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, Fliss E.M. Murtagh, Lorna K. Fraser, Irene J. Higginson, Katherine E. Sleeman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The 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. Aim: To examine the association between home death and socioeconomic position during the Covid-19 pandemic, and how this changed between 2019 and 2020. Design: Retrospective cohort study using population-based individual-level mortality data. Setting/participants: All 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. Results: Between 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. Conclusions: The 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.

Original languageEnglish
Pages (from-to)1034-1039
Number of pages6
JournalPalliative Medicine
Volume37
Issue number7
Early online date23 Apr 2023
DOIs
Publication statusPublished - Jul 2023

Keywords

  • Covid-19
  • deprivation
  • inequalities
  • mortality
  • Palliative care
  • pandemics
  • place of death
  • socio-economic position
  • terminal care

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