Regional Disparities in Excess Mortality Due to COVID-19 in the Americas Region

Aim The aim of this study was to estimate excess mortality in 35 countries in the region of the Americas, between 2020 and 2021, and its association with socioeconomic indicators. Subjects and Methods This is an ecological time series study. Mortality data and socioeconomic indicators were obtained from the World Bank database. Expected deaths were estimated using Prais-Winsten regression. Results Between January 1, 2020 and December 31, 2021, estimates indicated an excess mortality of 2.9 (95% CI: 0.4;5.3) million deaths in the region, which resulted in a percentage of excess mortality in relation to expected deaths (Pscore) of 19.0% (95% CI: 15.6%; 22.4%), representing 285 (95% CI: 236;334) excess deaths per 100 000 inhabitants. During this period, official statistics recorded 2.4 (95% CI: 0.29;4.5) million deaths from COVID-19. The study also showed that the average Pscore of countries with higher GDP per capita and high income was lower in relation to countries with lower middle and upper middle income per capita, respectively. Furthermore, the correlation matrix showed that HDI and GDP per capita were negatively correlated with the Pscore. Conclusion The findings of this study showed an excess mortality in the region, where poorer countries were hit harder when compared to richer countries.