Regional differences and the impact of the COVID-19 pandemic on mortality trends in Moldova in 2014-2023

Abstract

Previous studies have demonstrated a statistically significant difference in mortality between the capital, Chisinau, and the leading northern region, compared to the lagging central and southern regions in Moldova. Aim of the study: To examine the evolution of overall and cause-specific mortality by sex and major geographical regions in Moldova from 2014 to 2023, with particular emphasis on the COVID-19 pandemic period. Material and methods: Life tables with 95% confidence intervals were computed by sex and geographical region. Changes in life expectancy were decomposed by cause of death. The analysis was based on a depersonalised database of individual death records and the usual resident population for 2014-2023. Results: Between 2014 and 2023, life expectancy at birth for both sexes increased by 2.4 years, with equal or greater gains observed in the lagging central (2.3 years) and southern (3.2 years) regions compared to the leading northern region (1.6 years) and the capital (2.3 years). The impact of the COVID19 pandemic on life expectancy losses between 2019 and 2021 was most severe in the capital (3.8 years) and northern region (2.7 years), while the lagging regions were much less affected. Post-crisis recovery was more evident in the hardest-hit leading regions, though notable improvements were also observed in other regions. Conclusions: Overall improvements in life expectancy in Moldova after 2014 were significantly disrupted by the COVID-19 pandemic, particularly in the bestperforming regions. Conversely, the lesser impact of the pandemic on the worstperforming regions contributed to more pronounced overall life expectancy gains in those areas.