Thursday 11 August 2022

Life expectancy in the age of COVID-19

It seems self-evident that the coronavirus pandemic has reduced life expectancy, both in individual countries and globally in aggregate. However, just how extraordinary declining global life expectancy is, is not so obvious. In this recent article published in the journal Population and Development Review (open access, with non-technical summary here), Patrick Heuveline (UCLA) summarises the changes. Using a mix of life tables from the United Nations, supplemented by excess deaths data from the World Mortality Database, Heuveline constructed new estimates of life expectancy for each country and each quarter in 2020 and 2021 (using a machine learning algorithm to fill in some of the data gaps). The estimated effect of the pandemic on global life expectancy is summarised in Figure 2 from the article:

As you can see, the long-run increase in global life expectancy was interrupted and reversed course substantially in 2020 and 2021. However, even that figure understates just how remarkable this reversal is. As Heuveline notes (emphasis added):

The increase in the number of deaths during the pandemic had a substantial impact on the global life expectancy. After 69 years of uninterrupted increase from 1950 to 2019, the global life expectancy is estimated here to have declined by −0.92 years between 2019 and 2020 and by another 0.72 years between 2020 and 2021... In 2021, the global life expectancy is estimated to have dropped below its 2013 level.

The coronavirus pandemic ended at least seven decades of increasing global life expectancy. Of course, not all countries have been equally affected. Heuveline reports that:

...many countries experienced substantial changes in life expectancy... Between 2019 and 2021, life expectancy is estimated to have declined by more than two years annually (four years overall) in eight countries... five in America (Peru, 5.6; Guatemala, 4.8; Paraguay, 4.7; Bolivia, 4.1; and Mexico, 4.0 years) and three in Europe (the Russian Federation, 4.3; Bulgaria, 4.1; and North Macedonia, 4.1 years)... Among those with sufficient data, the only countries that did not reach the two-year mark at any point between 2020 and 2021 are countries in Eastern Asia, Australia, New Zealand, and European countries, west of a line running from the Baltic to the Balkans.

For comparison:

Instances of life expectancy declines, from one calendar year to the next, remain rare in the UN time series and relatively modest though. The main exceptions to this generalization are found for Cambodia (up to −4.63 years per year) and Rwanda (up to −5.02 years per year) - two countries that experienced massive increases in violent mortality, in the late 1970s and early 1990s, respectively - and a few sub-Saharan countries during by the AIDS pandemic. According to the UN estimates, the impact of AIDS mortality on life expectancy was most severe in Eswatini in the late 1990s (up to −2.10 years per year).

So, in the worst affected countries the impact of the coronavirus pandemic was roughly equivalent in its impact on life expectancy to the worst years of the HIV/AIDS pandemic in the worst affected country. And, the impact of the coronavirus pandemic in the worst affected countries was nearly half of the annual impact of the Khmer Rouge or the Rwandan genocide. That certainly puts things in perspective.

However, there is one ray of hope in the article:

Comparing life expectancy estimates for each of the eight 12-month periods, however, the decline in global life expectancy appears to have stopped in the last quarter of 2021...

We can only hope that is a signal of a return to increases in global life expectancy (albeit at an apparently decreasing rate over time), and possibly even some catch-up growth. Now, we just need to know what that means for the discrepancies in life expectancy between rich and poor.

[HT: N-IUSSP]

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