Inequity in Mortality Rates and Potential Years of Life Lost caused by COVID-19 in the Greater Santiago, Chile

Abstract Background Several studies have shown that in Chile income inequality is relevant in explaining inequities in health outcomes. The COVID-19 pandemic has also had a non-neutral impact, with higher mortality rates in municipalities with lower socioeconomic status. Methods We study inequity in mortality based on Potential Years of Life Lost (PYLL) in 34 urban municipalities of the Metropolitan Region (Greater Santiago) and analyze its evolution between 2018 and 2021 and by COVID-19 waves. In order to compare the results obtained for PYLL, we also computed the mortality rates adjusted by direct standardization. In addition, we used the concentration index to measure the health inequalities between municipalities. Results In the first year of the pandemic, the absolute PYLL and the crude mortality rate for all causes of death showed an increase of 13.6% and 19.8%, respectively. Moreover, 409,086 years of life were prematurely lost in 2020, one-fifth of them due to COVID-19. The concentration indices show signs of inequality in both mortality rates and PYLL, where it is more pronounced when calculating the latter measure. Conclusions Results show that the excess deaths due to the COVID-19 pandemic affected the most economically disadvantaged municipalities, and even more so the young people in those places.