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Changes in all-cause and cause-specific mortality by occupational skill during COVID-19 epidemic in Spain.

Publicated to:JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH. jech-222065 - 2024-07-08 78(11), DOI: 10.1136/jech-2024-222065

Authors: González-Beltrán D; Donat M; Politi J; Ronda E; Barrio G; Belza MJ; Regidor E

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Abstract

There is little information on the differential impact of the COVID-19 pandemic on mortality by occupation. The objective was to examine changes in mortality during the COVID-19 period compared with the prepandemic period in different occupational groups in Spain. Average mortality in the entire period 2020-2021, and each of its semesters, was compared, respectively, with the average mortality in the entire period 2017-2019, and the corresponding semester (first or second) of this last period, across occupational skill levels. For this, age-standardised death rates and age-adjusted mortality rate ratios (MRRs) obtained through Poisson regression were used. Data were obtained from the National Institute of Statistics and the Labour Force Survey. The excess all-cause mortality during the 2020-2021 pandemic period by the MRR was higher in low-skilled (1.18, 95% CI 1.16 to 1.20) and medium-skilled workers (1.14; 95% CI 1.13 to 1.15) than high-skilled workers (1.04; 95% CI 1.02 to 1.05). However, the greatest excess mortality was observed in low-skilled workers in 2020 and in medium-skilled workers in 2021. Focusing on causes of death other than COVID-19, low-skilled workers showed the highest MRR from cardiovascular diseases (1.31; 95% CI 1.26 to 1.36) and high-skilled workers the lowest (1.02; 95% CI 0.98 to 1.02). However, this pattern was reversed for mortality from external causes, with low-skilled workers showing the lowest MRR (1.04; 95% CI 0.97 to 1.09) and high-skilled workers the highest (1.08; 95% CI 1.03 to 1.13). Globally, in Spain, during the 2020-2021 COVID-19 epidemic period, low-skilled workers experienced a greater excess all-cause mortality than other occupational groups, but this was not the case during the entire epidemic period or for all causes of death.

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