How the COVID-19 pandemic lowered life expectancy in Canada last year

COVID-19 deaths led to a  five-month decrease in life expectancy at birth last year, recent data released by Statistics Canada suggest, potentially putting the country at a level not seen in seven years.

The findings varied widely across the country, with Quebec logging a drop in life expectancy of almost a year while the Atlantic provinces and the territories barely saw any change, confirming major differences in the pandemic's toll by region. Some experts also suggest that life expectancy doesn't capture the long-term toll of COVID-19.

The numbers released by Statistics Canada are not a reason to hit the panic button, said Marisa Creatore, the associate scientific director at the Canadian Institutes of Health Research and an assistant professor in public health at the University of Toronto.

"We're in the middle of a pandemic, so we would expect that the mortality rates would be a little bit higher right now," she said, adding it was very unlikely that these rates would continue for the entire lifespan of a baby born today.

The pandemic's death toll was already clear — more than 25,700 people have died from the virus in Canada since the start of the pandemic, according to the Public Health Agency of Canada — but the hit to life expectancy helps put those losses in context, experts say. 

It's happened before

It's not the first time that a health crisis has impacted Canada's life expectancy at birth.

In 2017, the opioid crisis reduced life expectancy at birth by 0.07 years, according to Statistics Canada. The Public Health Agency of Canada reported more than 19,300 opioid-related deaths from January 2016 to September 2020.

The country's HIV epidemic, which led to the deaths of about 18,300 people between 1987 and 2011, also contributed to a small drop.

The main difference this time is that COVID-19 claimed a lot more lives in a much shorter period of time. However, those who died were a lot older on average than during the other two health crises.

To understand the impact of these deaths, Statistics Canada estimated what life expectancy would have been if the pandemic hadn't happened, and calculated how much it changed when they took into account COVID-19 mortality rate in 2020. 

The agency used 2019's life expectancy of 82.1 years as a baseline for their calculations, because the actual life expectancy for 2020 won't be known until the number of non-COVID deaths for that year is available.

Life expectancy is used to measure the overall health of a population, and can help determine how well a country or region is doing compared to other places.

Quebec sees biggest drop

Quebec, which accounted for more than half of Canada's COVID-19 deaths last year, had a decrease in life expectancy of about 10 months — twice as much as the rest of the country.

"This corresponds with the crisis we saw in the long term care facilities," said Tim Evans, director of the School of Population and Global Health at McGill University and executive director of the COVID-19 Immunity Task Force. 

"They were understaffed, they were under-equipped to deal with this," he said, qualifying the death toll in these homes as "very, very, very high."

Manitoba's life expectancy was the second worst-affected with a drop of 0.6 years, followed by Ontario and Alberta. 

In comparison, the estimated change to life expectancy in the Atlantic provinces and the territories was minimal, due to the relatively low number of COVID-19 deaths. These regions, which implemented stricter lockdowns at the start of the pandemic and more rigid travel restrictions at their borders, experienced lower cases of the virus than elsewhere in the country. 

Canada faring better than other countries

Canada is doing better than the United States and many other European countries, including France, Italy and Spain, when it comes to this indicator, Statistics Canada found. But it fared worse than Germany, Denmark, Finland, Norway, Australia and New Zealand.

While the agency did not compile estimates for other countries, they used data published by them to make this comparison, said Patrice Dion, the author of the study and a statistician at Statistics Canada.

Citing similar research done in the United States, Dion said the impact of COVID-19 deaths on life expectancy in that country was three times worse than in Canada. "They came up with an estimate of 1.26 years [reduction]," he said.

That's because Canada's southern neighbour has a much higher COVID death rate attributed to the virus and people there were dying from it at a younger age, he explained.

Capturing the whole picture

While Statistics Canada's findings are a good indicator of how taxing the virus has been on the population, it's important to keep in mind that they don't reflect the whole picture, Dion said.

"If you have delayed medical care, that may have a negative impact on life expectancy, but maybe there were less traffic accidents for example, and that could have a positive impact," he said. 

Simply looking at life expectancy also fails to show the damage done to our health care system, said Creatore. "Are people for years to come going to be suffering the impacts of delayed cancer screening, insufficient control of chronic diseases?"

And it doesn't capture the ways in which the pandemic affected communities differently, she added. "The overall life expectancy can continue to stay lower for several years, because it's being driven by widening inequities across groups." 

Low-income and racially diverse neighbourhoods have had higher rates of infections and deaths than more wealthy residential areas. 

"There's not one number that will give you the whole impact of a pandemic, and even less capture human loss," said Dion.