Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factors
Abstract Background This study aims to investigate how pre-existing health status and social background contribute to excess mortality during the COVID-19 crisis in Belgium. Methods The study population consists of almost 1.4 million adult members of Solidaris, the second largest health insurance fu...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | Archives of Public Health |
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| Online Access: | https://doi.org/10.1186/s13690-025-01499-2 |
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| author | Laura Van den Borre Brecht Devleesschauwer Sylvie Gadeyne Katrien Vanthomme Didier Willaert |
| author_facet | Laura Van den Borre Brecht Devleesschauwer Sylvie Gadeyne Katrien Vanthomme Didier Willaert |
| author_sort | Laura Van den Borre |
| collection | DOAJ |
| description | Abstract Background This study aims to investigate how pre-existing health status and social background contribute to excess mortality during the COVID-19 crisis in Belgium. Methods The study population consists of almost 1.4 million adult members of Solidaris, the second largest health insurance fund in Belgium. Pre-existing health status was identified using health care reimbursement data, including medication use. Social characteristics included a proxy for low socio-economic status, nationality of origin, and living arrangement. Excess mortality during the COVID-19 crisis was measured by computing the relative difference between all-cause mortality in 2020 or 2021 and the average yearly mortality in 2015–2019. Directly Standardised Mortality Rates (DSMRs) were calculated to investigate absolute mortality inequalities. Mortality Rate Ratios (MRRs) were computed using Poisson regression analyses to investigate relative mortality inequalities. Results DSMRs show that persons with no previous disease experienced significant excess mortality in 2020, like men with one, two or three diseases and women with various numbers of pre-existing diseases. Results by specific disease show heterogenous results. After adjusting for age, sex and social characteristics, persons with cancer experienced a significant mortality deficit of 17% in 2020 and of 9% in 2021. For persons with cancer and asthma or COPD, significant mortality deficits of 10% and 3% were observed in 2020 and 2021, respectively. Conclusion The study provides insights into the complex dynamics of mortality during the COVID-19 crisis, emphasising the need to consider individual-level information on pre-existing health and social background jointly. |
| format | Article |
| id | doaj-art-b3410cedac644b62b5f690e59b1ada13 |
| institution | Kabale University |
| issn | 2049-3258 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Archives of Public Health |
| spelling | doaj-art-b3410cedac644b62b5f690e59b1ada132025-01-26T12:16:21ZengBMCArchives of Public Health2049-32582025-01-0183111110.1186/s13690-025-01499-2Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factorsLaura Van den Borre0Brecht Devleesschauwer1Sylvie Gadeyne2Katrien Vanthomme3Didier Willaert4Department of Epidemiology and Public HealthDepartment of Epidemiology and Public HealthBrussels Institute for Social and Population Studies, Vrije Universiteit BrusselDepartment of Public Health and Primary Care, Ghent UniversitySolidaris - Socialist Health Insurance FundAbstract Background This study aims to investigate how pre-existing health status and social background contribute to excess mortality during the COVID-19 crisis in Belgium. Methods The study population consists of almost 1.4 million adult members of Solidaris, the second largest health insurance fund in Belgium. Pre-existing health status was identified using health care reimbursement data, including medication use. Social characteristics included a proxy for low socio-economic status, nationality of origin, and living arrangement. Excess mortality during the COVID-19 crisis was measured by computing the relative difference between all-cause mortality in 2020 or 2021 and the average yearly mortality in 2015–2019. Directly Standardised Mortality Rates (DSMRs) were calculated to investigate absolute mortality inequalities. Mortality Rate Ratios (MRRs) were computed using Poisson regression analyses to investigate relative mortality inequalities. Results DSMRs show that persons with no previous disease experienced significant excess mortality in 2020, like men with one, two or three diseases and women with various numbers of pre-existing diseases. Results by specific disease show heterogenous results. After adjusting for age, sex and social characteristics, persons with cancer experienced a significant mortality deficit of 17% in 2020 and of 9% in 2021. For persons with cancer and asthma or COPD, significant mortality deficits of 10% and 3% were observed in 2020 and 2021, respectively. Conclusion The study provides insights into the complex dynamics of mortality during the COVID-19 crisis, emphasising the need to consider individual-level information on pre-existing health and social background jointly.https://doi.org/10.1186/s13690-025-01499-2MultimorbidityChronic diseasesSocio-economic statusCOVID-19All-cause mortality |
| spellingShingle | Laura Van den Borre Brecht Devleesschauwer Sylvie Gadeyne Katrien Vanthomme Didier Willaert Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factors Archives of Public Health Multimorbidity Chronic diseases Socio-economic status COVID-19 All-cause mortality |
| title | Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factors |
| title_full | Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factors |
| title_fullStr | Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factors |
| title_full_unstemmed | Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factors |
| title_short | Understanding excess mortality during COVID in Belgium: the influence of pre-existing health status and social factors |
| title_sort | understanding excess mortality during covid in belgium the influence of pre existing health status and social factors |
| topic | Multimorbidity Chronic diseases Socio-economic status COVID-19 All-cause mortality |
| url | https://doi.org/10.1186/s13690-025-01499-2 |
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