Centre for Research on Pandemics & Society (PANSOC)

Poverty and Ethnic Patterns in COVID-19 Excess Mortality: Evidence from Chile, 2020-2022 | American Journal of Epidemiology | Oxford Academic

The COVID-19 pandemic highlighted deep-rooted health inequities globally, with marginalized populations showing disproportionate disease burden. We employed Serfling regression models and multivariable analyses to estimate excess mortality across geographic, demographic, and poverty groups from 2020-2022 in Chile. Elderly populations (80+ years) experienced the highest excess mortality (267.35 per 10,000 population), more than eight times higher than those under 80 years (30.80 per 10,000 population). Multivariable linear regression models showed both Indigenous proportion (coefficient=53.66, p<0.001) and elderly population proportion (coefficient=5.68, p<0.01) as the strong predictors of comuna level excess mortality. Poverty correlated significantly with excess mortality (r=0.23, p<0.001) but this association weakened after adjustment for other covariates in multivariable models.

Excess mortality peaked in 2021 rather than in 2020 for most groups, with males initially experiencing higher rates during early pandemic waves. Spatial analyses revealed statistically significant clustering (Moran’s I=0.119, p<0.001) with identifiable hotspots in northern Chile and parts of the south. These findings indicated persistent mortality disparities by age and Indigenous status, independent of poverty, and highlight the urgent need for equity-focused pandemic preparedness. An effective pandemic response should integrate biomedical measures, such as vaccination, with culturally grounded strategies that address structural barriers and the broader social determinants of health.

This new paper is part of the MERIT – Mother Income Inequality project co-authored with several Portuguese colleagues including prior PANSOC post-doc Margarida Pereira and Centre leader Svenn-Erik Mamelund: “Be Mothers as if we Were not Workers, Be Workers as if we Were not Mothers”: A Qualitative Study on Parenthood’s Impact on Careers and Well-Being – Ana Sofia Monteiro Maia, Margarida Miguel Costeira e Pereira, Svenn-Erik Mamelund, Joana Maria Correia Amaro, Sílvia Jesus da Silva Fraga, Teresa Isabel Costa Leão, 2025

Abstract: Parenthood challenges work–life balance, particularly where traditional gender norms persist. Despite policy advancements, disparities in income and career progression remain, with mothers disproportionately assuming childcare and household responsibilities. This study explored the impact of parenthood on professional and personal life through thirty semi-structured interviews with Portuguese mothers and fathers living in Portugal and seven other European countries. Thematic content analysis revealed a dual narrative shaped by gender norms and country contexts. Women perceived motherhood as a career barrier, with some reducing work hours or leaving the workforce to become primary caregivers. In contrast, men assumed the breadwinner role by increasing workloads. Parenthood also had gendered health implications: women, particularly in Portugal, experienced anxiety and guilt, whereas men described physical health effects. The findings underscore how parenthood perpetuates gender disparities, highlighting the need for equitable parental leave policies and workplace reforms that support caregiving responsibilities for both mothers and fathers.

A systematic review to understand the long-term mental health effects of influenza pandemics – Jessica L. Dimka, Benjamin M. Schneider, Svenn-Erik Mamelund, 2025

abstract

Aims:

Health effects of pandemics extend beyond morbidity and mortality from the disease itself and may include long-term mental health consequences. However, previous studies only consider narrowly defined populations at risk or examine pandemics caused by varied pathogens that may have inconsistent effects. We examine existing literature on these long-term mental health effects following one type of pandemic (influenza).

Methods:

We conducted a systematic review of the long-term mental health effects of the 1889, 1918, 1957, 1968, and 2009 influenza pandemics. To our knowledge, this is the first review of studies of broad populations and multiple measures of mental health morbidity.

Results:

The literature search returned 8190 articles. After deduplication and title/abstract and full-text screening, 12 articles were reviewed. Seven articles focused on the 1918 pandemic and five on the 2009 pandemic. Study regions were USA or North America (n=5), Europe (n=3), and Asia (n=4). Long-term outcomes studied were suicide (n=4), admission to hospital or psychiatric facility (n=2), stress/anxiety/post-traumatic stress disorder (n=4) and schizophrenia and other/related conditions (n=2). The suggested mechanisms were infection (n=6), effects of non-pharmaceutical interventions (NPIs) (n=3), or other exposure pathways (n=3). Seven studies had a moderate risk of bias and five studies a high risk of bias.

Conclusions:

Mental health effects have been an outcome of pandemics. Researchers should consider a variety of possible mechanisms, and that infection and restrictive NPIs may contribute to mental health morbidity. This study highlights the need for better understanding of the broader health, social, and demographic impacts of pandemics.