Changes in life expectancy at birth during the COVID-19 pandemic and contributions by cause of death in British Columbia, Canada.

BACKGROUND

Studies have shown that excess all-cause mortality during the COVID-19 pandemic caused declines of life expectancy at birth (LE₀) in most countries around the world, after decades of improvement prior to the pandemic. However, those studies rarely examined the contributions from specific causes of death other than COVID-19.

METHODS

This study used the Chiang method to estimate LE₀ for each year in British Columbia from 2000 to 2022 and the changes from 2019 to 2020, 2021, and 2022. Each death case was classified into 1 of 23 categories, including COVID-19, unregulated drug toxicity, cardiovascular diseases, and injuries, according to the International Classification of Diseases, 10th Revision (ICD-10). The changes in LE₀ were decomposed into age and causes of death using the Arriaga method.

RESULTS

Compared with 2019, male LE₀ decreased by 1.16 years in 2020, 1.81 years in 2021, and 1.62 years in 2022; female LE₀ did not change in 2020, but decreased by 0.65 years in 2021, and by 0.56 years in 2022. COVID-19 and unregulated drug toxicity were the top two causes of deaths contributing to the LE₀ declines in males and females, with COVID-19 being the number one contributor in females and unregulated drug toxicity deaths as the number one contributor in males.

INTERPRETATION

The COVID-19 pandemic impacted population health not only through its direct effects but also through indirect impacts on other health outcomes, including the unregulated drug toxicity crisis, the combination of which were driving factors in the decline in life expectancy at birth.