Intended for healthcare professionals


The end of great expectations?

BMJ 2022; 377 doi: (Published 05 May 2022) Cite this as: BMJ 2022;377:e071329
  1. Lucinda Hiam, DPhil candidate,
  2. Danny Dorling, Halford Mackinder professor of geography
  1. School of Geography and the Environment, University of Oxford, Oxford, UK
  1. Correspondence to: D Dorling danny.dorling{at}

The pandemic inquiry must account for stalling life expectancy before the pandemic

Life expectancy at birth is a key summary measure of the health of any given population. Ideally, it should increase steadily over time in the absence of data artefact, mass migration in or out, or a large scale event such as war or natural disaster, disease outbreak, or societal collapse. Any break in the trend beyond isolated annual fluctuations should raise the alarm among health workers, policy makers, and the public.

The covid-19 pandemic has caused life expectancy to fall below predicted levels worldwide, including in the UK.1 Part of this may have been inevitable given what we now know about this new coronavirus, but part could have been avoided. The inquiry into the UK government’s handling of the pandemic is essential,2 not least to provide answers to the tens of thousands of bereaved families who are rightly asking whether more could have been done to save their loved ones.

When the UK inquiry takes place—public hearings are likely to begin in 2023 (the Scottish government’s inquiry may start in 2022)3—it …

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