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Life expectancy rising alongside illness and disability

Global life expectancy rises 6.2 years since 1990

Adrian O'Dowd

Friday, 28 August 2015

People are living 6.2 years longer, on average, across the world since 1990, but there has also been a rise in illness and disability, concludes a new study* published in The Lancet.

Researchers found that globally, people were living longer, even in some of the poorest countries, but a complex mix of fatal and non-fatal ailments were causing a large amount of health loss.

The study – an analysis of all major diseases and injuries in 188 countries – was conducted by an international consortium of researchers working on the Global Burden of Disease study and led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

They found that global life expectancy at birth for both sexes rose by 6.2 years (from 65.3 in 1990 to 71.5 in 2013), while healthy life expectancy (HALE) at birth rose by 5.4 years (from 56.9 in 1990 to 62.3 in 2013).

Health had improved significantly over the period studied thanks to marked declines in death and illness caused by HIV/AIDS and malaria in the past decade and significant advances made in addressing communicable, maternal, neonatal, and nutritional disorders.

In this study, healthy life expectancy takes into account not just mortality but also the impact of non-fatal conditions and summarises years lived with disability and years lost due to premature mortality.

The increase in healthy life expectancy was not as dramatic as the growth of life expectancy, and as a result, people were living more years with illness and disability.

The top 10 countries for highest healthy life expectancy for men and women were (in order) Japan, Singapore, Andorra, Iceland, Cyprus, Israel, France, Italy, South Korea, and Canada.

The countries with the lowest healthy life expectancy were Lesotho, Swaziland, Central African Republic, Guinea-Bissau, Zimbabwe, Mozambique, Afghanistan, Chad, South Sudan, and Zambia.

For most countries, changes in healthy life expectancy for males and females between 1990 and 2013 were significant and positive, but in dozens of countries including Botswana, Belize, and Syria healthy life expectancy in 2013 was not significantly higher than in 1990.

In some of those countries, including South Africa, Paraguay, and Belarus, healthy life expectancy had actually dropped since 1990.

The differences between countries with the highest and lowest healthy life expectancies was stark.

In 2013, Lesotho had the lowest, at 42 years, and Japan had the highest globally, at 73.4 years.

The leading global causes of health loss, as measured by DALYs (disability-adjusted life years), in 2013, were ischaemic heart disease, lower respiratory infections, stroke, low back and neck pain, and road injuries.

Professor Theo Vos of IHME, the study’s lead author, said: “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.”

IHME director Dr Christopher Murray said: “Looking at healthy life expectancy and health loss at the country level can help guide policies to ensure that people everywhere can have long and healthy lives no matter where they live.”

* GBD 2013 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. The Lancet, August 2016. DOI: 10.1016/S0140-6736(15)61340-X

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