calculated the overall and cause-specific mortality rates during the 2017-2019 pre-pandemic period and four epidemic periods in 2020 and 2021 (first, second, third-fourth, and fifth-sixth waves). Mortality rates were analyzed based on educational levels (low, medium, and high) and across various age groups (25–64, 65–74, and 75+). The increase in mortality during each epidemic period compared to the pre-pandemic period was estimated using mortality rate ratios (MRR) derived from Poisson regression models. Results: an inverse educational gradient in overall mortality was observed across all periods; however, this pattern was not consistent for COVID-19 mortality in some age groups. Among those aged 75 years and older, highly educated individuals showed higher COVID-19 mortality during the first wave. In the 25-64 age group, individuals with low education experienced the highest overall mortality increase, while those with high education had the lowest increase. The MRRs were 1.21 and 1.06 during the first wave and 1.12 and 0.97 during the last epidemic period. In the 65–74 age group, highly educated individuals showed the highest overall mortality increase during the first wave, whereas medium-educated individuals had the highest increase during the subsequent epidemic periods. Among those aged 75 and older, highly educated individuals exhibited the highest overall mortality increase while the individuals with low education showed the lowest overall mortality increment, except during the last epidemic period. Conclusion: the varying educational patterns of COVID-19 mortality across different age groups contributed to the disparities of findings in increased overall mortality by education levels during the COVID-19 pandemic.

Description

Keywords

Cause of death, COVID-19 pandemic, Education, Mortality, Spain

Department

Sociología y Trabajo Social / Soziologia eta Gizarte Lana

Faculty/School

Degree

Doctorate program

item.page.cita

Pulido, J., Donat, M., Moreno, A., Politi, J., Cea-Soriano, L., Sordo, L., Mateo-Urdiales, A., Ronda, E., Belza, M. J., Barrio, G., Regidor, E. (2024) Assessing educational disparities in COVID-19 related excess mortality in Spain: a population register-linked mortality study. Frontiers in Public Health, 12, 1-10. https://doi.org/10.3389/fpubh.2024.1381298.

item.page.rights

© 2024 Pulido, Donat, Moreno, Politi, Cea-Soriano, Sordo, Mateo-Urdiales, Ronda, Belza, Barrio and Regidor. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).

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