Changes in life expectancy and life span equality during the COVID-19 epidemic in Japan up to 2022.

ObjectivesTo evaluate the impact of COVID-19 on life expectancy in Japan through demographic analyses. MethodsWe evaluated the relationship between life expectancy gap from 2020-21 and 2021-22 and indicators of COVID-19 epidemic size at prefectural level. We also conducted age- and cause-specific decomposition of life expectancy change. Trends of life span equality from 2000-22 were also evaluated at the national level. ResultsPrefectural analysis between 2021-22 life expectancy change and annual per-population COVID-19 cases, person days in intensive care, reported COVID-19 deaths did not reveal significant correlations, which was contrary to our analysis from 2020-21. However, decomposition analysis revealed substantial life expectancy shortening attributable to the over-35-year-old population, and large increases in death causes such as cardiovascular or respiratory disorders along with COVID-19. Life span equality in Japan for the total population declined in 2020 but increased in 2021 and 2022 despite the shortening in life expectancy. ConclusionsDiscrepancy between life expectancy change and COVID-19 statistics in 2022 suggests the growing ascertainment bias of COVID-19. The increased contribution of cardiovascular disorders to life expectancy shortening is an alarming sign for the future. Life span equality in 2021 and 2022 is likely attributed to increased mortality among the elderly. HighlightsO_LILife expectancy change was not correlated with epidemic activity of COVID-19 in 2022 C_LIO_LIOlder people contributed to life expectancy shortening more than ever C_LIO_LICardiovascular disorders contributed substantially to life expectancy shortening C_LIO_LILife span equality increased in 2021 and 2022 despite life expectancy shortening C_LI