The Mean Unfulfilled Lifespan (MUL): A new indicator of the impact of mortality shocks on the individual lifespan, with application to mortality reversals induced by COVID-19

Abstract

Declines in period life expectancy at birth (PLEB) provide seemingly intuitive indicators of the impact of a cause of death on the individual lifespan. Derived under the assumption that future mortality conditions will remain indefinitely those observed during a reference period, however, their intuitive interpretation becomes problematic when period conditions reflect a temporary mortality “shock”, resulting from a natural disaster or the diffusion of a new epidemic in the population for instance. Rather than to make assumptions about future mortality, I propose measuring the difference between a period average age at death and the average expected age at death of the same individuals (death cohort): the Mean Unfulfilled Lifespan (MUL). For fine-grained tracking of the mortality impact of an epidemic, I also provide an empirical shortcut to MUL estimation for small areas or short periods. For illustration, quarterly MUL values in 2020 are derived from estimates of COVID-19 deaths that might substantially underestimate overall mortality change in affected populations. These results nonetheless illustrate how MUL tracks the mortality impact of the pandemic in several national and sub-national populations. Using a seven-day rolling window, the empirical shortcut suggests MUL peaked at 6.43 years in Lombardy, 8.91 years in New Jersey, and 6.24 years in Mexico City for instance. Sensitivity analyses are presented, but in the case of COVID-19, the main uncertainty remains the potential gap between reported COVID-19 deaths and actual increases in the number of deaths induced by the pandemic in some of the most affected countries. Using actual number of deaths rather than reported COVID-19 deaths may increase seven-day MUL from 6.24 to 8.96 years in Mexico City and from 2.67 to 5.49 years in Lima for instance. In Guayas (Ecuador), MUL is estimated to have reached 12.7 years for the entire month of April 2020.

Investigating regional excess mortality during 2020 COVID-19 pandemic in selected Latin American countries

“…Life expectancy at birth estimates are a simple summary of current mortality, assuming that age-specific rates remain constant for a long period. Excess mortality in 2020 is a temporary shock and will not hold into the future (Aburto et al, 2021b ; Heuveline, 2021 ). Under normal conditions, changes in mortality tend to be steady, making its interpretation more direct; under a temporary shock (the pandemic), its interpretation might be misleading (Aburto et al, 2021b ; Heuveline, 2021 ).…”

“…Excess mortality in 2020 is a temporary shock and will not hold into the future (Aburto et al, 2021b ; Heuveline, 2021 ). Under normal conditions, changes in mortality tend to be steady, making its interpretation more direct; under a temporary shock (the pandemic), its interpretation might be misleading (Aburto et al, 2021b ; Heuveline, 2021 ). In any event, based on available data, we use the impacts on life expectancy at birth, considering its limitations, to show the impact of excess mortality in each country of the region in 2020.…”

American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care

“…1,7 The US also leads in “excess” mortality; with avoidable deaths worsening three years after the COVID-19 pandemic began despite other countries showing lower mortality. 1,8,9…”

A re-examination of the impact of COVD-19 deaths on the computation of average life expectancy

“…(FIGURE 1 ABOUT HERE) Following Goldstein and Lee (2020) and Heuveline (2021), we next compute the loss of expected remaining life due to COVID-19.…”