Health Reports
Changes in life expectancy at birth during the COVID-19 pandemic and contributions by cause of death in British Columbia, Canada

Abstract

Background

Studies have shown that excess all-cause mortality during the COVID-19 pandemic caused declines of life expectancy at birth (LE₀) in most countries around the world, after decades of improvement prior to the pandemic. However, those studies rarely examined the contributions from specific causes of death other than COVID-19.

Methods

This study used the Chiang method to estimate LE₀ for each year in British Columbia from 2000 to 2022 and the changes from 2019 to 2020, 2021, and 2022. Each death case was classified into 1 of 23 categories, including COVID-19, unregulated drug toxicity, cardiovascular diseases, and injuries, according to the International Classification of Diseases, 10th Revision (ICD-10). The changes in LE₀ were decomposed into age and causes of death using the Arriaga method.

Results

Compared with 2019, male LE₀ decreased by 1.16 years in 2020, 1.81 years in 2021, and 1.62 years in 2022; female LE₀ did not change in 2020, but decreased by 0.65 years in 2021, and by 0.56 years in 2022. COVID-19 and unregulated drug toxicity were the top two causes of deaths contributing to the LE₀ declines in males and females, with COVID-19 being the number one contributor in females and unregulated drug toxicity deaths as the number one contributor in males.

Interpretation

The COVID-19 pandemic impacted population health not only through its direct effects but also through indirect impacts on other health outcomes, including the unregulated drug toxicity crisis, the combination of which were driving factors in the decline in life expectancy at birth.

Keywords

life expectancy, COVID-19, unregulated drug toxicity, inequalities

Authors

Xibiao Ye, Ioana Sevcenco, Richard Mercer, Henry Ngo, Alyssa Parker and Bonnie Henry are with the Office of the Provincial Health Officer, Ministry of Health, British Columbia. Xibiao Ye is also with the University of Victoria. Henry Ngo and Bonnie Henry are also with the University of British Columbia. Viet Dao is currently with Foundry BC . Reiko Okamoto is currently with the Bruyère Research Institute.

 

 

What is already known on this subject?

• Life expectancy at birth declined in most countries around the world during the COVID 19 pandemic.
• In British Columbia, the mortality rate for unregulated drug toxicity death increased during the pandemic.

What does this study add?

• Life expectancy at birth in British Columbia declined during the first two years of the COVID-19 pandemic but started to recover in 2022.
• While COVID-19 and unregulated drug toxicity deaths were the top two causes contributing to the life expectancy at birth declines in both males and females, COVID-19 was the number one contributor for females and unregulated drug toxicity was the number one contributor for males.
• Future research should further examine the contribution patterns by gender, race, ethnicity, and other socioeconomic factors.

Introduction

Since COVID-19 was declared a pandemic on March 11, 2020, there have been at least 772 million confirmed cases and 6.9 million confirmed deaths worldwide.^Note 1 In Canada, there were 59,083 COVID-19 deaths^Note 2 as of September 9, 2024, including 6,852 deaths in the province of British Columbia.^Note 3 Globally, the COVID-19 pandemic led to 120.3 excess deaths per 100,000 population (95% confidence interval [95% CI] 113.1 to 129.3) in 2020 and 2021 combined.^Note 4 The study estimated that, during the same period, there were 5,260 excess deaths (95% CI 4,350 to 6,250) caused by the pandemic in British Columbia and 43,700 excess deaths (95% CI 39,900 to 47,300) in Canada. Another study using a different statistical method reported an even higher estimate of excess deaths caused by COVID-19 in British Columbia.^Note 5

Earlier studies demonstrate that these excess deaths led to a decrease in life expectancy at birth (LE₀), a summary measure of population health, around the world for the first two years of the pandemic.^Note 6, ^Note 7, ^Note 8 For instance, Aburto and colleagues^Note 6 reported declines in LE₀ for 27 out of 29 countries in 2020. Islam and colleagues looked at 37 upper-middle and high-income countries worldwide and found similar results.^Note 7 Many of those studies found further disproportional impacts of the pandemic on LE₀. In the United States, the largest LE₀ decline was found in the Hispanic population, followed by the non-Hispanic Black population.^Note 8, ^Note 9 The population living in lower income communities had a larger LE₀ decline compared with those living in higher-income communities.^Note 9 Analyses by sex also revealed a higher LE₀ decline in males than that in females in many countries.^Note 10, ^Note 11

Those studies primarily focused on quantifying the overall impact of the pandemic on LE₀, but little was known about the contributions of COVID-19 deaths and excess deaths because of other causes indirectly related to COVID-19. While most excess deaths were directly attributable to COVID-19, about 17% of these excess deaths were attributable to indirect effects of COVID-19.^Note 12 In British Columbia, opioid use-related deaths have accelerated since the start of the pandemic.^Note 13 Increased opioid toxicity deaths were also observed in other jurisdictions in Canada and the United States.^Note 14, ^Note 15 Studies have examined the life expectancy changes during the first two years of the pandemic, but little was known on whether the declining trends continued in 2022, given the changing COVID-19 situation. The present study aimed to quantify the changes from 2019 to each year during the pandemic and the contributions from COVID-19, unregulated drug toxicity, and other causes of death in British Columbia, Canada.

Materials and methods

Data sources

The death registry of the British Columbia Vital Statistics Agency (VSA) contains all deaths of British Columbia residents. This study included all deaths recorded in the registry as occurring between 2000 and 2022. A Medical Certification of Death (MCOD) with details about the cause of death is completed by a certifier, i.e., doctor, nurse practitioner, or coroner. The British Columbia Coroners Service (BCCS) is required to determine the cause of death for all unexpected and unnatural deaths in the province. VSA medical coders review the paper MCODs for completeness, internal consistency, obvious errors, and special items of interest and contact certifiers for clarification or additional information. Medical coding staff translate the cause of death information written on the MCOD by the certifier into International Statistical Classification of Diseases and Related Health Problems 10th revision (ICD-10) codes. The ICD‑10 codes are classified into one of the causes of death as listed in Appendix Table 1. COVID-19‑associated deaths are coded U07.1 or U07.2 in the registry. Cases without a known cause of death are coded as “R99-ill-defined and unknown cause of mortality.”

For this study, unregulated drug toxicity deaths (i.e., deaths from controlled drugs such as heroin, cocaine, and illicit fentanyl; and deaths from medications not prescribed to the deceased but obtained or purchased from unknown means or where the origin of the drug is not known) were classified using the death registry data for cases occurring between 2000 and 2017. For deaths occurring from 2018 to 2022, the BCCS list of deaths flagged as suspected unregulated drug toxicity cases was used to identify cases, because of the lagged investigation or confirmation of these cases. Remaining cases with unknown cause of death (“R99”) were included in the “Other causes” category. The denominator was derived from the Ministry of Health Client Roster, a provincial database containing information on virtually everyone who lives or has lived in British Columbia over time and has registered with the province’s health care system.

Statistical analysis

Age-standardized all-cause and cause-specific mortality rates were calculated using the British Columbia population in 2011 as the standard population. The Chiang method was used to construct period life tables and estimate LE₀ for males and females in each year.^Note 16 Changes in LE₀ were estimated between 2019 and each year from 2020 to 2022 for males and females. Each change was then partitioned into age groups and causes of death, including COVID-19 and unregulated drug toxicity, using Arriaga’s decomposition method.^Note 17 A sensitivity analysis was conducted by removing all suspected unregulated drug toxicity deaths (i.e., using only the VSA as the source for cause of death from 2018 to 2022). All data and statistical analyses were performed in R. This study was conducted as part of a population health research program approved by the University of British Columbia Research Ethics Board (Ethics REB # H22-01818).

Results

From 2000 to 2014, LE₀ had been increasing at an average rate of 0.18 years per year for females and 0.21 years per year for males (Chart 1) . From 2015 to 2018, LE₀ for both sexes saw a decline and then a recovery, reaching a new high level in 2019 (85.47 years for females, 80.99 years for males). Compared with 2019, LE₀ for females did not change during the first year of the pandemic in 2020 but decreased by 0.65 years in 2021. However, LE₀ for males decreased by 1.16 years in 2020 and the trend continued in 2021, resulting in a cumulative decline of 1.81 years. LE₀ slightly recovered in 2022 in both sexes, with an increase of 0.09 years among females and 0.19 years among males from 2021.

Description of Chart 1



Data table for Chart 1
Table summary
This table displays the results of Data table for Chart 1 Females and Males, calculated using number of years units of measure (appearing as column headers).

	Females	Males
	number of years
2000	82.71	77.86
2001	82.78	77.80
2002	82.77	78.09
2003	82.93	78.42
2004	83.01	78.54
2005	83.36	78.52
2006	83.44	78.95
2007	83.67	79.04
2008	83.67	79.28
2009	84.21	79.94
2010	84.57	80.36
2011	84.82	80.49
2012	84.89	80.84
2013	85.01	80.80
2014	85.25	80.87
2015	85.12	80.87
2016	84.99	80.42
2017	84.99	79.89
2018	85.26	80.16
2019	85.47	80.99
2020	85.47	79.84
2021	84.82	79.19
2022	84.91	79.38
Source: British Columbia Vital Statistics Agency Death Registry, 2000 to 2022.

Age-standardized all-cause mortality rates for both males and females steadily decreased during 2000 to 2014, then slightly increased between 2015 and 2017. The rates fell again in 2018 and reached their lowest levels in 2019 (791 deaths per 100,000 population for males and 552 deaths per 100,000 population for females), before starting to increase again during the pandemic (Appendix Chart 1). Age-standardized rates for the top two causes of deaths, cardiovascular diseases and malignant neoplasms, declined during the study period, while the rates for other causes, including unregulated drug toxicity, neurological conditions, and other causes, increased in both males and females (Chart 2). The unregulated drug toxicity mortality rate increased from 2014 to 2017, with a significant decline between 2018 and 2019 but started to substantially increase in 2020. While most COVID-19 death cases were among seniors aged 80 years and older, adults aged between 20 and 69 years accounted for most unregulated toxicity drug deaths in both males and females (Table 1).

Description of Chart 2



Data table for Chart 2
Table summary
This table displays the results of Data table for Chart 2 Female, COVID-19-related deaths, Unregulated drugs related deaths, Malignant neoplasms, Neurological conditions and Cardiovascular diseases, calculated using rate (per 100,000) units of measure (appearing as column headers).

	Female
	COVID-19-related deaths	Unregulated drugs related deaths	Malignant neoplasms	Neurological conditions	Cardiovascular diseases
	rate (per 100,000)
2000	0.0	3.6	199.1	47.5	264.3
2001	0.0	4.6	195.9	50.9	254.9
2002	0.0	4.4	202.2	52.7	247.7
2003	0.0	3.9	199.5	50.3	241.3
2004	0.0	3.9	201.4	50.1	239.0
2005	0.0	4.5	188.4	45.9	225.7
2006	0.0	4.3	191.5	52.9	212.8
2007	0.0	4.7	190.1	54.2	206.9
2008	0.0	5.8	184.7	57.8	210.4
2009	0.0	4.8	180.2	55.7	188.3
2010	0.0	4.9	183.9	55.0	176.3
2011	0.0	6.0	176.0	60.4	163.2
2012	0.0	5.1	179.0	62.9	157.7
2013	0.0	5.3	174.1	62.6	156.0
2014	0.0	5.6	172.4	65.4	152.4
2015	0.0	6.9	173.0	68.4	152.3
2016	0.0	10.9	169.8	65.0	150.1
2017	0.0	12.6	166.9	74.5	150.0
2018	0.0	12.9	157.7	73.3	142.0
2019	0.0	9.3	158.9	75.2	139.0
2020	12.7	13.1	151.6	72.1	137.5
2021	22.8	19.8	154.9	79.0	133.2
2022	33.9	19.3	147.1	84.4	130.4
	Male
2000	0.0	12.0	282.0	50.1	393.8
2001	0.0	11.9	286.0	53.5	393.2
2002	0.0	9.4	273.5	46.7	368.7
2003	0.0	10.1	272.1	49.3	357.3
2004	0.0	11.3	274.0	49.2	343.3
2005	0.0	11.1	273.7	51.0	323.8
2006	0.0	11.3	259.4	54.7	309.3
2007	0.0	10.8	268.5	56.1	304.2
2008	0.0	9.3	260.9	57.4	296.6
2009	0.0	10.3	254.4	57.1	272.6
2010	0.0	11.7	245.4	57.9	257.9
2011	0.0	12.3	239.8	61.7	237.3
2012	0.0	12.1	235.7	61.1	228.1
2013	0.0	13.5	238.6	65.3	224.6
2014	0.0	14.6	241.0	65.7	213.9
2015	0.0	20.6	227.5	70.1	217.8
2016	0.0	36.4	225.5	70.9	219.7
2017	0.0	52.5	227.2	75.4	220.4
2018	0.0	50.5	218.3	73.7	208.1
2019	0.0	30.0	215.1	76.2	197.4
2020	20.4	56.6	213.8	76.8	202.6
2021	39.3	69.1	204.6	83.8	202.2
2022	58.3	70.3	195.5	91.8	204.6
Source: British Columbia Vital Statistics Agency Death Registry, 2000 to 2022.



Table 2 shows the contributions of COVID-19, unregulated drug toxicity, and other causes of death to the differences in LE₀ between each year from 2020 to 2022 and the pre-pandemic reference in 2019. COVID-19 was the leading cause of death driving the LE₀ decline in females. Among females, COVID-19-related deaths in 2020 contributed -0.24 years to LE₀ loss, and the contribution increased in 2021 (-0.46 years) and further in 2022 (-0.65 years). COVID-19 deaths caused almost the same LE₀ loss in males in 2020 (-0.25 years), but greater contributions to male LE₀ loss in 2021 (-0.57 years) and 2022 (-0.75 years). However, unregulated drug toxicity was the leading cause of death for the LE₀ loss in males from 2020 to 2022. Deaths from unregulated drug toxicity contributed to the male LE₀ decline by 0.67 years in 2020, 0.94 years in 2021, and 0.96 years in 2022. Among females, contributions from unregulated drug toxicity deaths were half of those from COVID-19. Sensitivity analysis after removing all suspected unregulated drug toxicity deaths under BCCS investigations showed smaller but still significant contributions, especially in males. The comparisons to 2014 showed similar differences (data not shown).



The contributions from COVID-19 and unregulated drug toxicity deaths were unevenly distributed across different age groups (Chart 3). In 2021, unregulated drug toxicity deaths among men aged between 20 and 59 years contributed -0.81 years to the LE₀ decline from 2019, accounting for 86% of the total loss (-0.94 years) from this cause among males. This proportion was higher for women in the same age group (90%). During the same period, COVID-19-related deaths among both men and women aged 60 years and older accounted for 74% of the total loss.

Description of Chart 3



Data table for Chart 3
Table summary
This table displays the results of Data table for Chart 3 Female, COVID-19, Unregulated drugs and Other causes unrelated to COVID-19 or unregulated drugs, calculated using contribution (years) units of measure (appearing as column headers).

	Female
	COVID-19	Unregulated drugs	Other causes unrelated to COVID-19 or unregulated drugs
	contribution (years)
Younger than 20	0.00	-0.04	-0.10
20 to 29	0.00	-0.09	0.02
30 to 39	-0.01	-0.07	0.01
40 to 49	-0.02	-0.05	0.04
50 to 59	-0.03	-0.06	0.04
60 to 69	-0.06	-0.02	-0.02
70 to 79	-0.10	0.00	0.08
80 to 89	-0.19	0.00	0.13
90 and older	-0.23	0.00	0.19
	Male
Younger than 20	-0.01	-0.04	-0.03
20 to 29	-0.01	-0.13	0.06
30 to 39	-0.01	-0.21	-0.02
40 to 49	-0.02	-0.26	-0.02
50 to 59	-0.05	-0.22	0.02
60 to 69	-0.10	-0.09	-0.07
70 to 79	-0.16	-0.01	-0.01
80 to 89	-0.22	0.00	0.11
90 and older	-0.17	0.00	0.04
Source: BC Vital Statistics Agency Death Registry, 2019 to 2022.

Increased mortality rates for neurological conditions and other causes had negative contributions (i.e., reducing LE₀) in both sexes. Despite the overall LE₀ decline in both sexes, decreases in mortality rates from some other causes resulted in positive contributions (i.e., increasing LE₀). These include respiratory infections excluding COVID-19 (ranging from 0.1 to 0.2 years in females and ranging from 0.02 to 0.11 years in males from 2020 to 2022), malignant neoplasms (ranging from 0.15 to 0.23 years in females and from 0.05 to 0.32 years in males from 2020 to 2022), and diabetes (ranging from 0.03 to 0.11 years in females and from 0.11 to 0.17 years in males from 2021 to 2022). Cardiovascular disease mortality increased in males (therefore reducing LE₀) but decreased in females (therefore increasing LE₀). Injury mortality rates also decreased, resulting in positive contributions in males (ranging from 0.10 to 0.42 years from 2020 to 2022).

Discussion

The present study found that LE₀ for both females and males declined during the pandemic. From 2019 to 2021, LE₀ for males declined by 1.81 years, a loss equal to almost 9 years of LE₀ gains, based on the average 0.2 years LE₀ increase per year over the past five decades.^Note 18 The loss in females was smaller (equal to four years of gains in the past). This reflected a worldwide trend, although the extent of the decline varied geographically. Globally, LE₀ for both sexes has been increasing since 1950, but the trends reversed starting in 2020, with a total decline of 1.6 years from 2019 to 2021 (-0.9 years in 2020 and -0.7 years in 2021). LE₀ declined in 84% of countries worldwide, with declines ranging from 0.3 years to 3.7 years.^Note 11, ^Note 19 Despite the decline in 2020 and 2021, LE₀ started to recover in British Columbia in 2022. This trend was found in two other provinces (Saskatchewan and Alberta) but not in the rest of the provinces and territories in Canada.^Note 20 A similar recovery was seen in other countries, such as the United States and the United Kingdom.^Note 10, ^Note 21 However, LE₀ has not returned to the pre-pandemic level in those areas.

The declines in the present study and those reported elsewhere were due to the excess all-cause mortality during the pandemic.^Note 4, ^Note 22 Globally, COVID-19 was the largest contributor directly driving the excess mortality and LE₀ decline.^Note 11 However, the pandemic also had indirect impacts on mortality because of non-COVID-19 causes, although these indirect impacts varied both geographically and with different waves of the pandemic. COVID-19 and unregulated drug toxicity deaths were the top two contributors to the LE₀ decline in British Columbia, with their contributions differing between males and females. More specifically, COVID-19 was the number one cause of death for the LE₀ decline among females, but unregulated drug toxicity was the number one contributor to the LE₀ decline among males in British Columbia. The province declared a public health emergency because of the opioid toxicity crisis in April 2016. Previous analysis showed that LE₀ in British Columbia started to level off in 2015 and then declined for the first time in 2016 after three decades of continuous increases, partially because of the opioid toxicity crisis.^Note 23 The province’s response measures led to stabilized or even decreased unregulated drug toxicity mortality rates starting in 2018 and continuing in 2019. However, the pandemic accelerated the number of unregulated drug toxicity-related deaths in British Columbia and other jurisdictions,^Note 14, ^Note 15 especially among males.15 This increase was the largest contributor (-0.93 years) to the male LE₀ decline from 2019 to 2021 in British Columbia. Early evidence also suggested that alcohol sales, as well as emergency department visits for mental health problems, increased during the pandemic compared with the pre-pandemic period.^Note 24, ^Note 25, ^Note 26 These findings underscore the importance of undisrupted access to harm reduction services, drug addiction treatments, mental health supports, and other risk reduction strategies.

Studies have reported different impacts of the pandemic on other cause-specific excess mortality rates.^Note 27, ^Note 4 Pandemic response measures including physical distancing, hand hygiene, masking requirements, and vaccination substantially reduced the death rate for respiratory infections.19 There is early evidence on excess mortality because of other causes during the pandemic, including heart disease, Alzheimer’s disease and dementia, and diabetes in Ontario,^Note 28 China,^Note 29 the United States,^Note 30 and European countries,^Note 31 and these non-COVID-19 excess deaths contributed to the LE₀ decline as well. The increased mortality rate for neurological conditions in British Columbia was aligned with the findings in other studies, which found increased mortality risk for parkinsonism, dementia, encephalopathy, and stroke during the pandemic.^Note 32, ^Note 33 The mechanisms for the increased mortality risk for neurological conditions are not fully understood, but aging, cognitive decline, comorbidities, and immune status may play a role.^Note 33 This study found reduced mortality rates for malignant neoplasms, diabetes, and injuries in both males and females, and cardiovascular diseases among females only. The decreased mortality for injuries might be attributable to less outdoor and indoor physical activities and transportation, as well as delayed death cause investigations by the coroner’s service during the pandemic. The investigation delay also partially contributed to the increased mortality in the “other causes” category.

Disproportionate impacts of COVID-19 and unregulated drug toxicity deaths have been reported by sex, race, Indigenous identity, and income. This study showed a larger impact among males than females (and therefore larger LE₀ decline in males and greater LE₀ gap between males and females) in British Columbia, which was also seen in other countries and regions.^Note 6, ^Note 10 Males were more likely to develop severe COVID-19 and die from the disease than females.^Note 34 The sex differences may result from sex-related biological factors, such as immune responses and comorbidities, as well as social and behavioural factors such as smoking.^Note 34 The evidence highlights the need to conduct sex- and gender-based analysis and to develop sex- and gender-based COVID-19 clinical and public health intervention strategies. Collaborative work with the First Nations Health Authority in British Columbia also found that First Nations people (-5.8 years) suffered a larger LE₀ decline than other residents (-1.1 years) in the province.^Note 35 This was attributed to higher mortality rates for both COVID-19^Note 36 and unregulated drug toxicity among First Nations people compared with other BC residents.^Note 37 Similarly, American Indian or Alaska Native people had a greater LE₀ decline than other people in the United States.23 COVID-19 disproportionately impacted certain racialized groups, e.g., the Hispanic population and non-Hispanic Black population in the United States, leading to higher excess all-cause deaths and therefore greater LE₀ declines in those populations.^Note 38 Those living in lower-income neighbourhoods were more heavily hit by the pandemic.^Note 9, ^Note 39 Patients with cancer, cystic fibrosis, organ transplants, chronic renal disease, and severe developmental disabilities were more likely to experience severe COVID-19 outcomes, including hospitalization and death.^Note 40, ^Note 41 Many factors, such as systemic racism (e.g., residential segregation), occupational risk (i.e., less likely to work from home or had to work in jobs that required contact with the public), and housing conditions, played a role in generating the disparities.^Note 42, ^Note 43, ^Note 44

The reversing trends in LE₀ after decades of continuous improvements reflect the significant impacts of public health emergencies, such as the unregulated drug toxicity crisis and the COVID-19 pandemic. These results, along with similar findings from other studies described above, have two public health implications. First, public health emergency response measures should consider unintended consequences that may be directly and indirectly associated with the emergency. The pandemic not only had immediate direct impacts on physical and mental health, but also broader societal consequences on aspects such as income, access to medical and social services, employment, and education, which determine the health of a population down the road. It is also important to remember that vulnerable populations, including racialized groups, socioeconomically disadvantaged people, and people with disabilities were disproportionately impacted, indicating a requirement to prioritize and target interventions for these groups. In British Columbia, clinically extremely vulnerable patients, Indigenous people who were 55 years of age and older, other people who were 65 years and older, and residents of long-term care and assisted living facilities were prioritized for COVID-19 vaccines and treatment.  

This study examined the impacts of dual public health emergencies in British Columbia (i.e., COVID-19 and unregulated drug toxicity crisis), but other Canadian provinces, such as Ontario, and other countries, such as the United States, were experiencing a similar situation (i.e., worsening illicit drug overdoses during the pandemic). Using BCCS data as the source for identifying unregulated drug toxicity-related deaths may overestimate the number of such deaths for the last five years since they include both confirmed and suspected cases, but the issue was mitigated by the sensitivity analysis, which still showed substantial impacts of the deaths on the LE₀ changes. The “Other causes” category includes other inconclusive or pending cause of death investigations by BCCS and deaths coded as R99 (accounting for 4.4% of all death records during the last three years in British Columbia as of September 16, 2024). Often these will eventually resolve to injury-related deaths, including unregulated drug toxicity deaths. In addition, the underlying cause for many deaths may have been misclassified.^Note 45

Description of Appendix Chart 1



Data table for Appendix Chart 1
Table summary
This table displays the results of Data table for Appendix Chart 1 Female, Male and Total, calculated using rate (per 100,000) units of measure (appearing as column headers).

	Female	Male	Total
	rate (per 100,000)
2000	725	1,069	867
2001	715	1,077	864
2002	720	1,034	853
2003	709	1,013	839
2004	703	1,003	833
2005	680	994	815
2006	674	966	801
2007	661	960	792
2008	662	946	786
2009	628	899	747
2010	607	864	719
2011	595	852	709
2012	589	835	698
2013	580	827	692
2014	570	813	681
2015	578	818	687
2016	576	832	693
2017	579	856	707
2018	561	827	686
2019	554	791	665
2020	552	851	692
2021	582	883	724
2022	573	878	716
Source: British Columbia Vital Statistics Agency Death Registry, 2000 to 2022.