Inequality in life expectancy losses by education in Finland during COVID-19 pandemic.

backgroundThe COVID-19 pandemic has resulted in a rapid increase in mortality in most societies examined. The effects of the pandemic have varied considerably between different populations, time periods and age groups. Studies also report pronounced socioeconomic differentials, with mortality rates being higher in lower socioeconomic groups. However, the evidence about mortality changes across socioeconomic groups is somewhat patchier. DATA: We use annual death counts and population exposures by 5-year age groups for ages 30 + and open age group 100+, sex, and education from the Finnish population register. We also used data on a number of COVID-19 deaths by age and sex published by the Statistical Office of Finland.

methodsUsing the excess mortality approach, we estimate life expectancy losses in Finland in 2020–2024 by education, and quantify the contribution of changes in age-specific mortality to the total changes in differences in life expectancy between the high and low education groups. The abridged life tables for ages 30 + were calculated using observed and counterfactual (Lee-Carter estimates) death rates with open age group 100 + without smoothing. Counterfactual death counts were calculated using observed population estimates and expected death rates assuming no pandemic scenario. We used stepwise decomposition to estimate the contribution of age-specific groups to changes in life expectancy and inequality measures.

resultsWe found that life expectancy losses vary considerably by year, sex, and education group. During the first pandemic year 2020, the most affected group was males with an intermediate level of education, showing life expectancy loss of 0.40 years. Interestingly, the corresponding loss among higher educated males was almost the same (0.36 years). Meanwhile, the life expectancy decline in the low education group was only 0.2 years. At the same time, females in all educational groups showed only negligible changes. The situation reversed between 2021 and 2023, with the most significant losses being observed among low-educated males and females in 2022. These education-specific trends contributed to widening life expectancy differences.

conclusionThe group that benefits more from the health care system in normal circumstances will also be at an advantage in the crisis situation. Our study confirms the importance of combatting socioeconomic inequalities and better protecting vulnerable groups in order to reduce the life expectancy losses at the national level during the mortality crisis.