Decomposing the decline in life expectancy at birth by cause of death during the COVID-19 pandemic in Canada.
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BACKGROUND: Life expectancy at birth has increased in Organisation for Economic Co-operation and Development countries and across the globe over the past few decades, until 2019. However, this trend was disrupted by the COVID-19 pandemic, which saw a significant decrease in life expectancy in Canada and many other countries. Few studies to date have decomposed the life expectancy gap by cause of death observed during the pandemic in a Canadian context. DATA AND METHODS: Death counts were generated from the Canadian Vital Statistics - Death database. Life tables were created using Chiang's method. The Arriaga method for decomposing a life expectancy gap was implemented by comparing life tables between the periods of 2017 to 2019 and 2020 to 2022 by province and sex. RESULTS: COVID-19 was the single largest contributor to the life expectancy decline in Canada between the periods of 2017 to 2019 and 2020 to 2022, reducing life expectancy at birth by 0.46 years for both sexes. Opioid-related deaths, another significant contributor to the life expectancy decline, reduced life expectancy by 0.22 years for both sexes. By contrast, cancers contributed to a slight increase (+0.17 years) in life expectancy between the two periods. INTERPRETATION: Although COVID-19 was the most significant driving force in declining life expectancy during the pandemic in Canada, increased opioid-related deaths, potentially related to the indirect effects of the pandemic, also played a significant role in the notable life expectancy decline. A greater understanding of the indirect impacts of the COVID-19 pandemic in terms of mortality, including the harms related to substance use and abuse, will be possible as more information on the causes and circumstances of death is made available.