Download This PaperThe Covid-19 Pandemic's Impact on All-Cause Mortality Disparities in Medicare: By Race, Income, Chronic Health, Mental/Behavioral Health, Disability
39 Pages Posted: 28 Dec 2022
Abstract
Background: The Medicare-enrolled population is heterogeneous across race, ethnicity, age, dual eligibility, and a breadth of chronic health, mental and behavioral health, and disability-related conditions, which may be differentially impacted by the COVID-19 pandemic.
Objective: Quantify and identify Medicare subpopulation all-cause mortality differences prior to, and in the first year (2020) of the COVID-19 pandemic.
Methods: This observational, population-based study of Medicare beneficiaries investigated, via bivariate regression, subpopulation changes in all-cause mortality, both prior to the COVID-19 pandemic (i.e., 2019 versus 2016) and in its first year (2020 versus 2019).
Results: All-cause mortality in the overall Medicare beneficiary population (FFS and MA) improved by a relative one percent over the ten years that preceded the start of the COVID-19 pandemic, but escalated by a relative 15.9 percent in 2020, the pandemic’s first year. A closer look at FFS subpopulations reveals critical differences. Between 2016 and 2019, for all race/ethnicity groups except Non-Hispanic White, pre-pandemic all-cause mortality had actually been worsening prior to the pandemic, followed by a relative 30.1 percent spike in 2020, over twice that of Non-Hispanic White individuals. Similar patterns were found for dual-eligible beneficiaries and individuals with certain psychiatric and disability-related conditions. Of all 61 chronic health conditions studied, beneficiaries with schizophrenia were the most adversely affected, with all-cause mortality increasing 38.4 percent between 2019 and 2020.
Conclusion: This analysis reveals subpopulation differences in all-cause mortality trends, both prior to and in year-one of the COVID-19 pandemic, indicating that the events of 2020 exacerbated preexisting health-related inequities.
Note:
Funding Information: None to declare.
Declaration of Interests: The authors of this manuscript have no conflicts of interest, activities or relationships – financial or otherwise – to declare.
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