The unequal impact of the COVID-19 pandemic on life expectancy across Chile
Objectives: To quantify the effect of the COVID-19 pandemic on life expectancy in Chile categorized by rural and urban, and to correlate life expectancy changes with socioeconomic factors at the municipal level. Design: Retrospective cross-sectional demographic analysis using aggregated data. Setting: Vital and demographic statistics from the national institute of statistics and department of vital statistics of ministry of health. Participants: Aggregated national all-cause death data stratified by year (2000-2020), sex, and municipality. Main Outcome measures: Stratified mortality rates using a Bayesian methodology. With this, we assessed the unequal impact of the pandemic in 2020 on life expectancy across Chilean municipalities for men and women and analyzed previous mortality trends since 2010. Results: Life expectancy declined for both men and women in 2020. Urban areas were the most affected, with males losing 1.89 and females 1.33 in 2020. The strength of the decline in life expectancy correlated with indicators of social deprivation and poverty. Also, inequality in life expectancy between municipalities increased, largely due to excess mortality among the working-age population in socially disadvantaged municipalities. Conclusions: Not only do people in poorer areas live shorter lives, they also have been substantially more affected by the COVID-19 pandemic, leading to increased population health inequalities. Quantifying the impact of the COVID-19 pandemic on life expectancy provides a more comprehensive picture of the toll.