AJPH 11/24: The Critical Role of Excess Mortality in Shaping Public Health Decisions

Alfredo Morabia and Prof. Vickie Mays (UCLA) from AJPH interview Profs Neil Pearce (London School of Hygiene and Tropical Medicine), Andrew C. Stokes (Boston University School of Public Health), and Jan P Vandenbroucke (Leiden University Medical Center, Dept. Clinical Epidemiology) in a compelling discussion about excess mortality and its significance during the COVID-19 pandemic. Why might excess mortality be a more accurate measure than COVID-19-specific mortality? What is the theoretical foundation for using excess mortality as an evaluative tool? How can excess mortality help determine whether countries or regions performed ‘equally well’ during the pandemic? Can it provide insights into what strategies worked—or didn’t—during the crisis? Despite delays in obtaining mortality data, how can excess mortality be used to track health emergencies in real time? Finally, what key recommendations should guide those using excess mortality as an outcome measure? Join us for this insightful conversation to better understand the critical role of excess mortality in shaping public health decisions and pandemic evaluations. 00:00 Introduction 01:12 Defining Key Terms: Comorbidity and Random Sampling 04:45 Understanding Case-Control Studies 07:30 What are Absolute and Relative Excess Measures? 10:15 The Concept of Baseline Life Expectancy 12:50 Panel Discussion Introduction 14:20 Historical Use of Excess Mortality 17:35 Environmental Factors and Excess Mortality 20:10 Global Perspectives on Excess Mortality 22:45 Belgium vs. Netherlands: Data Differences in COVID Mortality 26:00 Importance of Random Sampling in Pandemics 29:15 Excess Mortality vs. COVID-Specific Mortality 32:50 Challenges of International Data Standardization 35:45 Cultural Behaviors and Public Health Policies 38:20 Lessons for Epidemiologists 41:00 Ethical Obligations of Researchers 43:25 Recommendations for Future Research 46:00 Concluding Remarks: Preparing for Future Pandemics 48:15 Outro and Thank You