Department of Healthcare Management, Gachon University, Seongnam, Republic of Korea.
Department of Health Policy and Management, General Graduate School of Gachon University, Seongnam, Republic of Korea.
Front Public Health. 2023 Aug 1;11:1215914. doi: 10.3389/fpubh.2023.1215914. eCollection 2023.
Comparative evidence suggests that the impact of COVID-19 on life expectancy has been relatively milder in South Korea. This study aims to examine whether the pandemic has universal or unequal impacts on life expectancy across 250 districts with varying levels of deprivation.
Using mortality data from 2012 to 2021 obtained from the Microdata Integrated Service of Statistics Korea, we calculated life expectancy at birth and age 65 for both sexes, by deprivation quintiles, before and during the pandemic. We summarized life expectancy gaps using the slope of the inequality index (SII) and further decomposed the gaps by the contribution of age and cause of death using Arriaga's method.
Both men and women experienced consistent improvements in life expectancy from 2012 to 2019, but the trend was disrupted during 2020 and 2021, primarily driven by older people. While men in more deprived areas were initially hit harder by the pandemic, the life expectancy gap across deprivation quintiles remained relatively constant and persistent across the study period [SII: -2.48 (CI: -2.70 from -2.27) for 2019 and - 2.84 (CI: -3.06 from -2.63) for 2020]. Middle-aged men from the most deprived areas were the most significant contributors to the life expectancy gap, with liver disease, liver cancer, transport accidents, and intentional injuries being the leading causes, both in the pre and during the pandemic. While these contributors remained largely similar before and during the pandemic, the contribution of transport accidents and liver cancer to the male life expectancy gap slightly decreased during the pandemic, while that of ischemic heart disease and pneumonia slightly increased. A similar increase was also observed for the female life expectancy gap.
This study found no clear evidence of an increased life expectancy gap during the pandemic in South Korea, unlike in other countries, although access to emergency healthcare services may have been slightly more disturbed in deprived areas. This achievement can provide lessons for other countries. However, the persistent regional gaps in life expectancy observed over the past decade indicate the need for more targeted public health policies to address this issue.
比较证据表明，COVID-19 对韩国预期寿命的影响相对较轻。本研究旨在检验大流行是否对不同贫困程度的 250 个地区的预期寿命产生普遍或不平等的影响。
使用从韩国统计数据综合服务的微观数据获得的 2012 年至 2021 年的死亡率数据，我们按贫困五分位数计算了出生时和 65 岁时两性的预期寿命，分别在大流行之前和期间。我们使用不平等指数（SII）的斜率来总结预期寿命差距，并进一步使用 Arriaga 方法按年龄和死因对差距进行分解。
男性和女性的预期寿命都在 2012 年至 2019 年期间持续提高，但这一趋势在 2020 年和 2021 年被打乱，主要是老年人受到的影响。虽然较贫困地区的男性最初受到大流行的打击更大，但在整个研究期间，贫困五分位数之间的预期寿命差距相对稳定且持续[2019 年 SII：-2.48（CI：-2.70 至-2.27），2020 年 SII：-2.84（CI：-3.06 至-2.63）]。来自最贫困地区的中年男性是造成预期寿命差距的最大贡献者，肝疾病、肝癌、交通事故和故意伤害在大流行前后都是主要原因。虽然这些贡献者在大流行前后基本相似，但交通事故和肝癌对男性预期寿命差距的贡献略有减少，而缺血性心脏病和肺炎略有增加。女性预期寿命差距也观察到类似的增加。
本研究发现，与其他国家不同，韩国在大流行期间没有明显的预期寿命差距扩大的证据，尽管在贫困地区获得紧急医疗服务可能受到轻微干扰。这一成就可以为其他国家提供经验教训。然而，过去十年观察到的持续的地区预期寿命差距表明，需要采取更有针对性的公共卫生政策来解决这一问题。
