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Researchers also found that counties with greater income inequality, more non-Hispanic Black residents, less homeownership, and high population density saw excess deaths. Credit: Chase Sutton

A recent study led by Penn researchers found that the United States' COVID-19 death toll is likely much larger than reported, suggesting that the number of deaths should be inflated by 36%.

According to the study, which was conducted by researchers from Penn, Boston University, and the Robert Wood Johnson Foundation, there were an additional 36 excess deaths to every 100 excess deaths directly attributed to COVID-19. The analysis is the first to examine excess deaths at the county level, which revealed patterns in demographic and structural factors.

Socioeconomic factors and structural racism had a major influence on where deaths occurred. The researchers found that counties with greater income inequality, more non-Hispanic Black residents, less home ownership, and high population density saw excess deaths.

Excess deaths include COVID-19 deaths that were attributed to other causes or indirectly linked to the pandemic, such as fear of going to the hospital for another condition or other issues unveiled by the pandemic's economic and mental health impacts, Penn Today reported

“Excess deaths can provide a more robust measure of the total mortality effects of the pandemic compared to direct tallies of COVID deaths," assistant professor of global health at Boston University and lead study author Andrew Stokes told Penn Today. 

Penn sociology professors Samuel Preston and Irma Elo were also a part of the research team.

The study analyzed county-level mortality data from the National Center for Health Statistics for over 1,021 counties that had more than ten COVID-19 deaths from Feb. 1 to Sept. 23, Penn Today reported. 

The researchers used the Centers for Disease Control and Prevention data from 2013 to 2018 to estimate expected deaths in each county without the presence of COVID-19, which led to the finding that excess deaths were 65,481 deaths higher than what was reported. 

Counties with high levels of COVID-19 related deaths also had extremely high levels of mortality from other causes of death this year, Preston told Penn Today, suggesting that the pandemic is responsible for many more deaths than those solely attributed to the virus.

“Our results focus important attention on the disparate impact of the COVID-19 pandemic on low-income and minority communities,” Elo told Penn Today. “These groups have historically experienced high death rates, which are now further exacerbated by the current pandemic.”