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'Dramatic' increases in younger Canadians' deaths contributed to our reduced life expectancy

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Amid a declining life expectancy across the country, new national data released this week show that years on from the beginning of the pandemic, COVID-19 and the opioid crisis have had lasting impacts on life and death in Canada.

Record-breaking COVID deaths and the disproportionate loss of life to overdoses among younger Canadians have driven the country’s life expectancy down a full year since 2019; only the second decrease of its kind in the 21st century.

And while the numbers suggest that COVID’s mortality impact may be less extreme this year, enduring losses to overdose mean that the decline is not necessarily finished.

According to the latest figures from Statistics Canada (StatCan), just short of 20,000 Canadians died of COVID-19 in 2022, up from roughly 14,500 in 2021 and surpassing unintentional injuries (including overdoses) as the third-most common cause of death, behind cancer and heart disease.

This past year was the first time since 2017 that the top three causes of death shifted, when strokes and other similar diseases gave way to accidental deaths.

Together, the top 10 causes accounted for nearly 70 per cent of all deaths in 2022, with 228,000 out of 335,000 in total according to preliminary numbers shared by the federal government.

COVID deaths peaked last year as restrictions eased

Despite the “gradual return to normalcy” described in this week’s StatCan report, as lockdowns and mask mandates ended across the country, 2022 saw more deaths to COVID-19 than either of the previous two pandemic years.

Weekly death figures maintained by Health Canada show that unlike 2020 and 2021, which were characterized by steep spikes but also lulls in COVID-related deaths, last year’s trajectory was steadier, with a higher baseline rate of deaths attributed to the disease.

The average week in 2022 saw roughly 372 deaths to COVID-19, compared with 312 and 277 in 2020 and 2021, respectively. And while the first two years of the pandemic featured death tolls that could drop as low as 26 per week, the lowest weekly count recorded in all of 2022 was more than five times as high, at 140.

So far this year, COVID-19 death rates have been at their lowest since the pandemic began, with a rough total of 6,200 reported between January and mid-November. Health Canada notes, however, that more recent totals for cases and deaths should be interpreted with caution, as they may be subject to undercounts due to delayed reporting.

Compared with other causes of death tracked by StatCan this past year, a 6,200 approximate total would place COVID-19 at the eighth-most common, between influenza and pneumonia (roughly 6,000 deaths in 2022) and diabetes mellitus (7,600 deaths).

Life expectancies drop across G7 since 2019

According to this week’s StatCan release, Canada’s national life expectancy dropped for its third year in a row in 2022, to 81.3 from 81.6 the year prior, and down a full year from 82.3 in 2019.

The post-pandemic drop is only the second time since 2000 that Canada has recorded decreasing life expectancies, following a one-year decline of 0.1 years in 2017.

The report notes that last year’s decrease can be attributed in part to “deaths under investigation by a coroner or medical examiner,” which can include drug overdoses, suicides and homicides.

Tom Elliott, an associate professor of medicine at the University of British Columbia who has spent years studying life expectancies, says it’s a sign of the outsized impact of deaths among Canada’s younger demographics, spurred in large part by the opioid crisis and other “deaths of despair.”

“If you get someone dying in their 30s, it’s going to have a big effect on life expectancy, but someone dying at the age of 81, at which point, you know, only around 25 per cent of the population is still alive, it’s going to have a much smaller effect,” Elliott said in an interview with CTVNews.ca.

Detailed mortality data analyzed by Elliott and shared with CTVNews.ca show what he calls “dramatic” increases in mortality among younger Canadians, including men aged 30-45 and women aged 25-35.

To Elliott, whose work also includes collaborations with Together We Can, an addiction treatment centre in Vancouver, that speaks to the rise of opioids.

“I predicted a reduction in life expectancy,” he said. “And then, along comes COVID in 2020 … putting it all together, I’m not at all surprised.”

A 2021 study of COVID-19’s impacts on Canadian mortality estimated a drop in life expectancy of nearly half a year in 2020, attributable in part to pandemic deaths.

It’s a trend shared by many countries.

Data from the Organisation for Economic Co-operation and Development (OECD) show that of G7 nations, only Japan has seen an increased life expectancy since 2019 (to 84.5 in 2021 from 84.4), with drops elsewhere including 0.6 years in Germany, 0.7 years in France and a staggering 2.4 years in the United States between 2019 and 2021.

Elliott said that the gulf between the U.S. and its counterparts can be explained by differences in healthcare, and in particular, high infant mortality compared to most wealthy countries.

“That really hurts in your life expectancy,” he said. “You’ve got infant mortality, which is inadequate perinatal care, it’s the opioid crisis in the 20s and 30s and it’s COVID … in the elderly.”

A multinational review by European and U.K. researchers published last year described COVID-19 as responsible for a “global and severe” reduction in lifespans, joining the grim ranks of world wars, collapsing superpowers and prior pandemics.

“The COVID-19 pandemic led to global increases in mortality and declines in period [life expectancy] that are without precedent over the past 70 years,” the study reads. “The scale of these losses was clear by the end of 2020. By the end of 2021, it was clear that the pandemic had induced a protracted mortality shock.”

As of the most recent data, countries including Italy and France have shown either reversals or easing of declines in life expectancy, but elsewhere, including Canada, those figures have yet to bounce back from years of decline.

To Elliott, even as COVID deaths decrease year-on-year, the ongoing loss of life to the opioid crisis means that although one storm may be passing, it’s fair to say that another remains.

“I don’t see any hope until we get somewhere with opioids,” he said.

“We need people in sober recovery; that’s what’s required.”

Edited by CTVNews.ca Special Projects Producer Phil Hahn

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