Evidence map›Paper›PMID 37352359›Full record

ArticleScience advances2023

Monthly excess mortality across counties in the United States during the COVID-19 pandemic, March 2020 to February 2022.

Eugenio Paglino, Dielle J Lundberg, Zhenwei Zhou, Joe A Wasserman, Rafeya Raquib, Anneliese N Luck, Katherine Hempstead, Jacob Bor, Samuel H Preston, Irma T Elo and 1 more

Abstract read
In one paragraph

Article in Science advances, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Trends in maternal mortality rates by state, United States, 2018 to 2023.American journal of obstetrics and gynecology · 2026
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Metropolitan/nonmetropolitan differences of the impact of COVID-19 on cancer survivors' care.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025
    Article
  13. Real-time monitoring of excess mortality under a new endemic regime.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025
    Article
  14. Scaling COVID-19 rates with population size in the United States.Journal of the Royal Society, Interface · 2025
    Article
  15. Article
  16. Article
  17. Excess deaths associated with COVID-19 by rurality and demographic factors in the United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024
    Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Eugenio PaglinoDepartment of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA.ORCID 0000-0001-8733-6460
Dielle J LundbergDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0003-1494-4443
Zhenwei ZhouDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0002-9424-7826
Joe A WassermanRTI International, Research Triangle Park, NC, USA.ORCID 0000-0002-9705-1853
Rafeya RaquibDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0002-0631-4081
Anneliese N LuckDepartment of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA.ORCID 0000-0003-3224-2090
Katherine HempsteadRobert Wood Johnson Foundation, Princeton, NJ, USA.
Jacob BorDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0002-5112-8536
Samuel H PrestonDepartment of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA.
Irma T EloDepartment of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA.
Andrew C StokesDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.ORCID 0000-0002-8502-3636

Funding

Sci-Tech Core-Population Dynamics Research CenterP2CHD044964 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI EMILIO ALBERTO PARRADO · 2018 to 2026
$5.3M
AHRQ HHS T32 HS013853NICHD NIH HHS P2C HD044964
6 · The paper itself

Abstract

Excess mortality is the difference between expected and observed mortality in a given period and has emerged as a leading measure of the COVID-19 pandemic's mortality impact. Spatially and temporally granular estimates of excess mortality are needed to understand which areas have been most impacted by the pandemic, evaluate exacerbating factors, and inform response efforts. We estimated all-cause excess mortality for the United States from March 2020 through February 2022 by county and month using a Bayesian hierarchical model trained on data from 2015 to 2019. An estimated 1,179,024 excess deaths occurred during the first 2 years of the pandemic (first: 634,830; second: 544,194). Overall, excess mortality decreased in large metropolitan counties but increased in nonmetropolitan counties. Despite the initial concentration of mortality in large metropolitan Northeastern counties, nonmetropolitan Southern counties had the highest cumulative relative excess mortality by July 2021. These results highlight the need for investments in rural health as the pandemic's rural impact grows.

Indexed as

COVID-19PandemicsBayes TheoremHumansRural PopulationUnited StatesUrban Population

Identifiers

PMID37352359
PMCPMC10289647

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.