Decrease in Life Expectancy in Germany in 2020: Men from Eastern Germany Most Affected

Sauerberg, Markus; Muszyńska-Spielauer, Magdalena; Lego, Vanessa di

doi:10.12765/cpos-2021-20

Cited by 6 publications

(7 citation statements)

References 15 publications

(18 reference statements)

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“…For Germany as a whole, 94% of all COVID-19 deaths in 2020 were recorded in this age group, as additional analyses of our data show. These results confirm the strong connection of COVID-19 mortality with age: While young and middle ages are hardly affected, fatality increases significantly at older ages [ 3 , 7 , 32 , 33 ].…”

Section: Discussionsupporting

confidence: 74%

Evaluating Spatial, Cause-Specific and Seasonal Effects of Excess Mortality Associated with the COVID-19 Pandemic: The Case of Germany, 2020

Mühlichen

Sauerberg

Grigoriev

2023

J Epidemiol Glob Health

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Background Evaluating mortality effects of the COVID-19 pandemic using all-cause mortality data for national populations is inevitably associated with the risk of masking important subnational differentials and hampering targeted health policies. This study aims at assessing simultaneously cause-specific, spatial and seasonal mortality effects attributable to the pandemic in Germany in 2020. Methods Our analyses rely on official cause-of-death statistics consisting of 5.65 million individual death records reported for the German population during 2015–2020. We conduct differential mortality analyses by age, sex, cause, month and district (N = 400), using decomposition and standardisation methods, comparing each strata of the mortality level observed in 2020 with its expected value, as well as spatial regression to explore the association of excess mortality with pre-pandemic indicators. Results The spatial analyses of excess mortality reveal a very heterogenous pattern, even within federal states. The coastal areas in the north were least affected, while the south of eastern Germany experienced the highest levels. Excess mortality in the most affected districts, with standardised mortality ratios reaching up to 20%, is driven widely by older ages and deaths reported in December, particularly from COVID-19 but also from cardiovascular and mental/nervous diseases. Conclusions Our results suggest that increased psychosocial stress influenced the outcome of excess mortality in the most affected areas during the second lockdown, thus hinting at possible adverse effects of strict policy measures. It is essential to accelerate the collection of detailed mortality data to provide policymakers earlier with relevant information in times of crisis.

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Section: Discussionsupporting

confidence: 74%

Evaluating Spatial, Cause-Specific and Seasonal Effects of Excess Mortality Associated with the COVID-19 Pandemic: The Case of Germany, 2020

Mühlichen

Sauerberg

Grigoriev

2023

J Epidemiol Glob Health

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“…This can likely be explained by the fact that the incidence rate of COVID-19 infections was much higher in eastern Germany, potentially due to the lower vaccination rates and lower acceptance of containment measures in the East. Moreover, some differences in the mortality levels and the healthcare systems of eastern and western Germany still remain [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of the COVID-19 pandemic on life expectancy and premature mortality in the German federal states in 2020 and 2021

Marinetti,

Jdanov,

Grigoriev

et al. 2023

PLoS ONE

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The mortality impact of COVID-19 has mainly been studied at the national level. However, looking at the aggregate impact of the pandemic at the country level masks heterogeneity at the subnational level. Subnational assessments are essential for the formulation of public health policies. This is especially important for federal countries with decentralised healthcare systems, such as Germany. Therefore, we assess geographical variation in the mortality impact of COVID-19 for the 16 German federal states in 2020 and 2021 and the sex differences therein. For this purpose, we adopted an ecological study design, using population-level mortality data by federal state, age, and sex, for 2005–2021 obtained from the German Federal Statistical Office. We quantified the impact of the pandemic using the excess mortality approach. We estimated period life expectancy losses (LE losses), excess premature mortality, and excess deaths by comparing their observed with their expected values. The expected mortality was based on projected age-specific mortality rates using the Lee-Carter methodology. Saxony was the most affected region in 2020 (LE loss 0.77 years, 95% CI 0.74;0.79) while Saarland was the least affected (-0.04, -0.09;0.003). In 2021, the regions with the highest losses were Thuringia (1.58, 1.54;1.62) and Saxony (1.57, 1.53;1.6) and the lowest in Schleswig-Holstein (0.13, 0.07;0.18). Furthermore, in 2021, eastern regions experienced higher LE losses (mean: 1.13, range: 0.85 years) than western territories (mean: 0.5, range: 0.72 years). The regional variation increased between 2020 and 2021, and was higher among males than among females, particularly in 2021. We observed an unequal distribution of the mortality impact of COVID-19 at the subnational level in Germany, particularly in 2021 among the male population. The observed differences between federal states might be partially explained by the heterogeneous spread of the virus in 2020 and by differences in the population’s propensity to follow preventive guidelines.

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“…However, there are considerable regional variations in mortality levels and trends, even within German federal states [5, 8]. The reasons for these differences could be differences in economic prosperity as well as differences in population composition by socioeconomic position, exacerbated by selective migration, factors considered to be related to health-related behaviours, and health infrastructures in the regions [2, 5, 8, 9]. In general, however, the differences between the districts decreased from 1997 to 2016 due to the strong decline in mortality in the eastern parts of Germany [8].…”

Section: Introductionmentioning

confidence: 99%

“…Following the onset of the COVID-19 pandemic in 2020, life expectancy dropped substantially, reaching 78.1 years among men and 82.8 years among women in 2022 [7]. However, there are considerable regional variations in mortality levels and trends, even within German federal states [5, 8]. The reasons for these differences could be differences in economic prosperity as well as differences in population composition by socioeconomic position, exacerbated by selective migration, factors considered to be related to health-related behaviours, and health infrastructures in the regions [2, 5, 8, 9].…”

Section: Introductionmentioning

confidence: 99%

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The socioeconomic gap in life expectancy in Germany: a decomposition of age- and cause-specific mortality contributions, 2003–2021

Tetzlaff,

Sauerberg,

Grigoriev

et al. 2023

Preprint

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SummaryBackgroundEarlier death among people in socioeconomically deprived circumstances has been found internationally and for various causes of death, resulting in a considerable life expectancy gap between socioeconomic groups. This study examines how age- and cause-specific mortality contributions to the socioeconomic gap in life expectancy have changed in Germany over time.MethodsOfficial German population and cause-of-death statistics from 2003 to 2021 were linked to the district-level German Index of Socioeconomic Deprivation. Life-table and decomposition methods were applied to calculate life expectancy by deprivation quintile and decompose the life expectancy gap (ΔLE) between the most and least deprived quintiles into age- and cause-specific mortality contributions.FindingsFrom 2003 to 2019, the ΔLE between the most and least deprived quintiles of districts increased from 1.1 to 1.8 years among women and from 3.0 to 3.1 years among men. Thereafter, in the COVID-19 pandemic, it increased more rapidly to 2.2 and 3.5 years respectively in 2021. The causes of death contributing most to the ΔLE were cardiovascular diseases (CVD) and cancer, with declining contributions of CVD deaths at age 70 and above and increasing contributions of cancer deaths at ages 40–74 over time. COVID-19 mortality at ages 45+ was the strongest contributor to the increase in ΔLE after 2019.InterpretationTo reduce the socioeconomic gap in life expectancy, effective efforts are needed to prevent early deaths from CVD and cancer in deprived populations, with cancer prevention and control becoming an increasingly important field of action in this respect.

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Decrease in Life Expectancy in Germany in 2020: Men from Eastern Germany Most Affected

Cited by 6 publications

References 15 publications

Evaluating Spatial, Cause-Specific and Seasonal Effects of Excess Mortality Associated with the COVID-19 Pandemic: The Case of Germany, 2020

Evaluating Spatial, Cause-Specific and Seasonal Effects of Excess Mortality Associated with the COVID-19 Pandemic: The Case of Germany, 2020

Effects of the COVID-19 pandemic on life expectancy and premature mortality in the German federal states in 2020 and 2021

The socioeconomic gap in life expectancy in Germany: a decomposition of age- and cause-specific mortality contributions, 2003–2021

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