Stalling life expectancy trends in Europe and decomposition analysis of mortality data

BACKGROUND: Life expectancy (LE) is an important population health metric over the life course. LE has increased significantly, over the past two centuries but has showed signs of slowing recently in Europe, the United Kingdom, and the United States. Several drivers have been suggested to be causing the slowdown, including slowing improvements in cardiovascular mortality. We set out to investigate trends in LE across Europe from 1990-2019, and how deaths from different causes have contributed to annual average change in LE across two time periods: 2007-2009 to 2012-2014 and 2012-2014 to 2017-2019. METHODS: Data were obtained from the Global Burden of Disease (GBD) Study 2019, which are in public domain. The GBD Study is a comprehensive global epidemiologic data resource employing standardized methodology for comparability. Joinpoint regression analysis was utilised to identify trends. The Arriaga decomposition method was applied to produce estimates of the contribution of different age groups and underlying causes of death to changes in LE at birth for the two periods. RESULTS: Overall, LE in Europe was 72.6 years in 1990- increasing to 78.3 years in 2019, with significant variations within EU countries. However, LE showed a slower pace from 2012 onwards in Europe- much slower in Western Europe, and more pronounced among females. LE in females fell from an annual increase of 0.38% between 2003-2012 to 0.16% between 2012-2019, and LE in males showed a similar pattern (from 0.66% between 2004-2012 to 0.26% between 2012-1019). Overall, improvements in mortality from almost all causes of death slowed, with LE contributions from improvements in ischemic heart disease (IHD) reduced by half. CONCLUSIONS: LE is slowing down in Europe, especially in the Western region. Females and the elderly are facing the brunt of the slowdown. Slowing improvements in IHD mortality are the primary driver of the LE slowdown. KEY MESSAGES: • Life expectancy has overall improved in Europe but has slowed down from 2012 onwards- more pronounced among females and in Western Europe. • The decomposition analyses showed that improvements in mortality from all causes of death slowed, life expectancy contributions from improvements in ischemic heart disease (IHD) reduced by half.