Why Was Life Expectancy Declining Before COVID-19?

Priscilla Lynch 

October 15, 2021

A substantial number of English communities experienced a decline in life expectancy in the five years before the onset of the COVID-19 pandemic, according to a new study published in the  Lancet Public Health.

Although recent data from the Office for National Statistics found that life expectancy for men in the UK had fallen for the first time in 40 years due to the pandemic, this new research shows that between 2014 and 2019, life expectancy declined in almost one in five communities for women and one in nine communities for men.

The study, funded by the Wellcome Trust, Imperial College London (ICL), the Medical Research Council, Health Data Research UK and the National Institute for Health Research, analysed all deaths in England for all years from 2002 to 2019, amounting to more than 8.6 million death records, and assigned them to the community where each one lived at the time of their death.

There were 6791 local communities included in the study, and the researchers assessed life expectancy trends over time for each of these for men and women.

The study found that between 2002 and 2010, the vast majority of communities saw their life expectancy rates increase. However, from 2010 to 2014, longevity began declining for women in one in 20 communities (5%; 351/6791 local areas) and in one community for men.

This deterioration accelerated and spread from 2014 to 2019, with life expectancy declining for women in almost one in five communities (18.7%; 1270/6791), and in one in nine communities for men (11.5%; 784/6791). In these places, between 2014 and 2019, life expectancy declined by an average of 0.17 years for women (around two months) and 0.12 years for men (around a month and a half).

Taken over the entire period from 2002 to 2019, the biggest life expectancy decline seen for women was a loss of three years for an area of Leeds (from 78.7 to 75.6 years) and for men was a loss of 0.4 years in a part of Blackpool (from 68.7 to 68.3 years). There were also startling reversals in life expectancies for women in a number of communities in Yorkshire and The Humber over this period.

The researchers note that the regions where life expectancy declines occurred often already had lower life expectancy and higher levels of poverty, unemployment and low education.

In comparison, between 2002 and 2019, life expectancy increases of nine years or more were seen for men and women in some parts of Central and North London.

These trends created stark geographical differences. In 2019, there was about a 20-year gap in life expectancy for women living in communities with the highest and lowest life expectancies. For men, the gap was 27 years.

Communities with the lowest life expectancies were typically located in urban areas in the North, including Leeds, Newcastle, Manchester, Liverpool and Blackpool. Communities with the highest life expectancies were often based in London and the surrounding home counties.

Lead author Theo Rashid, from the School of Public Health at ICL, said: “These results mirror an earlier trend in the USA – which also saw life expectancy declines prior to the pandemic. In both England and the USA, life expectancy declines are associated with unemployment and insecure employment following deindustrialisation, compounded by reductions in social and welfare support, and reduced funding for local governments. These factors had larger effects in the North of England than in London and Southern parts of the country.”

The researchers conclude that urgent action must be taken to stop the deterioration and improve health in disadvantaged communities. They call on the Government to increase investments in public health and health care in communities with lower life expectancies and to introduce pro-equity economic and social policies.

Rashid T, Bennett JE, Paciorek CJ, Doyle Y, Pearson-Stuttard J, Flaxman S, Fecht D, Toledano MB, Li G, Daby HI, Johnson E, Davies B, Ezzati M. Life expectancy and risk of death in 6791 communities in England from 2002 to 2019: high-resolution spatiotemporal analysis of civil registration data. Lancet Public Health. 2021 Oct 12 [Epub ahead of print]. doi: 10.1016/ S2468-2667(21)00205-X.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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