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- Title
Excess Mortality Calculations to Assess the Impact of the COVID-19 Pandemic: Concepts and Methodological Issues.
- Authors
Vandenbroucke, Jan P.; Pearce, Neil
- Abstract
We discuss some intriguing methodological aspects of excess mortality analyses, which have been widely used to describe the impact of the COVID-19 pandemic. We describe the main ways of presenting excess mortality: as a mortality rate (incidence rate) or as a percentage increase (relative risk or rate ratio). We discuss what should be regarded as the null value of excess mortality (i.e., when countries or regions can be judged as having fared equally well) and when age and sex standardization, adjustment for other determinants of the spread of a pandemic, or both is necessary. We discuss the level of detail by time and place and person that may be necessary. We note that an excess mortality comparison is essentially a difference-in-differences analysis. We conclude that, although one cannot rule out using excess mortality analyses for causal effect estimates, such analyses will remain most fruitful for generating hypotheses about both the efficiency of measures to curtail the pandemic and factors that cannot be influenced. Nevertheless, a judicious use of arguments and counterarguments can then lead to identifying best practices for various situations. (Am J Public Health. 2024;114(6):593–598. https://doi.org/10.2105/AJPH.2024.307572)
- Subjects
MORTALITY; RISK assessment; SOCIOECONOMIC factors; PUBLIC health; COVID-19 pandemic; COVID-19
- Publication
American Journal of Public Health, 2024, Vol 114, Issue 6, p593
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2024.307572