Island Jurisdictions

Island jurisdictions were analysed separately because their pandemic experience differed materially from non-island jurisdictions. Islands had much lower mean age-standardised excess mortality than non-islands during 2020-2021. The GHS Index did not meaningfully predict mortality outcomes among island jurisdictions. Many islands used geography to support border closure, exclusion, or elimination strategies during the pandemic. Many island jurisdictions achieved strong mortality outcomes despite relatively low GHS Index scores, weakening the global association between GHS scores and pandemic mortality. Missing data limited island-specific analyses and may have excluded islands with strong COVID-19 outcomes.