Inequalities in mortality rise due to COVID-19 and non-COVID-19 causes

In June of this year, we published data showing that since the beginning of the pandemic there have been more non-COVID-19 related deaths than would be expected in a given year. Today, alongside our Weekly COVID-19 Statistical Report, we have published analysis of the underlying causes that have contributed to those non-COVID-19 excess deaths. We specifically looked at the 14 week period from the registration of the first COVID-19 deaths in Scotland up until the numbers of deaths from all causes had returned to normal levels (16 March to 21 June 2020, inclusive). In addition, our analysis quantifies how non-COVID-19 excess mortality varies between the most and least deprived areas in Scotland and what caused those deaths.

Since the beginning of the COVID-19 pandemic, many people in Scotland have tragically lost their lives to the virus. During the 14 week period studied in this report, 82% of excess deaths had an underlying cause of COVID-19. Our report found that the remainder of the excess deaths had other underlying causes, including; dementia and Alzheimer’s (8% contribution), external and ill-defined causes (8%), circulatory causes (3%), other causes (3%), cancer (2%) and diabetes (2%). External and ill-defined causes of death were grouped for our analysis because some external causes (including some drug-related deaths, alcohol-related deaths, and suicides) are temporarily coded as “ill-defined” in these provisional data, pending further investigation. Deaths from respiratory causes were lower than the average for the time of year (-7% contribution), potentially due to COVID-19 being the underlying cause of death for people who may otherwise have died from respiratory conditions.

Pre-existing inequalities in deaths from dementia and Alzheimer’s, external and ill-defined causes, and circulatory causes widened. Inequalities in external and ill-defined causes widened the most.

Dr Gerry McCartney, Consultant in Public Health and Head of Public Health Observatory said:

“Based on this report and the other work we have published, it is clear that the COVID-19 pandemic has caused substantial direct and indirect harm to the health of the population. The rise in health inequalities we see here underlines the importance of protecting those at highest risk from the virus, but also from the unintended consequences of lockdown. Specifically, this includes the impacts of the reduced use of health services and loss of income and work on health and wellbeing. It’s important to ensure that health services are available to, and used by, those who need them most and that the consequences of the economic downturn are fully mitigated for those on the lowest incomes and in our poorest areas.

“Before the pandemic, health inequalities persisted. Understanding the impact of the pandemic on these is a crucial part of our efforts to respond to and recover from it. As we continue to provide guidance on and evidence for actions to stop the spread of the virus we will also monitor the wider impact it has in our communities. Importantly, we will work to make the most of this chance to build resilience into our services and communities, as we build back a better Scotland where all of us can thrive.”

View the non-COVID-19 excess deaths by cause report