More than 200,000 people in the United States have now died from COVID-19. But the death toll of the U.S. epidemic is likely much higher, according to a new, first-of-its-kind study from researchers at the University of Pennsylvania, Boston University, and the Robert Wood Johnson Foundation.
Available as a pre-print on medRxiv ahead of peer-reviewed publication, the study estimates the number of “excess deaths,” those that occurred from February through September 2020 above what would be expected in a normal year. For every 100 excess deaths directly attributed to COVID-19, there were another 36 excess deaths. This means 26% of all excess deaths were not directly attributed to COVID.
The research team, which included Penn demographers Samuel Preston and Irma Elo, found more of these additional deaths in counties with greater income inequality, more non-Hispanic Black residents, less homeownership, and high-population density, indicating a pattern related to socioeconomic disadvantage and structural racism.
“Excess deaths can provide a more robust measure of the total mortality effects of the pandemic compared to direct tallies of COVID deaths,” says study lead author Andrew Stokes, an assistant professor of global health at BU. “Excess deaths include COVID deaths that were ascribed to other causes, as well as the indirect consequences of the pandemic on society.” These could include fear of going to the hospital for another condition or any number of issues caused or exacerbated by COVID’s economic and mental health impacts.
Stokes and colleagues analyzed county-level mortality data from the National Center for Health Statistics for 1,021 counties with 10 or more COVID deaths from Feb. 1 to Sept. 23. Previous studies have estimated excess deaths at the national and state levels, but this is the first to examine the question at the county level, allowing the researchers to