Higher COVID-19 death rates in the southern U.S. due to behavior
differences, study finds

Date:
April 28, 2022
Source:
Georgetown University Medical Center
Summary:
During the pre-Omicron phases of the COVID-19 pandemic, regions
of the U.S. had markedly different mortality rates, primarily due
to differences in mask use, school attendance, social distancing,
and other behaviors.

Had the entire country reacted to the pandemic as the Northeast
region, more than 316,000 deaths might have been avoided, 62
percent of those avoidable deaths being in the South, according
to a new study.



FULL STORY ========================================================================== During the pre-Omicron phases of the COVID-19 pandemic, regions of
the U.S. had markedly different mortality rates, primarily due to
differences in mask use, school attendance, social distancing, and
other behaviors. Had the entire country reacted to the pandemic as the Northeast region, more than 316,000 deaths might have been avoided, 62%
of those avoidable deaths being in the South.


==========================================================================
The study, by Georgetown University's School of Nursing & Health Studies researchers, appeared April 28, 2022, in PLOS ONE.

Excess mortality, which helps account for avoidable deaths from a new
disease or situation, is defined by the difference between total current
deaths and deaths expected based on earlier time period, usually the
previous decade or so. The U.S. Centers for Disease Control and Prevention (CDC) calculates these numbers weekly. For this study, the CDC excess
mortality data were analyzed for the period between January 3, 2020,
to September 26, 2021. For regional comparison purposes, areas of the
country were broken down into the Northeast, Midwest, South and West.

"Our goal was to carefully examine regional differences in COVID-19 death
rates based on reliable statistical data," says Michael Stoto, Ph.D.,
professor of Health Systems Administration and Population Health at
the School of Nursing & Health Studies and corresponding author of the
study. "Our study is the first to quantify avoidable deaths and confirm
that both COVID-19 deaths and avoidable deaths disproportionately occurred
in the South." The investigators found that regional differences in
COVID-19 mortality rates have persisted throughout the pandemic. The
southern part of the United States has had higher mortality rates than
the rest of the U.S. since the start of summer in 2020. Since October
2020, 48% of COVID-19 deaths were in the South, which makes up 38%
of the population, pointing to disproportionate outcomes regionally.

The researchers also determined that between January 2020 and September
2021 there were 895,693 excess deaths associated with COVID-19, which is
26% more than reported by other experts who track disease. Although the official total neared on one million deaths in the U.S due to COVID-19
by late April 2022, based on this undercount the scientists believe that threshold was actually passed at the beginning of 2022.

These estimates of undercounts are important because most studies have
looked at excess mortality at the state and county level in the U.S., but because of small population sizes, the studies have not examined patterns
over time. Some earlier studies explored the relationship between COVID-19 mortality and age, education, and other factors as well as vaccine uptake, party affiliation, and other factors. But most studies have used reported COVID-19 deaths rather than excess deaths, as compared to what Dr. Stoto
and collaborators have done, and may not be as statistically reliable.

"This is one of a series of planned studies to look carefully at the
response to COVID-19 in the U.S. and other countries and to learn from
the experience in order to strengthen preparedness for future potential outbreaks," says Stoto.

"Our team has also looked at testing and surveillance, and other
COVID-19 metrics to understand how communities have come together to effectively deal with the pandemic." In addition to Stoto, the other
authors from Georgetown include Samantha Schlageter, who conducted this
work as an undergraduate in the Health Care Management & Policy program
at the School of Nursing & Health Studies (NHS), and John D. Kraemer, an associate professor in Department of Health Systems Administration at NHS.


========================================================================== Story Source: Materials provided by
Georgetown_University_Medical_Center. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Michael A. Stoto, Samantha Schlageter, John D. Kraemer. COVID-19
mortality in the United States: It's been two Americas from
the start.

PLOS ONE, 2022; 17 (4): e0265053 DOI: 10.1371/journal.pone.0265053 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220428142700.htm

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