The health impact of COVID-19 in regions

In most OECD countries, remote regions have experienced lower excess mortality than other regions.

The COVID-19 pandemic has hit certain parts of countries harder than others. Beyond the count of fatalities directly reported as due to the COVID-19 infection, the increase in the number of total deaths in a region relative to previous years provides a useful indication of the overall health impact of the current pandemic. More specifically, the excess mortality during the pandemic – the increase in deaths as a percentage of deaths in previous years – avoids problems of misreporting caused by low levels of testing. From February to June 2020, large regions in 31 OECD countries with available data registered on average 6% more deaths than in the same months of the previous 2 years (average of 2018-19). Interestingly, regional disparities in this indicator are strikingly high. Excess mortality in Greater London (United Kingdom), New Jersey (United States), Lombardy (Italy) and Madrid (Spain) ranged from 46% to 80% in the period from February to June 2020 – at least 22 percentage points higher than the average excess mortality in their respective country (Figure 1.1, panel A and Figure 1.3-Figure 1.4).

Differences in excess mortality during this period also reveal clear patterns between regions far from metropolitan areas and other types of regions, particularly metropolitan. In 17 out of 22 OECD countries, regions far from a metropolitan area have recorded lower excess mortality than metropolitan regions. More specifically, regions far from a metropolitan area experienced an average excess mortality of 5% compared to 9.5% in metropolitan regions. The gap is even larger between remote regions (3%) and large metropolitan regions (13%). However, there are exceptions to such a pattern, as is the case of Switzerland, where excess mortality is significantly higher in regions far from a metropolitan area than in metropolitan regions (Figure 1.1, panel B).

Another measure of the health impact of the current pandemic consists of the reported deaths due to COVID-19. In the 24 OECD countries with data available from January to 15 August 2020 (see Annex B for more details), regions registered 30 COVID-19 deaths per 100 000 people (mortality rate due to COVID-19) on average. Nevertheless, this figure masks stark differences across regions. For example, New Jersey (United States), Lombardy (Italy), Castile-La Mancha (Spain), Amazonas (Colombia), Brussels Capital (Belgium) and Stockholm (Sweden) recorded more than 100 COVID-19 deaths per 100 000 people by mid-August (Figure 1.2). In addition, large regional disparities in COVID-19 deaths are present even within countries. In the United States, Italy and Spain, those regional gaps exceeded 140 deaths per 100 000 people as regions such as Hawaii (United States), Basilicata (Italy) and Canary Islands (Spain) experienced less than 8 COVID-19 deaths per 100 000 people.

OECD (2020), OECD Regional Statistics (database), OECD, Paris

See country metadata in Annex B.

See territorial grids and regional typology in Annex A.

Figure 1.1, panel B: Weighted averages of small regions (TL3).

Figure 1.3-Figure 1.4: Small regions (TL3) if available, otherwise large regions (TL2) for AUS, AUT, CAN, COL, DEU, EST, NZL and USA.

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