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Excess mortality in Denmark, Finland, Norway and Sweden during the COVID-19 pandemic 2020–2022

Forthun, Ingeborg ; Madsen, Christian ; Emilsson, Louise ; Nilsson, Anton LU ; Kepp, Kasper P. ; Björk, Jonas LU ; Vollset, Stein Emil ; Lallukka, Tea and Knudsen, Ann Kristin Skrindo (2024) In European Journal of Public Health 34(4). p.737-743
Abstract

Background: The Nordic countries represent a unique case study for the COVID-19 pandemic due to socioeconomic and cultural similarities, high-quality comparable administrative register data and notable differences in mitigation policies during the pandemic. We aimed to compare weekly excess mortality in the Nordic countries across the three full pandemic years 2020–2022. Methods: Using data on weekly all-cause mortality from official administrative registers in Denmark, Finland, Norway and Sweden, we employed time series regression models to assess mortality developments within each pandemic year, with the period 2010–2019 used as reference period. We then compared excess mortality across the countries in 2020–2022, taking differences... (More)

Background: The Nordic countries represent a unique case study for the COVID-19 pandemic due to socioeconomic and cultural similarities, high-quality comparable administrative register data and notable differences in mitigation policies during the pandemic. We aimed to compare weekly excess mortality in the Nordic countries across the three full pandemic years 2020–2022. Methods: Using data on weekly all-cause mortality from official administrative registers in Denmark, Finland, Norway and Sweden, we employed time series regression models to assess mortality developments within each pandemic year, with the period 2010–2019 used as reference period. We then compared excess mortality across the countries in 2020–2022, taking differences in population size and age- and sex-distribution into account. Results were age- and sex-standardized to the Danish population of 2020. Robustness was examined with a variety of sensitivity analyses. Results: While Sweden experienced excess mortality in 2020 [75 excess deaths per 100 000 population (95% prediction interval 29–122)], Denmark, Finland and Norway experienced excess mortality in 2022 [52 (14–90), 130 (83–177) and 88 (48–128), respectively]. Weekly death data reveal how mortality started to increase in mid-2021 in Denmark, Finland and Norway, and continued above the expected level through 2022. Conclusion: Although the Nordic countries experienced relatively low pandemic excess mortality, the impact and timing of excess mortality differed substantially. These estimates—arguably the most accurate available for any region in capturing pandemic-related excess deaths—may inform future research and policy regarding the complex mortality dynamics in times of a health crisis such as the COVID-19 pandemic.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Public Health
volume
34
issue
4
pages
7 pages
publisher
Oxford University Press
external identifiers
  • pmid:38758188
  • scopus:85200251272
ISSN
1101-1262
DOI
10.1093/eurpub/ckae091
language
English
LU publication?
yes
id
51bd33f4-55e1-4e09-9104-d8dce2f434e1
date added to LUP
2024-09-09 14:42:27
date last changed
2024-09-10 03:00:10
@article{51bd33f4-55e1-4e09-9104-d8dce2f434e1,
  abstract     = {{<p>Background: The Nordic countries represent a unique case study for the COVID-19 pandemic due to socioeconomic and cultural similarities, high-quality comparable administrative register data and notable differences in mitigation policies during the pandemic. We aimed to compare weekly excess mortality in the Nordic countries across the three full pandemic years 2020–2022. Methods: Using data on weekly all-cause mortality from official administrative registers in Denmark, Finland, Norway and Sweden, we employed time series regression models to assess mortality developments within each pandemic year, with the period 2010–2019 used as reference period. We then compared excess mortality across the countries in 2020–2022, taking differences in population size and age- and sex-distribution into account. Results were age- and sex-standardized to the Danish population of 2020. Robustness was examined with a variety of sensitivity analyses. Results: While Sweden experienced excess mortality in 2020 [75 excess deaths per 100 000 population (95% prediction interval 29–122)], Denmark, Finland and Norway experienced excess mortality in 2022 [52 (14–90), 130 (83–177) and 88 (48–128), respectively]. Weekly death data reveal how mortality started to increase in mid-2021 in Denmark, Finland and Norway, and continued above the expected level through 2022. Conclusion: Although the Nordic countries experienced relatively low pandemic excess mortality, the impact and timing of excess mortality differed substantially. These estimates—arguably the most accurate available for any region in capturing pandemic-related excess deaths—may inform future research and policy regarding the complex mortality dynamics in times of a health crisis such as the COVID-19 pandemic.</p>}},
  author       = {{Forthun, Ingeborg and Madsen, Christian and Emilsson, Louise and Nilsson, Anton and Kepp, Kasper P. and Björk, Jonas and Vollset, Stein Emil and Lallukka, Tea and Knudsen, Ann Kristin Skrindo}},
  issn         = {{1101-1262}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{737--743}},
  publisher    = {{Oxford University Press}},
  series       = {{European Journal of Public Health}},
  title        = {{Excess mortality in Denmark, Finland, Norway and Sweden during the COVID-19 pandemic 2020–2022}},
  url          = {{http://dx.doi.org/10.1093/eurpub/ckae091}},
  doi          = {{10.1093/eurpub/ckae091}},
  volume       = {{34}},
  year         = {{2024}},
}