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Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland

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  • Wyper, Grant Mark Andrew
  • Fletcher, Eilidh
  • Grant, Ian
  • Harding, Oliver
  • de Haro Moro, Maria Teresa
  • Stockton, Diane L
  • McCartney, Gerard

Abstract

Background: COVID-19 has caused almost unprecedented change across health, education, the economy and social interaction. It is widely understood that the existing mechanisms which shape health inequalities have resulted in COVID-19 outcomes following this same, familiar, pattern. Our aim was to estimate inequalities in the population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020. These were scaled against pre-pandemic inequalities in DALYs combined across all causes, derived from the Scottish Burden of Disease (SBoD) study. Methods: National deaths and daily case data were input into the European Burden of Disease Network consensus model to estimate DALYs. Total Years of Life Lost (YLL) were estimated for each area-based deprivation quintile of the Scottish population. Years Lived with Disability were proportionately distributed to deprivation quintiles, based on YLL estimates. Inequalities were measured by: the range, Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. Overall, and inequalities in, COVID-19 DALYs were scaled against pre-pandemic estimates of inequalities across all causes from the SBoD study. Results: Marked inequalities were observed across several measures. The SII was 2,048–2,289 COVID-19 DALYs per 100,000 population. The RII was 1.16, meaning that the rate in the most deprived areas was around 58% higher than the mean population rate, with 40% of COVID-19 DALYs attributed to differences in area-based deprivation. Overall DALYs due to COVID-19 ranged from 7–20% of the annual pre-pandemic impact of inequalities in health loss combined across all causes. Conclusion: The substantial population health impact of COVID-19 in Scotland was not shared equally across areas experiencing different levels of deprivation. The extent of inequality due to COVID-19 was similar to averting all annual DALYs due to diabetes. In the wider context of population health loss, overall ill-health and mortality due to COVID-19 was, at most, a fifth of the annual population health loss due to inequalities in multiple deprivation. Implementing effective policy interventions to reduce health inequalities must be at the forefront of plans to recover and improve population health.

Suggested Citation

  • Wyper, Grant Mark Andrew & Fletcher, Eilidh & Grant, Ian & Harding, Oliver & de Haro Moro, Maria Teresa & Stockton, Diane L & McCartney, Gerard, 2021. "Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland," SocArXiv js3h6, Center for Open Science.
    • Handle: RePEc:osf:socarx:js3h6
    DOI: 10.31219/osf.io/js3h6
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    References listed on IDEAS

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    1. Brecht Devleesschauwer & Scott A. McDonald & Niko Speybroeck & Grant M. A. Wyper, 0. "Valuing the years of life lost due to COVID-19: the differences and pitfalls," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 0, pages 1-2.
    2. Cuschieri, Sarah & Calleja, Neville & Devleesschauwer, Brecht & Wyper, Grant Mark Andrew, 2021. "Estimating the direct Covid-19 disability-adjusted life years impact on the Malta population for the first full year," SocArXiv 8gdrs, Center for Open Science.
    3. Wyper, Grant Mark Andrew & Fletcher, Eilidh & Grant, Ian & McCartney, Gerry & Fischbacher, Colin & Harding, Oliver & Jones, Hannah & de Haro Moro, Maria Teresa & Speybroek, Niko & Devleesschauwer, Bre, 2021. "Measuring the direct population impact of COVID-19 in Scotland, 2020: estimating disability-adjusted life years (DALYs) during the first full calendar year," SocArXiv ey36d, Center for Open Science.
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    Cited by:

    1. Pi Högberg & Göran Henriksson & Carme Borrell & Marius Ciutan & Giuseppe Costa & Irene Georgiou & Rafal Halik & Jens Hoebel & Katri Kilpeläinen & Theopisti Kyprianou & Tina Lesnik & Indre Petrauskaite, 2022. "Monitoring Health Inequalities in 12 European Countries: Lessons Learned from the Joint Action Health Equity Europe," IJERPH, MDPI, vol. 19(13), pages 1-13, June.
    2. Severin J. S. Oeckl & Stephen Morrow, 2022. "CSR in Professional Football in Times of Crisis: New Ways in a Challenging New Normal," IJFS, MDPI, vol. 10(4), pages 1-26, September.

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    1. Wyper, Grant Mark Andrew & Fletcher, Eilidh & Grant, Ian & McCartney, Gerry & Fischbacher, Colin & Harding, Oliver & Jones, Hannah & de Haro Moro, Maria Teresa & Speybroek, Niko & Devleesschauwer, Bre, 2021. "Measuring the direct population impact of COVID-19 in Scotland, 2020: estimating disability-adjusted life years (DALYs) during the first full calendar year," SocArXiv ey36d, Center for Open Science.

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