Global life expectancy rises, but not all is healthy
An international study has found that life expectancy worldwide has jumped by more than 6 years since 1990. The comprehensive survey of data from 188 countries found that while people are living longer, even in some of the poorest countries, how healthy our extended lives will be remains a challenge.
The Global Burden of Disease Study 2013 was led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in partnership with researchers in various countries. The findings show that life expectancy at birth has risen by 6.2 years for both sexes, up from 65.3 in 1990 to 71.5 in 2013.
Healthy life expectancy at birth rose by 5.4 years, from 56.9 in 1990 to 62.3 in 2013.
Leading the way in terms of healthy life expectancy are Japan, Singapore, Andorra, Iceland, Cyprus, Israel, France, Italy, South Korea and Canada. At the other end of the spectrum are Lesotho, Swaziland, Central African Republic, Guinea-Bissau, Zimbabwe, Mozambique, Afghanistan, Chad, South Sudan and Zambia, which has the lowest healthy life expectancy.
In order to calculate healthy life expectancy, the study factored in the impact nonfatal illnesses can have on quality of life. Since the increase in healthy life expectancy has not been as great as overall life expectancy, the conclusion is that while people are living longer, they are also living with illness and disability.
The major causes of health loss include ischemic heart disease, lower respiratory infections, stroke, low back and neck pain, and road injuries. These vary according to gender with road injuries, for example, affecting mainly men, while depression-related disorders are more common among women.
The HIV epidemic makes for an interesting case study. Although the number of infections increased by 341.5% between 1990 and 2013, focus on the disease and access to treatment have resulted in a decreased health loss of 23.9%.
On a positive note, in countries such as Nicaragua and Cambodia people can expect 14.7 and 13.9 more healthy years of life respectively, compared to 1990. Another success story comes from Ethiopia, which has added 13.5 years to the average 40.8 years of healthy life expectancy in the same period.
"The world has made great progress in health, but now the challenge is to invest in finding more effective ways of preventing or treating the major causes of illness and disability," said the study's lead author, Professor Theo Vos of IHME.
Countries that did not experience the upward trend include Botswana, Belize, and Syria, where healthy life expectancy in 2013 was not much higher than in 1990. In Lesotho and Swaziland, healthy life expectancy for people born in 2013 is actually 10 years shorter than for people born two decades ago. In Botswana and Belize, the drop is 2 years and 1.3 years, respectively. A fall in healthy life expectancy was also identified in South Africa, Paraguay, and Belarus.
The study also highlights regional variations. Neighboring countries can have significantly different healthy life expectations as is the case with Laos, where people born in 2013 have healthy life expectancies 58.1 years, while people born in Thailand or Vietnam could make it to 67 in good health.
Not surprisingly, differences in socio-demographic conditions such as income, population age and education play a significant role in health loss, accounting for more than half of the differences across countries and over time for maternal and neonatal diseases. But when it comes to health loss caused by illnesses such as diabetes and cardiovascular diseases, socio-demographic status is not so relevant.
The study was published in The Lancet on August 27.