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Inequalities in COVID-19 deaths by migration background during the first wave, interwave period and second wave of the COVID-19 pandemic: a closed cohort study of 17 million inhabitants of the Netherlands
  1. Felix P Chilunga1,
  2. Lenny Stoeldraijer2,
  3. Charles Agyemang1,
  4. Karien Stronks1,
  5. Carel Harmsen2,
  6. Anton E Kunst1
  1. 1Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
  2. 2Statistics Netherlands, The Hague, The Netherlands
  1. Correspondence to Dr Felix P Chilunga, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam 1105 AZ, Netherlands; f.p.chilunga{at}amsterdamumc.nl

Abstract

Background It is not known how differences in COVID-19 deaths by migration background in the Netherlands evolved throughout the pandemic, especially after introduction of COVID-19 prevention measures targeted at populations with a migration background (in the second wave). We investigated associations between migration background and COVID-19 deaths across first wave of the pandemic, interwave period and second wave in the Netherlands.

Methods We obtained multiple registry data from Statistics Netherlands spanning from 1 March 2020 to 14 March 2021 comprising 17.4 million inhabitants. We estimated incidence rate ratios for COVID-19 deaths by migration background using Poisson regression models and adjusted for relevant sociodemographic factors.

Results Populations with a migration background, especially those with Turkish, Moroccan and Surinamese background, exhibited higher risk of COVID-19 deaths than the Dutch origin population throughout the study periods. The elevated risk of COVID-19 deaths among populations with a migration background (as compared with Dutch origin population) was around 30% higher in the second wave than in the first wave.

Conclusions Differences in COVID-19 deaths by migration background persisted in the second wave despite introduction of COVID-19 prevention measures targeted at populations with a migration background in the second wave. Research on explanatory mechanisms and novel prevention measures are needed to address the ongoing differences in COVID-19 deaths by migration background.

  • COVID-19
  • human migration
  • ethnic groups
  • mortality

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • Contributors FPC, LS, CH and AEK conceived and designed the study. FPC and LS analysed the data. FPC wrote the paper with LS, CH and AEK. All authors FPC, LS, CA, KS, CH and AEK participated in drafting the article or revising it critically for content. AEK is the guarantor of this work and accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.