Study Finds Longer Life Expectancy Often Means More Years with Poor Health
A recent large-scale study published in Lancet Public Health, led by epidemiologist Professor Simon Hay from the University of Washington, analyzed health expectancy trends from 1990 to 2023 across 204 countries. The research examined how many years older adults are expected to live with significant illnesses that impair quality of life. It found that increased life expectancy does not necessarily translate into more years of healthy living; rather, people are spending more years with chronic conditions such as hearing loss, severe back pain, and mental health disorders.
The study revealed that wealthy countries with high life expectancy, including the United States, Australia, Canada, New Zealand, and the Netherlands, have the highest number of unhealthy years, with the U.S. leading at 14 years. Lebanon was an exception among less affluent countries, with an average life expectancy of 76 years and 12.8 years spent in poor health. When considering the proportion of life spent in poor health, Afghanistan ranked highest at nearly 19%, followed by the U.S. at 18%. Some remote island nations had shorter life expectancies, which resulted in fewer years lived with illness, while the Maldives stood out with 80 years average life expectancy and only 11% of those years in poor health.
Israel ranked 110th globally, with an average life expectancy of 80 years and 14% of those years (11.2 years) lived in poor health. The researchers emphasized that their goal was not to compare countries but to assess global trends. They found that from 1990 to 2023, the proportion of life spent in poor health increased from 13.6% to 14.5%, especially in higher socioeconomic countries. The main contributors to long-term health decline were musculoskeletal pain (notably back pain), depression, anxiety, and sensory impairments like hearing loss. In sub-Saharan Africa, infectious diseases such as malaria and tuberculosis also contributed.
Key risk factors identified included falls and fractures, high blood sugar, obesity, smoking, air pollution, and in poorer countries, maternal and child undernutrition and unsafe sex. The study noted that recent widespread use of new obesity treatments introduced in 2023 could impact major risk factors like diabetes and obesity. The authors also highlighted that advances in cardiovascular disease treatment in the late 20th century initially reduced years lived with illness, but more recently, unhealthy years have increased again. This indicates that longer life does not have to mean more years of poor health, but current trends show otherwise.
