Title page

Contents

Acknowledgements 4

Abstract 5

Resume 6

In brief 8

1. Introduction 10

2. Tracking deaths through the pandemic 13

2.1. Heatwaves and the return of respiratory infections contributed to high mortality in 2022 15

3. Determining the impact of demographic change on mortality trends 16

3.1. Demographic change has a significant impact on mortality 18

3.2. Increasing mortality rates reached a peak in 2021 19

3.3. Overall mortality driven by deaths in older age groups 21

3.4. Mortality in 2022 remained higher than pre-pandemic rates 23

3.5. Greater health system capacity continues to be associated with better health outcomes 26

4. Limitations and discussion 28

Annex A. Methodological note 33

Annex B. ASMR by country, 2015-22 37

OECD Health Working Papers 39

Recent related OECD publications 40

Figure 1. The pandemic reversed the trend of gradually declining mortality across the OECD 9

Figure 2.1. Annual deaths jumped by up to 2 million across the OECD during the pandemic 13

Figure 2.2. The number of additional all-cause deaths and COVID-19 deaths peaked in early 2021 14

Figure 2.3. Nearly one in five deaths were reported as COVID-19 deaths around the end of 2020 15

Figure 3.1. The number of people aged 65+ has risen significantly across the OECD since 2015 17

Figure 3.2. Deaths from 2020 to 2022 were up by 5%, when adjusted for demographic change 18

Figure 3.3. Mortality reached a peak in most countries in 2021 20

Figure 3.4. Most deaths occur at 65+, but some countries saw increased mortality at younger ages 22

Figure 3.5. Age-standardised mortality rates across selected OECD countries, 2015-22 24

Figure 3.6. Countries with high mortality rates pre-pandemic saw the greatest increases 25

Figure 4.1. Comparing OECD and ONS estimates of change in mortality, European countries 28

Figure 4.2. Mortality trends impact for selected countries 29

Boxes

Box 1.1. Understanding different approaches to measure 'excess mortality' 11

Box 3.1. Methodology to explore associations with changes in ASMR 26

Box 4.1. The impact of pre-pandemic mortality trends 29

Annex Tables

Table 1. Key all-cause mortality and population data sources 34

Table B.1. Age-standardised mortality rates (ASMR) 37