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Int J Public Health . Socioeconomic and Demographic Factors Associated With Mortality Before and During the COVID-19 Pandemic: An Analysis of 28 Eu

tetano

Editor, Senior Moderator
Int J Public Health


. 2025 Jul 23:70:1608560.
doi: 10.3389/ijph.2025.1608560. eCollection 2025. Socioeconomic and Demographic Factors Associated With Mortality Before and During the COVID-19 Pandemic: An Analysis of 28 European Countries

Paola Sillitti[SUP] 1 2 3 4 [/SUP], Clément Meier[SUP] 1 2 3 [/SUP], Olivier Mucchiut[SUP] 1 2 3 [/SUP], Jürgen Maurer[SUP] 1 2 3 [/SUP], Ralf J Jox[SUP] 4 5 [/SUP]



Affiliations
Abstract

Objectives: The pandemic was the most significant event affecting health systems in the last 100 years. Research shows that gender, age and socioeconomic status were associated with higher mortality during the pandemic. However, most studies are cross-sectional and country specific. This paper assesses sociodemographic characteristics associated with time and cause of death in Europe between 2018 and 2022.
Methods: The analysis includes 7,137 decedents aged over 50, using post-death interviews with proxy respondents, from the Survey on Health, Ageing, and Retirement in Europe (SHARE). Data from 28 countries, from SHARE waves 7 to 9, are examined using t-tests, chisquaretests and multivariate logit regression models, controlling for sociodemographic characteristics. The three binary outcome variable sindicate the time and cause of death.
Results: Being male, older, without a partner, self-reporting financial difficulties, and living in Eastern Europe were associated with an increased likelihood of dying during the pandemic. The association was stronger for deaths due to COVID-19, respiratory and infectious diseases.
Conclusion: The pandemic highlighted socioeconomic gradients in mortality. These results call for policymakers to prepare for future shocks, ensuring equal access to adequate care.

Keywords: COVID-19; end of life; health inequalities; pandemic; socioeconomic inequalities.

 
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