Archives of Public Health published a nationwide assessment of excess mortality during the first three COVID-19 waves in Belgium, conducted by Van den Borre and colleagues. This study aims to assess which population groups experienced the heaviest mortality burden; and investigate potential changes in social differences in all-cause mortality during the epidemic and compared to the pre-COVID period.

Nationwide information on all-cause mortality (2015-2021) was linked at the individual level with demographic and socio-economic census and population register data. Methods of analysis include direct standardization and Poisson regression analyses.

Key results show that elderly men had the highest absolute mortality burden in all three COVID-waves. Care home residents showed a particular mortality pattern. Traditional educational and income mortality inequalities persisted among the elderly, suggesting effective COVID-19 support and preventative measures in Belgium. The widening educational mortality gap among middle-aged persons in successive waves suggest an important role of knowledge and associated educational resources during the COVID-19 epidemic. Belgium’s broad implementation of public health control and prevention measures may have successfully averted a further widening of social mortality inequality between income groups and among the elderly population.

The full article is available via https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-024-01444-9