Reduction in life expectancy in Brazil after COVID-19

Abstract

Brazil has been heavily affected by coronavirus disease 2019 (COVID-19). In this study, we used data on reported total deaths in 2020 and in January-April 2021 to measure and compare the death toll across states. We estimate a decline in 2020 life expectancy at birth (e₀) of 1.3 years, a mortality level not seen since 2014. The reduction in life expectancy at age 65 (e₆₅) in 2020 was 0.9 years, setting Brazil back to 2012 levels. The decline was larger for males, widening by 9.1% the female-male gap in e₀. Among states, Amazonas lost 60.4% of the improvements in e₀ since 2000. In the first 4 months of 2021, COVID-19 deaths represented 107% of the total 2020 figures. Assuming that death rates would have been equal to 2019 all-cause rates in the absence of COVID-19, COVID-19 deaths in 2021 have already reduced e₀ in 2021 by 1.8 years, which is slightly larger than the reduction estimated for 2020 under similar assumptions.

Fig. 1. Changes in life expectancy by state and sex.

(a) Estimated change in life expectancy at birth in 2020 based on the difference from life tables calculated for 2019 and 2020 by state and sex. State acronyms by region, North: AC=Acre, AP=Amapá, AM=Amazonas, PA=Pará, RO=Rondônia, RR=Roraima, and TO=Tocantins; Northeast: AL=Alagoas, BA=Bahia, CE=Ceará, MA=Maranhão, PB=Paraíba, PE=Pernambuco, PI=Piauí, RN=Rio Grande do Norte, and SE=Sergipe; Center-West: DF=Distrito Federal, GO=Goiás, MT=Mato Grosso, and MS=Mato Grosso do Sul; Southeast: ES=Espírito Santo, MG=Minas Gerais, RJ=Rio de Janeiro, and SP=São Paulo; South: PR=Paraná, RS=Rio Grande do Sul, and SC=Santa Catarina. (b) Estimated change in life expectancy at age 65 in 2020 based on the difference from life tables calculated for 2019 and 2020 by state and sex. (c) Bivariate choropleth map of the estimated change in life expectancy at birth and at age 65 in 2020 based on the difference from life tables calculated for 2019 and 2020, by state. (d) Number of COVID-19 deaths in 2020 per 100,000 people by state (Methods).

Fig. 2. Changes in gaps of life expectancy at birth and age 65 by state and sex.

(a) Change (in years) in the female-male gap in life expectancy at birth and age 65 based on the difference from life tables calculated for 2019 and 2020 by state and sex. Lines represent changes for Brazil. Bars, organized by major regions, show changes for the states. State acronyms by region, North: AC=Acre, AP=Amapá, AM=Amazonas, PA=Pará, RO=Rondônia, RR=Roraima, and TO=Tocantins; Northeast: AL=Alagoas, BA=Bahia, CE=Ceará, MA=Maranhão, PB=Paraíba, PE=Pernambuco, PI=Piauí, RN=Rio Grande do Norte, and SE=Sergipe; Center-West: DF=Distrito Federal, GO=Goiás, MT=Mato Grosso, and MS=Mato Grosso do Sul; Southeast: ES=Espírito Santo, MG=Minas Gerais; RJ=Rio de Janeiro, and SP=São Paulo; South: PR=Paraná, RS=Rio Grande do Sul, and SC=Santa Catarina. (b) Gap (in years) in state life expectancy at birth and age 65 in 2019 and 2020, calculated as the difference between the largest and smallest life expectancy among states (Methods). Labels above bars indicate the states with extreme (high, low) life expectancies in 2019 and 2020.

Fig. 3. Loss in life expectancy at birth and at age 65 by state and sex.

Percentage loss due to COVID-19 mortality relative to increases in female and male life expectancy at birth (a) and age 65 (b) between 2000 and 2020, by state. States are colored according to major regions. State acronyms by region, North: AC=Acre, AP=Amapá, AM=Amazonas, PA=Pará, RO=Rondônia, RR=Roraima, and TO=Tocantins; Northeast: AL=Alagoas, BA=Bahia, CE=Ceará, MA=Maranhão, PB=Paraíba, PE=Pernambuco, PI=Piauí, RN=Rio Grande do Norte, and SE=Sergipe; Center-West: DF=Distrito Federal, GO=Goiás, MT=Mato Grosso, and MS=Mato Grosso do Sul; Southeast: ES=Espírito Santo, MG=Minas Gerais, RJ=Rio de Janeiro, and SP=São Paulo; South: PR=Paraná, RS=Rio Grande do Sul, and SC=Santa Catarina.

Fig. 4. COVID-19 mortality in 2021 and changes in life expectancy by state and sex.

(a) Ratio of COVID-19 deaths reported in 2021 (Jan-Apr) to those reported in 2020 (%). Numbers above 100 indicate more deaths in 2021 than 2020. State acronyms by region, North: AC=Acre, AP=Amapá, AM=Amazonas, PA=Pará, RO=Rondônia, RR=Roraima, and TO=Tocantins; Northeast: AL=Alagoas, BA=Bahia, CE=Ceará, MA=Maranhão, PB=Paraíba, PE=Pernambuco, PI=Piauí, RN=Rio Grande do Norte, and SE=Sergipe; Center-West: DF=Distrito Federal, GO=Goiás, MT=Mato Grosso, and MS=Mato Grosso do Sul; Southeast: ES=Espírito Santo, MG=Minas Gerais, RJ=Rio de Janeiro, and SP=São Paulo; South: PR=Paraná, RS=Rio Grande do Sul, and SC=Santa Catarina. (b) Bivariate choropleth map of the estimated change in life expectancy at birth in 2020 and 2021 based on the DT19 method (Supplementary Tables 5 and 11). Estimated change in life expectancy at birth (c) and age 65 (d) in 2021.