Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France

Abstract Background The first wave of the COVID-19 pandemic in France was associated with high excess mortality, and anecdotal evidence pointed to differing excess mortality patterns depending on social and environmental determinants. In this study we aimed to investigate the spatial distribution of...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hugo Pilkington, Thierry Feuillet, Stéphane Rican, Jeanne Goupil de Bouillé, Olivier Bouchaud, Johann Cailhol, Hélène Bihan, Pierre Lombrail, Chantal Julia
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	COVID-19 Mortality Socioeconomic factors Delivery of health care Deprivation Inequality Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/00a112c3cd4e4e279bd32e755d58d09d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:00a112c3cd4e4e279bd32e755d58d09d
record_format	dspace
spelling	oai:doaj.org-article:00a112c3cd4e4e279bd32e755d58d09d2021-11-28T12:12:44ZSpatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France10.1186/s12889-021-12203-81471-2458https://doaj.org/article/00a112c3cd4e4e279bd32e755d58d09d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12203-8https://doaj.org/toc/1471-2458Abstract Background The first wave of the COVID-19 pandemic in France was associated with high excess mortality, and anecdotal evidence pointed to differing excess mortality patterns depending on social and environmental determinants. In this study we aimed to investigate the spatial distribution of excess mortality during the first wave of the COVID-19 pandemic in France and relate it at the subnational level to contextual determinants from various dimensions (socioeconomic, population density, overall health status, healthcare access etc.). We also explored whether the determinants identified at the national level varied depending on geographical location. Methods We used available national data on deaths in France to calculate excess mortality by department for three age groups: 0–49, 50–74 and > 74 yrs. between March 1st and April 27th, 2020. We selected 15 variables at the department level that represent four dimensions that may be related to overall mortality at the ecological level, two representing population-level vulnerabilities (morbidity, social deprivation) and two representing environmental-level vulnerabilities (primary healthcare supply, urbanization). We modelled excess mortality by age group for our contextual variables at the department level. We conducted both a global (i.e., country-wide) analysis and a multiscale geographically weighted regression (MGWR) model to account for the spatial variations in excess mortality. Results In both age groups, excess all-cause mortality was significantly higher in departments where urbanization was higher (50–74 yrs.: β = 15.33, p < 0.001; > 74 yrs.: β = 18.24, p < 0.001) and the supply of primary healthcare providers lower (50–74 yrs.: β = − 8.10, p < 0.001; > 74 yrs.: β = − 8.27, p < 0.001). In the 50–74 yrs. age group, excess mortality was negatively associated with the supply of pharmacists (β = − 3.70, p < 0.02) and positively associated with work-related mobility (β = 4.62, p < 0.003); in the > 74 yrs. age group our measures of deprivation (β = 15.46, p < 0.05) and morbidity (β = 0.79, p < 0.008) were associated with excess mortality. Associations between excess mortality and contextual variables varied significantly across departments for both age groups. Conclusions Public health strategies aiming at mitigating the effects of future epidemics should consider all dimensions involved to develop efficient and locally tailored policies within the context of an evolving, socially and spatially complex situation.Hugo PilkingtonThierry FeuilletStéphane RicanJeanne Goupil de BouilléOlivier BouchaudJohann CailholHélène BihanPierre LombrailChantal JuliaBMCarticleCOVID-19MortalitySocioeconomic factorsDelivery of health careDeprivationInequalityPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 Mortality Socioeconomic factors Delivery of health care Deprivation Inequality Public aspects of medicine RA1-1270
spellingShingle	COVID-19 Mortality Socioeconomic factors Delivery of health care Deprivation Inequality Public aspects of medicine RA1-1270 Hugo Pilkington Thierry Feuillet Stéphane Rican Jeanne Goupil de Bouillé Olivier Bouchaud Johann Cailhol Hélène Bihan Pierre Lombrail Chantal Julia Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France
description	Abstract Background The first wave of the COVID-19 pandemic in France was associated with high excess mortality, and anecdotal evidence pointed to differing excess mortality patterns depending on social and environmental determinants. In this study we aimed to investigate the spatial distribution of excess mortality during the first wave of the COVID-19 pandemic in France and relate it at the subnational level to contextual determinants from various dimensions (socioeconomic, population density, overall health status, healthcare access etc.). We also explored whether the determinants identified at the national level varied depending on geographical location. Methods We used available national data on deaths in France to calculate excess mortality by department for three age groups: 0–49, 50–74 and > 74 yrs. between March 1st and April 27th, 2020. We selected 15 variables at the department level that represent four dimensions that may be related to overall mortality at the ecological level, two representing population-level vulnerabilities (morbidity, social deprivation) and two representing environmental-level vulnerabilities (primary healthcare supply, urbanization). We modelled excess mortality by age group for our contextual variables at the department level. We conducted both a global (i.e., country-wide) analysis and a multiscale geographically weighted regression (MGWR) model to account for the spatial variations in excess mortality. Results In both age groups, excess all-cause mortality was significantly higher in departments where urbanization was higher (50–74 yrs.: β = 15.33, p < 0.001; > 74 yrs.: β = 18.24, p < 0.001) and the supply of primary healthcare providers lower (50–74 yrs.: β = − 8.10, p < 0.001; > 74 yrs.: β = − 8.27, p < 0.001). In the 50–74 yrs. age group, excess mortality was negatively associated with the supply of pharmacists (β = − 3.70, p < 0.02) and positively associated with work-related mobility (β = 4.62, p < 0.003); in the > 74 yrs. age group our measures of deprivation (β = 15.46, p < 0.05) and morbidity (β = 0.79, p < 0.008) were associated with excess mortality. Associations between excess mortality and contextual variables varied significantly across departments for both age groups. Conclusions Public health strategies aiming at mitigating the effects of future epidemics should consider all dimensions involved to develop efficient and locally tailored policies within the context of an evolving, socially and spatially complex situation.
format	article
author	Hugo Pilkington Thierry Feuillet Stéphane Rican Jeanne Goupil de Bouillé Olivier Bouchaud Johann Cailhol Hélène Bihan Pierre Lombrail Chantal Julia
author_facet	Hugo Pilkington Thierry Feuillet Stéphane Rican Jeanne Goupil de Bouillé Olivier Bouchaud Johann Cailhol Hélène Bihan Pierre Lombrail Chantal Julia
author_sort	Hugo Pilkington
title	Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France
title_short	Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France
title_full	Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France
title_fullStr	Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France
title_full_unstemmed	Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France
title_sort	spatial determinants of excess all-cause mortality during the first wave of the covid-19 epidemic in france
publisher	BMC
publishDate	2021
url	https://doaj.org/article/00a112c3cd4e4e279bd32e755d58d09d
work_keys_str_mv	AT hugopilkington spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance AT thierryfeuillet spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance AT stephanerican spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance AT jeannegoupildebouille spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance AT olivierbouchaud spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance AT johanncailhol spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance AT helenebihan spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance AT pierrelombrail spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance AT chantaljulia spatialdeterminantsofexcessallcausemortalityduringthefirstwaveofthecovid19epidemicinfrance
_version_	1718408117830549504

Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France

Ejemplares similares