Dataset Information

Excess mortality and protected areas during the COVID-19 pandemic: Evidence from Italian municipalities.

ABSTRACT: There is widespread debate on the drivers of heterogeneity of adverse COVID-19 pandemic outcomes and, more specifically, on the role played by context-specific factors. We contribute to this literature by testing the role of environmental factors as measured by environmentally protected areas. We test our research hypothesis by showing that the difference between the number of daily deaths per 1,000 inhabitants in 2020 and the 2018-19 average during the pandemic period is significantly lower in Italian municipalities located in environmentally protected areas such as national parks, regional parks, or Environmentally Protected Zones. After controlling for fixed effects and various concurring factors, municipalities with higher share of environmentally protected areas show significantly lower mortality during the pandemic than municipalities that do not benefit from such environmental amenities.

SUBMITTER: Becchetti L

PROVIDER: S-EPMC9558647 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Excess mortality and protected areas during the COVID-19 pandemic: Evidence from Italian municipalities.

Becchetti Leonardo L Conzo Gianluigi G Conzo Pierluigi P Salustri Francesco F

Health policy (Amsterdam, Netherlands) 20221013 12

There is widespread debate on the drivers of heterogeneity of adverse COVID-19 pandemic outcomes and, more specifically, on the role played by context-specific factors. We contribute to this literature by testing the role of environmental factors as measured by environmentally protected areas. We test our research hypothesis by showing that the difference between the number of daily deaths per 1,000 inhabitants in 2020 and the 2018-19 average during the pandemic period is significantly lower in ...[more]

PMID: 36280518

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Project description:Official COVID-19 mortality statistics are strongly influenced by local diagnostic capacity, strength of the healthcare and vital registration systems, and death certification criteria and capacity, often resulting in significant undercounting of COVID-19 attributable deaths. Excess mortality, which is defined as the increase in observed death counts compared to a baseline expectation, provides an alternate measure of the mortality shock-both direct and indirect-of the COVID-19 pandemic. Here, we use data from civil death registers from a convenience sample of 90 (of 162) municipalities across the state of Gujarat, India, to estimate the impact of the COVID-19 pandemic on all-cause mortality. Using a model fit to weekly data from January 2019 to February 2020, we estimated excess mortality over the course of the pandemic from March 2020 to April 2021. During this period, the official government data reported 10,098 deaths attributable to COVID-19 for the entire state of Gujarat. We estimated 21,300 [95% CI: 20, 700, 22, 000] excess deaths across these 90 municipalities in this period, representing a 44% [95% CI: 43%, 45%] increase over the expected baseline. The sharpest increase in deaths in our sample was observed in late April 2021, with an estimated 678% [95% CI: 649%, 707%] increase in mortality from expected counts. The 40 to 65 age group experienced the highest increase in mortality relative to the other age groups. We found substantial increases in mortality for males and females. Our excess mortality estimate for these 90 municipalities, representing approximately at least 8% of the population, based on the 2011 census, exceeds the official COVID-19 death count for the entire state of Gujarat, even before the delta wave of the pandemic in India peaked in May 2021. Prior studies have concluded that true pandemic-related mortality in India greatly exceeds official counts. This study, using data directly from the first point of official death registration data recording, provides incontrovertible evidence of the high excess mortality in Gujarat from March 2020 to April 2021.

Dataset Information

Excess mortality and protected areas during the COVID-19 pandemic: Evidence from Italian municipalities.

Publications

Excess mortality and protected areas during the COVID-19 pandemic: Evidence from Italian municipalities.

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