Dear Editor,
The fall in life expectancy at birth was more alarming than the impact of the Covid-19 pandemic on national income for a majority of countries in the Central American and Caribbean region, as a result of the rise in death rates. There were just four countries where life expectancy rose between 2019 and 2021, thanks to the fact that they recorded relatively few Covid-related deaths: life expectancy in The Bahamas rose 0.6 percent, with smaller gains for Barbados, St Kitts-Nevis and Grenada. The magnitude of the global impact of the pandemic is reflected in the fact that the average life expectancy of countries worldwide fell by 2.3 percent.
Of the countries in the Central American and Caribbean region where life expectancy fell, Antigua-Barbuda and Nicaragua were the least affected. The other countries in the region where the fall in life expectancy was less severe than the world average were the Dominican Republic, Haiti, Trinidad-Tobago, Jamaica and Panama. The wider Latin American region includes countries which recorded among the world’s highest death rates from Covid, depressing the average life expectancy for the wider region (including the Caribbean) by as much as 3.9 percent, 70 percent worse than the world average.
There were five countries in the Central American and Caribbean sub-region where the fall in life expectancy was worse than the world average, but less severe than for the wider Latin American and Caribbean region: El Salvador, Suriname, Costa Rica, St Lucia and Honduras. The countries which suffered the greatest losses of life in the Central American and Caribbean sub-region were St Vincent and the Grenadines, Belize, Guyana, Cuba and Guatemala. These countries all experienced a decline in life expectancy between 2019 and 2021 that was four percent or larger. The loss for Guatemala, the worst affected, was 5.3 percent, more than twice the worldwide average. These results suggest a need for investigation into the reasons for the observed results.
We would expect that the quality and accessibility of health services would have a bearing on the outcomes, and the favourable results for The Bahamas, Barbados and St Kitts-Nevis are consistent with this. However, Cuba, with one of the most envied health services in Latin America and the Caribbean, had among the worst losses in life expectancy. What is more, the widely differing outcomes in Grenada and neighbouring St. Vincent and the Grenadines need to be explored. Comparative levels of average income might also be expected to play a role, because higher incomes in richer countries provide the means for access to private health care, in circumstances where the levels of public provision are inadequate.
However, the comparatively low loss of life in Haiti, the poorest nation in the Western Hemisphere, belies this supposition. The widely varying outcomes in the neighbouring countries of Nicaragua, Honduras, El Salvador and Belize are also surprising. One factor which we know would have had an impact on life expectancy was isolation. When airlines suspended operations at the height of the pandemic, island nations were automatically protected from infection, and for a considerable time, the spread of Covid in local communities could be tracked and contained, thanks to rigorous testing and tracing.
Islands would have avoided the early spike in death rates seen in the worst affected countries, before vaccines were widely available and before the less deadly Omicron strain of the virus overtook other variants. However, the widely varying losses for the island economies of the Lesser Antilles indicate that this factor also is not clearly reflected in the outcomes. Further investigation is needed into the complex of reasons and circumstances which explain the observed differences of Covid-19 on life expectancy in the economies of Central America and the Caribbean.
Sincerely,
DeLisle Worrell
