Declines in life expectancy following the COVID-19 pandemic in provinces of Spain

The COVID-19 pandemic has impacted population health on a global scale. Most of the studies on mortality impacts are at national level, while broad evidence exists on heterogeneous COVID-19 incidence across regions and within countries. Using Spanish data for 2020, we estimate life expectancy changes in 2020 compared with the 2017-19 period in 50 Spanish provinces. We visualize longer-term trends (1990-2020), and compare the robustness of our province-specific results with cumulative COVID-19 incidence using regional data from the Spanish ENECOVID seroprevalence study. In 2020 there was a 1.2 and 1.1 year drop in life expectancy for men and women in Spain, but this impact was heterogeneous across regions. For men these losses were highest in the province of Segovia (-3.5 years decline), while for women the highest drop was observed in Salamanca (-2.8 years decline). Life expectancy actually increased in Santa Cruz de Tenerife (+1.1 and +0.6 years for men and women, respectively). Declines in life expectancy in 2020 were also highly correlated with the cumulative seroprevalence through November 2020 ({rho}=0.80 and 0.77 in men and women, respectively). Monitoring regional life expectancy dynamics provide valuable and granular information on the heterogeneous impacts of the pandemic on health at the population level. Similar exercises in other European countries may reveal insightful geographic patterns in mortality impacts in COVID-19 pandemic years.