Infection-Independent Effect of the COVID-19 Pandemic on Diabetes and Cardiovascular Disease Mortality: An Illinois Vital Records System Analysis, 2019-2021

OBJECTIVES: Infection mitigation practices and health care infrastructure challenges during the COVID-19 pandemic caused delays in medical care and chronic disease detection and management. These challenges also hindered healthy lifestyle choices. We analyzed diabetes and cardiovascular disease (CVD) mortality independent of COVID-19 comorbidity to assess the effect of the COVID-19 pandemic on chronic disease mortality. METHODS: We obtained Illinois Vital Records System death records for calendar year 2019 (January 1 through December 1, 2019) and COVID-19 year 1 (March 16, 2020, through March 15, 2021). We included Illinois residents with causes of death recorded as diabetes or CVD and the absence of COVID-19 infection. We calculated age-adjusted mortality rates for diabetes and CVD as underlying causes of death. We examined data by age, sex, race and ethnicity, education, geography, and CVD subtypes. RESULTS: The infection-independent, all-cause mortality rate per 100 000 population in Illinois increased 3.6% from January 1, 2019, through March 15, 2021 (765.8 [95% CI, 761.2-770.3] vs 793.2 [95% CI, 788.6-797.8]). The overall diabetes mortality rate increased 19.9% (19.6 [95% CI, 18.9-20.3] vs 23.5 [95% CI, 22.7-24.3]). The overall CVD mortality rate change (3.9%; 239.2 [95% CI, 236.7-241.7] vs 248.5 [95% CI, 245.9-251.1]) was similar to the all-cause mortality rate change. Sex, minority race, ethnicity, those with high school diplomas or some college education, middle to older age, and urban residence influenced mortality rate increases among people with diabetes and CVD. CONCLUSION: The COVID-19 pandemic had an infection-independent effect on chronic disease mortality. This knowledge may help public health officials guide policy that protects chronic disease management during future public health emergencies.