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. 2021 Dec 18;20(1):258.
doi: 10.1186/s12939-021-01594-0.

Are we really all in this together? The social patterning of mortality during the first wave of the COVID-19 pandemic in Belgium

Sylvie Gadeyne  1 , Lucia Rodriguez-Loureiro  2 , Johan Surkyn  2 , Wanda Van Hemelrijck  2   3 , Wilma Nusselder  4 , Patrick Lusyne  5 , Katrien Vanthomme  2
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Are we really all in this together? The social patterning of mortality during the first wave of the COVID-19 pandemic in Belgium

Sylvie Gadeyne et al. Int J Equity Health. .

Abstract

Background: Belgium was one of the countries that was struck hard by COVID-19. Initially, the belief was that we were 'all in it together'. Emerging evidence showed however that deprived socioeconomic groups suffered disproportionally. Yet, few studies are available for Belgium. The main question addressed in this paper is whether excess mortality during the first COVID-19 wave followed a social gradient and whether the classic mortality gradient was reproduced.

Methods: We used nationwide individually linked data from the Belgian National Register and the Census 2011. Age-standardized all-cause mortality rates were calculated during the first COVID-19 wave in weeks 11-20 in 2020 and compared with the rates during weeks 11-20 in 2015-2019 to calculate absolute and relative excess mortality by socioeconomic and -demographic characteristics. For both periods, relative inequalities in total mortality between socioeconomic and -demographic groups were calculated using Poisson regression. Analyses were stratified by age, gender and care home residence.

Results: Excess mortality during the first COVID-19 wave was high in collective households, with care homes hit extremely hard by the pandemic. The social patterning of excess mortality was rather inconsistent and deviated from the usual gradient, mainly through higher mortality excesses among higher socioeconomic groups classes in specific age-sex groups. Overall, the first COVID-19 wave did not change the social patterning of mortality, however. Differences in relative inequalities between both periods were generally small and insignificant, except by household living arrangement.

Conclusion: The social patterning during the first COVID-19 wave was exceptional as excess mortality did not follow the classic lines of higher mortality in lower classes and patterns were not always consistent. Relative mortality inequalities did not change substantially during the first COVID-19 wave compared to the reference period.

Keywords: COVID-19; Inequalities; Mortality; Socioeconomic and socio-demographic patterning.

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Conflict of interest statement

The authors declare that there are no competing interest.

Figures

Fig. 1
Fig. 1
Change in relative inequalities in mortality between the first COVID-19 wave and the standard period (2015-2019) among the Belgian population aged 25-64 years, by gender. Results of the full-adjusted models
Fig. 2
Fig. 2
Change in relative inequalities in mortality between the first COVID-19 wave and the standard period (2015-2019) among the Belgian population aged 65-84 years, by gender and care home. Results of the full-adjusted models
Fig. 3
Fig. 3
Change in relative inequalities in mortality between the first COVID-19 wave and the standard period (2015-2019) among the Belgian population aged 85+ years, by gender and care home. Results of the full-adjusted models
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References

    1. SkyNews. Virus does not discriminate claims Gove [Conservative government Minister for the Cabinet Office, UK]. https://news.sky.com/video/coronavirus-virus-does-not-discriminate-gove-.... Accessed 22 Apr 2020.
    1. Terrisse M. Un faubourg du Havre: Ingouville. Population. 1961;16(2):285–300. doi: 10.2307/1526527. - DOI
    1. Sharlin A. Methods for estimating population total, age distribution and vital rates in family reconstitution studies. Pop Stud. 1978. 10.1080/00324728.1978.10412811. - PubMed
    1. Desplanques G. L'inégalité sociale devant la mort. Econ Stat. 1984;162:29–50. - PubMed
    1. Clouston SAP, Natale G, Link BG. Socioeconomic inequalities in the spread of coronavirus-19 in the United States: a examination of the emergence of social inequalities. Soc Sci Med. 2021. 10.1016/j.socscimed.2020.113554. - PMC - PubMed

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