Two new articles from the Interface Demography Research Unit explore mortality in Belgium during the COVID-19 pandemic, focusing on social inequalities in cancer mortality and excess deaths during the first three waves.
The article "A Nationwide Exploration of Social Inequalities in Cancer Mortality Amidst the COVID-19 Pandemic in Belgium", authored by Yasmine Khan, Laura Van den Borre, Delphine De Smedt, Nick Verhaeghe, Brecht Devleesschauwer, Patrick Deboosere, Katrien Vanthomme and Sylvie Gadeyne and published in Cancer Medicine, assesses changes in cancer mortality from March 1 to December 31, 2020 relative to the same period in 2019, and to examines potential shifts in cancer mortality's social disparities during the same time frame. The authors used nationwide individually linked cancer mortality data from the Belgian National Register, the Census 2011, and the tax register. Analyses were stratified by age group (45–59 years, 60–74 years, 75+ years) and sex across all cancer types, including breast, colorectal, lung, pancreatic, and prostate. Direct age-standardized mortality rates were calculated in 2019 and 2020 to calculate absolute and relative changes in cancer mortality by social indicators. Relative inequalities in cancer mortality by social groups were calculated for both time frames using Poisson regression. Sensitivity analysis considered any mention of specified cancer groups on the Belgian death certificate. For both overall and site-specific cancers, the study found decreases in cancer mortality during the pandemic's early stages, particularly among individuals aged 75 and older. These changes did not significantly alter established socioeconomic patterns in cancer mortality. Reductions in reported cancer deaths in 2020 may reflect COVID-19 prioritization in cause-of-death coding and its role as a competing risk, rather than true declines. Persistent educational disparities emphasize the need for continued policy and healthcare collaboration, with future research focused on the pandemic's long-term effects on cancer mortality and social inequalities.
Yasmine Khan, Laura Van den Borre, Delphine De Smedt, Nick Verhaeghe, Brecht Devleesschauwer, Patrick Deboosere, Katrien Vanthomme, Sylvie Gadeyne (2025), A Nationwide Exploration of Social Inequalities in Cancer Mortality Amidst the COVID-19 Pandemic in Belgium, Cancer Medicine, vol. 14 (1), https://doi.org/10.1002/cam4.70487
The paper published in Archives of Public Health and titled "Uncovering the toll of the first three COVID-19 waves: excess mortality and social patterns in Belgium" was authored by Laura Van den Borre, Sylvie Gadeyne, Brecht Devleesschauwer and Katrien Vanthomme. This study aims to assess which population groups experienced the heaviest mortality burden during the first three COVID-19 waves in Belgium; and investigate potential changes in social differences in all-cause mortality during the epidemic and compared to the pre-COVID period. Exhaustive all-cause mortality information (2015–2021) from the Belgian population register was linked to demographic and socioeconomic census and register data. Annual cohorts consisting of 6.5 million to 6.8 million persons were created selecting persons aged 35 and older. Excess mortality was investigated by comparing the 137,354 deaths observed during the first three COVID-19 waves with mortality in the reference period 2015–2019. Methods of analysis include direct standardization and Poisson regression analyses. The results revealed that elderly men experienced the highest absolute mortality burden during all three COVID-waves, followed by elderly women, middle-aged men, and middle-aged women. Care home residents consistently experienced higher mortality rates during the first and second wave compared to peers living in other living arrangements. In wave 3, care home residents showed significant absolute mortality deficits compared to the reference period. When adjusting for all demographic and socioeconomic factors, the traditional pattern of educational and income mortality inequalities was found among the elderly population during the COVID-waves. In contrast, the educational mortality gap among middle-aged persons deepened during COVID-waves 2 and 3 with excess mortality between 19 and 30% observed among mainly lower-educated persons. Income mortality inequalities among middle-aged women and men remained stable or even diminished for some specific groups in some waves. The widening educational mortality gap among middle-aged persons in successive waves suggests an important role of knowledge and associated educational resources during the COVID-19 epidemic. Belgium’s broad implementation of public health control and prevention measures may have successfully averted a further widening of social mortality inequality between income groups and among the elderly population.
Laura Van den Borre, Sylvie Gadeyne, Brecht Devleesschauwer and Katrien Vanthomme (2024), Uncovering the toll of the first three COVID-19 waves: excess mortality and social patterns in Belgium, Archives of Public Health, 82(17), https://doi.org/10.1186/s13690-024-01444-9
