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Palliative medicine · Jul 2023
Deaths at home, area-based deprivation and the effect of the Covid-19 pandemic: An analysis of mortality data across four nations.
- Javiera Leniz, Joanna M Davies, Anna E Bone, Mevhibe Hocaoglu, Julia Verne, Stephen Barclay, MurtaghFliss E MFEM0000-0003-1289-3726Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridge, Lorna K Fraser, Irene J Higginson, and Katherine E Sleeman.
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
- Palliat Med. 2023 Jul 1; 37 (7): 103410391034-1039.
BackgroundThe number and proportion of home deaths in the UK increased during the Covid-19 pandemic. It is not known whether these changes were experienced disproportionately by people from different socioeconomic groups.AimTo examine the association between home death and socioeconomic position during the Covid-19 pandemic, and how this changed between 2019 and 2020.DesignRetrospective cohort study using population-based individual-level mortality data.Setting/ParticipantsAll registered deaths in England, Wales, Scotland and Northern Ireland. The proportion of home deaths between 28th March and 31st December 2020 was compared with the same period in 2019. We used Poisson regression models to evaluate the association between decedent's area-based level of deprivation and risk of home death, as well as the interaction between deprivation and year of death, for each nation separately.ResultsBetween the 28th March and 31st December 2020, 409,718 deaths were recorded in England, 46,372 in Scotland, 26,410 in Wales and 13,404 in Northern Ireland. All four nations showed an increase in the adjusted proportion of home deaths between 2019 and 2020, ranging from 21 to 28%. This increase was lowest for people living in the most deprived areas in all nations, with evidence of a deprivation gradient in England.ConclusionsThe Covid-19 pandemic exacerbated a previously described socioeconomic inequality in place of death in the UK. Further research to understand the reasons for this change and if this inequality has been sustained is needed.
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