Scaling COVID-19 against inequalities: should the policy response consistently match the mortality challenge?

2020/11/03 by Gerry McCartney, Alastair H. Leyland, David Walsh +1 · 1 voice · 27 citations
Health Professions · Mathematics · Medicine · #2019-20 coronavirus outbreak #COVID-19 and healthcare impacts #Coronavirus disease 2019 (COVID-19) #Disease #Econometrics #Employment and Welfare Studies #Global Health Care Issues #Inequality #Internal medicine #Mathematical analysis #Mathematics #Medicine #Outbreak #Physics #Scaling #Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) #Statistical physics #Virology

paper · pdf · doi:10.1136/jech-2020-214373

published in Journal of Epidemiology & Community Health 75(4), 315-320 (BMJ)

openalex publication_date 2020/11/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01

Abstract

BACKGROUND: The mortality impact of COVID-19 has thus far been described in terms of crude death counts. We aimed to calibrate the scale of the modelled mortality impact of COVID-19 using age-standardised mortality rates and life expectancy contribution against other, socially determined, causes of death in order to inform governments and the public. METHODS: We compared mortality attributable to suicide, drug poisoning and socioeconomic inequality with estimates of mortality from an infectious disease model of COVID-19. We calculated age-standardised mortality rates and life expectancy contributions for the UK and its constituent nations. RESULTS: Mortality from a fully unmitigated COVID-19 pandemic is estimated to be responsible for a negative life expectancy contribution of -5.96 years for the UK. This is reduced to -0.33 years in the fully mitigated scenario. The equivalent annual life expectancy contributions of suicide, drug poisoning and socioeconomic inequality-related deaths are -0.25, -0.20 and -3.51 years, respectively. The negative impact of fully unmitigated COVID-19 on life expectancy is therefore equivalent to 24 years of suicide deaths, 30 years of drug poisoning deaths and 1.7 years of inequality-related deaths for the UK. CONCLUSION: Fully mitigating COVID-19 is estimated to prevent a loss of 5.63 years of life expectancy for the UK. Over 10 years, there is a greater negative life expectancy contribution from inequality than around six unmitigated COVID-19 pandemics. To achieve long-term population health improvements it is therefore important to take this opportunity to introduce post-pandemic economic policies to 'build back better'.

Citations

• What (or who) causes health inequalities: Theories, evidence and implications?
• Impact of Political Economy on Population Health: A Systematic Review of Reviews
• If the world fails to protect the economy, COVID-19 will damage health not just now but also in the future
• Mitigating the wider health effects of covid-19 pandemic response

Cited by

• Valuing the years of life lost due to COVID-19: the differences and pitfalls

Discussions

• As McCartney et al (2021) wrote here at the height of the pandemic: shouldn't the scale of the policy response match the mortality challenge? Even if these calculations were hugely inaccurate (!) the [bsky, 0 points, 0 comments]

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