Monitoring life expectancy levels during the COVID-19 pandemic: Example of the unequal impact of the first wave on Spanish regions

Abstract

Background: To provide an interpretable summary of the impact on mortality of the COVID-19 pandemic we estimate weekly and annual life expectancies at birth in Spain and its regions.

Methods: We used daily death count data from the Spanish Daily Mortality Monitoring System (MoMo), and death counts from 2018, and population on July 1st, 2019 by region (CCAA), age groups, and sex from the Spanish National Statistics Institute. We estimated weekly and annual (2019 and 2020*, the shifted annual calendar period up to 5 July 2020) life expectancies at birth as well as their differences with respect to 2019.

Results: Weekly life expectancies at birth in Spain were lower in weeks 11-20, 2020 compared to the same weeks in 2019. This drop in weekly life expectancy was especially strong in weeks 13 and 14 (March 23rd to April 5th), with national declines ranging between 6.1 and 7.6 years and maximum regional weekly declines of up to 15 years in Madrid. Annual life expectancy differences between 2019 and 2020 also reflected an overall drop in annual life expectancy of 0.9 years for both men and women. These drops ranged between 0 years in several regions (e.g. Canary and Balearic Islands) to 2.8 years among men in Madrid.

Conclusions: Life expectancy is an easy to interpret measure for understanding the heterogeneity of mortality patterns across Spanish regions. Weekly and annual life expectancy are sensitive and useful indicators for understanding disparities and communicating the gravity of the situation because differences are expressed in intuitive year units.

Fig 1. Weekly life expectancy at birth (with 95% confidence intervals) in Spain and three selected regions (Andalusia, Catalonia and Madrid)^a by sex (weeks 1–27, 2019 and 2020).

^a Weekly life expectancies at birth for Spain and its 17 regions can be found in S1 Fig in S1 Appendix.

Fig 2. Annual life expectancy at birth in 2019, 2020*^a and differences between periods for Spain and its 17 regions by sex.

^a Annual life expectancy at birth in 2020* was estimated using death counts from the shifted annual reference period up to 5 July 2020.

Fig 3. Associations between loss in annual life expectancy at birth between 2019 and 2020*^a and IgG anti SARS-Cov2 prevalence for Spain and its 17 regions by sex (95% CI).

^a Annual life expectancy at birth in 2020* was estimated using data from the one year window up to 5 July 2020. ^bCM stands for Castille-La Mancha.

Fig 4. Life expectancy at birth changes between 2019 and 2020*^a: Comparison between our main results and results derived from INE.

^a Annual life expectancy at birth in 2020* was estimated using data from the one year window up to 5 July 2020.