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Cited by 531Insurance, Mortality, Demography, Risk ManagementCOVID-19 epidemiological studiesCOVID-19 and healthcare impacts

Quantifying impacts of the COVID-19 pandemic through life-expectancy losses: a population-level study of 29 countries

Open access
Aburto, José Manuel, Schöley, Jonas, Kashnitsky, Ilya, Zhang, Luyin, Rahal, Charles, Missov, Trifon I, Mills, Melinda C, Dowd, Jennifer B +1 more·2022·International Journal of Epidemiology
DOI 10.1093/ije/dyab207PMC PMC8500096

Published version of a preprint

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Abstract

Background: Variations in the age patterns and magnitudes of excess deaths, as well as differences in population sizes and age structures, make cross-national comparisons of the cumulative mortality impacts of the COVID-19 pandemic challenging. Life expectancy is a widely used indicator that provides a clear and cross-nationally comparable picture of the population-level impacts of the pandemic on mortality. Methods: Life tables by sex were calculated for 29 countries, including most European countries, Chile and the USA, for 2015–2020. Life expectancy at birth and at age 60 years for 2020 were contextualized against recent trends between 2015 and 2019. Using decomposition techniques, we examined which specific age groups contributed to reductions in life expectancy in 2020 and to what extent reductions were attributable to official COVID-19 deaths. Results: Life expectancy at birth declined from 2019 to 2020 in 27 out of 29 countries. Males in the USA and Lithuania experienced the largest losses in life expectancy at birth during 2020 (2.2 and 1.7 years, respectively), but reductions of more than an entire year were documented in 11 countries for males and 8 among females. Reductions were mostly attributable to increased mortality above age 60 years and to official COVID-19 deaths. Conclusions: The COVID-19 pandemic triggered significant mortality increases in 2020 of a magnitude not witnessed since World War II in Western Europe or the breakup of the Soviet Union in Eastern Europe. Females from 15 countries and males from 10 ended up with lower life expectancy at birth in 2020 than in 2015.

AI snapshot

Written from the paper’s full text.

TL;DR

Life expectancy at birth declined from 2019 to 2020 in 27 of 29 countries studied, with the largest losses among males in the USA (2.2 years) and Lithuania (1.7 years). Losses were mostly attributable to increased mortality above age 60 and to official COVID-19 deaths.

Key findings

  • Life expectancy at birth declined from 2019 to 2020 in 27 of 29 countries; reductions of more than one year occurred in 11 countries for males and 8 for females. Females in 15 countries and males in 10 ended up with lower life expectancy at birth in 2020 than in 2015.
  • The largest losses at birth were among males in the USA (2.2 years) and Lithuania (1.7 years); losses of ≥1.5 years were documented among males in the USA, Lithuania, Bulgaria and Poland, and females in the USA and Spain. At age 60, the largest male losses were in Poland, the USA and Spain (>1.4 years each), while female remaining life expectancy declined by >1.2 years in Spain, the USA and Belgium.
  • Increased mortality above age 60 contributed most to life-expectancy declines. For females, mortality increases at ages ≥80 contributed most; for males, ages 60–79 contributed most in many countries, while in the USA midlife mortality below age 60 was the largest contributor for males.
  • For 18 countries with data, official COVID-19 deaths explained most life-expectancy losses; in Chile, England & Wales, Belgium, Spain and Slovenia for both sexes, and Italy for males, losses attributable to official COVID-19 deaths exceeded one year. In Denmark and Chile, COVID-19-attributable losses were larger than total losses because other causes declined.

Methods

  • Sex-specific life tables were calculated for 29 countries—most European countries, Chile and the USA—for 2015–2020. Life expectancy at birth and at age 60 in 2020 was contextualized against 2015–2019 trends.
  • All-cause death counts came from the Short Term Mortality Fluctuations series within the Human Mortality Database, supplemented by CDC and ONS data; COVID-19 deaths came from COVerAGE-DB for 18 countries; population estimates came from UN World Population Prospects. Age groups were harmonized to single years 0–110 using a penalized composite link model, and life tables used a piece-wise constant hazard model with deaths at ages ≥85 grouped.
  • Changes in life expectancy were decomposed by age and cause (official COVID-19 deaths vs remaining causes) using linear integral decomposition. Confidence intervals came from Poisson sampling of 500 death-count replications; sensitivity checks used stepwise decomposition and cause-deleted life tables.

Limitations

  • Stated: delays and under-registration of deaths in 2020 may underestimate losses, so results are interpreted as a lower bound; official COVID-19 mortality figures may be inaccurate due to classification and testing differences, also making COVID-attributable estimates a lower bound.
  • Stated: migration due to COVID-19 could affect estimates, especially in Eastern European countries with outmigration, but the effect is expected to be small because migrants are younger and increased mortality was mostly at older ages.
  • Stated/evident: decomposition assumes causes are exhaustive and independent, which may not hold if the pandemic indirectly affected other causes; only 29 countries, mostly Europe plus Chile and the USA, and national populations were analyzed, limiting broader and subgroup comparisons. Evident: smaller populations are more sensitive to the choice of the last open-ended age group and to random fluctuations.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1093/ije/dyab207

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 27 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Similar magnitudes of life-expectancy losses in Western Europe were last seen around World War II.

    “whereas similar magnitudes of losses in Western Europe were last seen around World War II.”
    • Also stated in: § Results · plain
      “the magnitudes of losses observed in 2020 have not been witnessed since World War II in many countries of Western Europe such as Spain, England & Wales, Italy, Belgium, France, the Netherlands, Sweden, Switzerland and Portugal, with data available for the full twentieth century”
    Quote in the paperSubstantial claim
  • Findingown data

    At age 60 years, the three countries with the largest losses in male remaining life expectancy were Poland, the USA and Spain, each losing more than 1.4 years.

    “At age 60 years, the three countries with the largest losses in male remaining life expectancy were Poland, the USA and Spain, each losing >1.4 years.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Between 2015 and 2019, mortality improvements in those aged ≥60 years consistently contributed to increasing life expectancy across countries.

    “Between 2015 and 2019, mortality improvements in those aged ≥60 years consistently contributed to increasing life expectancy across countries.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The magnitude of life-expectancy declines from 2019 to 2020 offset most gains in life expectancy in the 5 years prior to the pandemic.

    “The magnitude of these declines offset most gains in life expectancy in the 5 years prior to the pandemic.”
    Quote in the paperSubstantial claim
  • Findingown data

    Remaining life expectancy for females in Spain, USA and Belgium declined by more than 1.2 years from 2019 to 2020.

    “Remaining life expectancy for females in Spain, USA and Belgium declined by >1.2 years.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 17
  • May combine two claims. 26
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Similar trends across countries were observed for life expectancy at age 60 years from 2015 to 2019.

    “Similar trends across countries were observed for life expectancy at age 60 years, emphasizing the importance of improvements in older-age survival.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Reductions of more than an entire year in life expectancy at birth were documented in 11 countries for males and 8 among females.

    “reductions of more than an entire year were documented in 11 countries for males and 8 among females.”
    • Also stated in: § Results · plain
      “Our results show that from 2019 to 2020, females in 8 countries and males in 11 lost >1 year of life expectancy at birth.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    For the USA, our life-expectancy estimates show a sharper decrease than those based on provisional data up to June 2020, in line with including the remaining months of 2020 that also saw persistent levels of excess mortality.

    “Our results show a sharper decrease in life expectancy than those based on mid-year estimates, in line with including the remaining months of 2020 that also saw persistent levels of excess mortality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The biggest losses of 1.5 years or more of life expectancy at birth were documented among males in the USA, Lithuania, Bulgaria and Poland, and females in the USA and Spain.

    “The biggest losses of 1.5 years or more of life expectancy at birth were documented among males in the USA, Lithuania, Bulgaria and Poland, and females in the USA and Spain.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Life expectancy declined in all countries for both sexes from 2019 to 2020, except for females in Finland and both sexes in Denmark and Norway.

    “In contrast, life expectancy declined in all countries for both sexes from 2019 to 2020, except for females in Finland and both sexes in Denmark and Norway”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Most countries did not show deviations across sources, except Austria, where the STMF underestimates death counts varying from 2% and 4% for females and males, respectively.

    “Most countries did not show deviations across sources, except for Austria, where the STMF underestimates death counts varying from 2% and 4% for females and males, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among males, the lowest gains in life expectancy at birth from 2015 to 2019 were seen in the USA, Scotland, and Iceland (up to about 1 month per year), whereas Lithuanian males benefited from more than 5 months per year of additional life expectancy.

    “Among males, the lowest gains in life expectancy at birth were seen in the USA, Scotland, and Iceland (up to ∼1 month per year), whereas Lithuanian males benefited from >5 months per year of additional life expectancy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Female life expectancy was larger than that of males in every country.

    “Female life expectancy was larger than that of males in every country.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    At age 60 years, countries in Eastern Europe and Scotland exhibited the lowest remaining life expectancy, whereas older females in France and Spain enjoyed the highest.

    “At age 60 years, countries in Eastern Europe and Scotland exhibited the lowest remaining life expectancy, whereas older females in France and Spain enjoyed the highest.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Reductions in life expectancy in 2020 were mostly attributable to increased mortality above age 60 years and to official COVID-19 deaths.

    “Reductions were mostly attributable to increased mortality above age 60 years and to official COVID-19 deaths.”
    • Also stated in: § Conclusions · plain
      “Losses in life expectancy were largely attributable to increased mortality above age 60 years and linked to official COVID-19 deaths.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Countries in Eastern Europe (Lithuania, Bulgaria and Poland), as well as England & Wales and Scotland, also saw increased mortality in the <60-years age group.

    “Countries in Eastern Europe (Lithuania, Bulgaria and Poland), as well as England & Wales and Scotland, where recent life-expectancy stalls due to deteriorating midlife mortality too have been noted, also saw increased mortality in the <60-years age group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Females in 8 countries and males in 11 countries experienced losses of >1 year in 2020.

    “Females in 8 countries and males in 11 countries experienced losses of >1 year.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    In the USA, the pandemic saw a worsening of working-age mortality (<60 years), and this age group contributed most to life-expectancy losses for males.

    “the pandemic saw a worsening of working-age mortality (<60 years) in the USA, and this age group contributed most to life-expectancy losses for males.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In some contexts, such as Denmark and Chile, life-expectancy losses due to COVID-19 deaths were larger than total life-expectancy losses, as increased mortality due to COVID-19 was offset by mortality reductions among other causes.

    “In some contexts, such as Denmark and Chile, life-expectancy losses due to COVID-19 deaths were larger than total life-expectancy losses, as increased mortality due to COVID-19 was offset by mortality reductions among other causes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Improvements below age 60 years contributed less to life-expectancy gains between 2015 and 2019, but progress was still observed in many countries, especially in Eastern Europe.

    “Improvements below age 60 years contributed less, but progress was still observed in many countries, especially in Eastern Europe”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both females and males in Chile, England & Wales, Belgium, Spain and Slovenia, and males in Italy experienced losses of more than a whole year of life expectancy at birth attributable to official COVID-19 deaths, explaining most of the overall loss between 2019 and 2020.

    “Both females and males in Chile, England & Wales, Belgium, Spain and Slovenia, and males in Italy experienced losses of more than a whole year of life expectancy at birth attributable to official COVID-19 deaths, explaining most of the overall loss between 2019 and 2020.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    Among Western European countries, life-expectancy losses were also documented in 2020.

    “Among Western European countries, life-expectancy losses were also documented.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    In Eastern European countries, increased mortality in the 60- to 79-years age group contributed most to life-expectancy losses in comparison with Western European countries such as Spain, Italy and Belgium, where increased mortality in the ≥80-years age groups had sizable impacts.

    “In the Eastern European countries, increased mortality in the 60– to 79-years age group contributed most to life-expectancy losses in comparison with Western European countries such as Spain, Italy and Belgium, where increased mortality in the ≥80-years age groups had sizable impacts.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Death rates from COVID-19 tend to be higher among males than females, with higher case-fatality rates among older age groups.

    “Death rates from COVID-19 tend to be higher among males than females, with higher case-fatality rates among older age groups”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [17] Levin, 2020, Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications, Eur J Epidemiol source

      Not checked in the free run.

    • cites [18] Ahrenfeldt, 2021, Sex and age differences in COVID-19 mortality in Europe, Wien Klin Wochenschr source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The measure of years of life lost is affected by population age structure and therefore comparisons between countries and over time are not precise.

    “However, this measure of life lost is affected by population age structure and therefore comparisons between countries and over time are not precise.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4] Pifarré I Arolas, 2021, Years of life lost to COVID-19 in 81 countries, Sci Rep source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Lockdowns may have reduced the number of deaths due to accidents during the pandemic.

    “whereas lockdowns may have reduced the number of deaths due to accidents.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Calderon-Anyosa, 2021, Impact of COVID-19 lockdown policy on homicide, suicide, and motor vehicle deaths in Peru, Prev Med source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Only countries with high-quality age-disaggregated all-cause mortality data were included to estimate life tables.

    “Only countries with high-quality age-disaggregated all-cause mortality data were included to estimate life tables (see the ‘Methods’ section).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The ranking of countries by life-expectancy loss is affected not only by the pandemic-induced mortality shock but also by the inherent randomness of death counts, which are more sensitive for smaller populations.

    “Thus, the ranking of the countries is not only affected by the pandemic-induced mortality shock, but also by the inherent randomness of death counts, which are more sensitive for smaller populations.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Countries were selected for analysis only if sex-specific death counts across at least 10 age groups were available for every week in 2020.

    “We selected only those countries for which sex-specific death counts across at least 10 age groups were available for every week in 2020”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    We replicated our results with the stepwise decomposition method and quantified the impact of COVID-19 deaths on life expectancy by calculating cause-deleted life tables; results were consistent with those based on the linear integral model.

    “As part of our sensitivity checks, we replicated our results with the stepwise decomposition method36 and quantified the impact of COVID-19 deaths on life expectancy by calculating cause-deleted life tables.29 Results from these analyses with respect to those based on the linear integral model were consistent.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    We performed several sensitivity checks to ensure the robustness of our estimates, including comparisons with alternative sources such as the UN and HMD for 2015-2019.

    “We performed several sensitivity checks to ensure the robustness of our estimates including comparisons with alternative sources such as the UN and from the HMD for the period from 2015 to 2019, or their most recent year available”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    These patterns may reflect the continued impacts of the atypical mortality transitions and a delayed cardiovascular revolution in Eastern countries compared with Western Europe, whereby greater co-morbidities and vulnerabilities in population health are present at these ages.

    “These patterns may reflect the continued impacts of the atypical mortality transitions and a delayed cardiovascular revolution in Eastern countries compared with Western Europe,12 whereby greater co-morbidities and vulnerabilities in population health are present at these ages.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Aburto, 2018, Lifespan dispersion in times of life expectancy fluctuation: the case of central and Eastern Europe, Demography source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    In Eastern European countries with high levels of outmigration, increased mortality could have occurred because of elevated return migration due to the COVID-19 pandemic.

    “For example, in Eastern European countries with high levels of outmigration in their populations, increased mortality could have occurred because of elevated return migration due to the COVID-19 pandemic.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The USA has higher co-morbidities in working-age groups compared with European populations, with greater vulnerability to COVID-19.

    “Despite having a younger population, the USA also has higher co-morbidities in these age groups compared with European populations with greater vulnerability to COVID-19.42,43”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [42] Avendano, 2014, Why do Americans have shorter life expectancy and worse health than people in other high-income countries?, Annu Rev Public Health source

      Not checked in the free run.

    • cites [43] Lawrence, 2018, Wide educational disparities in young adult cardiovascular health, SSM Popul Health source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some countries (such as Austria, England & Wales, Germany and the Netherlands) employ extrapolation procedures to correct for incompleteness to adjust for missing death counts in the preceding 1-3 weeks.

    “Moreover, according to the STMF metadata, some countries (such as Austria, England & Wales, Germany and the Netherlands) employ extrapolation procedures to correct for incompleteness to adjust for missing death counts in the preceding 1–3 weeks.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites STMF metadata

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    Most countries included in the analysis have high-quality systems of death registration and usually report timely and complete death counts.

    “Although most of the countries included in our analysis have high-quality systems of death registration and usually report timely and complete death counts,37”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Barbieri, 2015, Data resource profile: the Human Mortality Database (HMD), Int J Epidemiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The magnitude of life-expectancy losses can also be influenced by migration due to COVID-19, especially in countries where persistent outmigration flows are not tracked accurately between censuses.

    “The magnitude of life-expectancy losses can also be influenced by migration due to COVID-19, especially in countries where persistent outmigration flows are not tracked accurately (such as via population registers) between censuses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    For Western European countries such as Spain, England & Wales, Italy and Belgium, among others, the last time such large magnitudes of losses were observed in a single year was during World War II.

    “For Western European countries such as Spain, England & Wales, Italy and Belgium, among others, the last time such large magnitudes of losses were observed in a single year was during World War II.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    The findings reflect a deepening during the pandemic of the US mid-life mortality crisis that has led to the stalling of life expectancy in recent years.

    “our findings reflect a deepening during the pandemic of the US mid-life mortality crisis that has led to the stalling of life expectancy in recent years.13,14,46”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [13] Ho, 2018, Recent trends in life expectancy across high income countries: retrospective observational study, BMJ source

      Not checked in the free run.

    • cites [14] Mehta, 2020, US life expectancy stalls due to cardiovascular disease, not drug deaths, Proc Natl Acad Sci USA source

      Not checked in the free run.

    • cites [46] Preston, 2021, Excess mortality in the United States in the 21st century, Proc Natl Acad Sci source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The study was only able to include two countries outside of Europe with reliable and complete information for 2020, and the analysis focused on national populations.

    “This limitation is manifested in our study as we were only able to include two countries outside of Europe with reliable and complete information for 2020, and our analysis focused on national populations.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    For official COVID-19 mortality figures, there are likely to be inaccuracies due to differences in classification and testing practices across countries.

    “For official COVID-19 mortality figures, there are likely to be inaccuracies due to differences in classification and testing practices across countries.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationnone given

    In settings with deficient or limited vital registration, the true mortality impacts of the pandemic may never fully be known and the use of data from such contexts would require further adjustments before use.

    “Nevertheless, we note that in settings with deficient or limited vital registration, the true mortality impacts of the pandemic may never fully be known and, at minimum, the use of data from such contexts would require further adjustments (e.g. for undercounting, age heaping) before use.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The 2014-2015 strong flu season was regarded as an exceptionally bad year among high-income countries, causing drops in life expectancy.

    “To put this into perspective, the 2014–2015 strong flu season was regarded as an exceptionally bad year among high-income countries, causing drops in life expectancy.13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Ho, 2018, Recent trends in life expectancy across high income countries: retrospective observational study, BMJ source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The authors dealt with potential death registration delays by harmonizing and smoothing death counts with a PCLM shown to provide reliable estimates of mortality for all countries in the study and by adjusting person-years exposed.

    “We deal with these potential issues by harmonizing and smoothing death counts with a PCLM that has been shown to provide reliable estimates of mortality for all countries in our study26 and by adjusting the person-years exposed.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Rizzi, 2015, Efficient estimation of smooth distributions from coarsely grouped data, Am J Epidemiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Losses in life expectancy are likely to vary substantially between subgroups within countries.

    “Losses in life expectancy are also likely to vary substantially between subgroups within countries.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The largest drop in life expectancy during the 2014-2015 flu season was observed in Italy with a loss of around half a year among males and females.

    “The largest drop was observed in Italy with a loss of around half a year among males and females.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Ho, 2018, Recent trends in life expectancy across high income countries: retrospective observational study, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    Other factors, such as those linked to unevenness in healthcare access in the working-age population and structural racism, may also help to explain the increased mortality in the USA.

    “Other factors, such as those linked to unevenness in healthcare access in the working-age population and structural racism, may also help to explain the increased mortality.”
    Quote in the paperNot a substantial claim
42 of 42

  • The authors state this as an assumption.

    Causes of death are exhaustive and independent, not allowing mortality to be duplicated.

    “This methodology assumes that causes of death are exhaustive and independent, not allowing mortality to be duplicated.”

  • The authors state this as an assumption.

    For England & Wales, Northern Ireland and Scotland, mid-year population estimates from HMD for 2018 can be projected for 2019 and 2020 using stable population assumptions.

    “For England & Wales, Northern Ireland and Scotland, mid-year population estimates from HMD for the year 2018 were projected for 2019 and 2020 using stable population assumptions”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Age 80 assigned to different decomposition groups

    Minor

    The Figure 4 caption groups age 80 with ages 60-80 and defines the oldest group as >80. The results instead describe the groups as 60-79 and ≥80, placing age 80 in the oldest group.

  • 2015 life tables claimed for countries with estimates only from 2016

    Minor

    The methods say life tables were constructed for all 29 countries for 2015-2020, but the figure notes say estimates for Chile, Greece and Germany were available only from 2016.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Glei, 2021, The US midlife mortality crisis continues: increased death rates from causes other than COVID-19 during 2020, medRxiv
  2. 2020, R: A Language and Environment for Statistical Computing

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Authors
Aburto, J. M., Schöley, J., Kashnitsky, I., Zhang, L., Rahal, C., Missov, T. I., Mills, M. C., Dowd, J. B., & Kashyap, R.
Affiliations
  • University of Southern Denmark (DK)
  • University of Oxford (GB)
Corresponding author
Aburto, José Manuel
ORCID
Venue
International Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
2021-09-26
Volume
51
Issue
1
Pages
63-74
ISSN
  • 0300-5771 (ISSN-L)
  • 1464-3685
DOI
10.1093/ije/dyab207
PMC
PMC8500096
OpenAlex
W3202586309
Semantic Scholar
42f010dd248123e954a992e2ce369ccafbc7bb93
Cited by
531
References
39
Citations by year
2026: 39 · 2025: 78 · 2024: 76 · 2023: 99 · 2022: 116 · 2021: 119 · 2020: 1 · 2014: 1 · 2013: 1
FWCI
161.16
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Epidemiology (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
Funders
  • British Academy’s Newton International Fellowship (NIFBA19/190679)
  • ROCKWOOL Foundation’s Excess Deaths
  • Leverhulme Trust Large Centre
  • John Fell Fund (0009182)
  • European Research Council (835079)
Topics
  • Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
Keywords
COVID-19 pandemic, life expectancy, excess mortality, age-specific mortality, life tables, decomposition analysis, sex differences in mortality, older adults, cross-national comparison
MeSH terms
COVID-19, SARS-CoV-2, Europe, Female, Humans, Infant, Newborn, Life Expectancy, Male, Middle Aged, Mortality, Research Design, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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