It’s one of those good news/bad news stories. A study in the medical journal The Lancet found that people around the world — in countries rich, poor and in the middle — are living longer. But here’s the rub. You can’t count on living those extra years in good health.
In the first of what will be an annual look at health along with life span around the world called the Global Burden of Disease Study, researchers found that between 1990 and 2013, life expectancy rose by 6.2 years. The average life span at birth across the globe is now 71.5 years, though rates vary tremendously by region. People live the longest, according to the Lancet study, in Andorra, in southwestern Europe, or an average of 83.9 years. People die the youngest, an average of 48.3 years, in Lesotho, in Africa.
But regardless of socioeconomics, geography or total number of years lived, the study shows what appears to be a universal part of the human condition: people live an average of one-eighth of their lives in a disabled or unhealthy state.
“What’s interesting is that wherever you go around the world, about seven-eighths of life expectancy is healthy,” says Peter Byass, professor of global health at Umea University in Sweden. “I’m not sure we totally understand why.”
“We probably can’t do a lot about decreasing this part of life that’s not healthy,” he adds. “That pretty much appears to be a part of being human.”
Healthy life — the measure researchers used, called HALE, or healthy life expectancy years — ranged from a high of 73.4 years in Japan to a low, again in Lesotho, of 42 years.
Not much is known about when those years of ill health occur. “A lot of the unhealthy stuff is around end of life,” says Byass.
Spending more money on health care doesn’t seem to reduce the proportion of life spent in ill health. The study was based on regional data and showed that in high-income North America, men live an average of 76.64 years, but only 66.17 of those years are healthy; women live an average of 81.62 years, but experience good health in only 68.85 of those years. The United States, which spends more on health care than any other country, is part of that high-income region. “This is seen even in places where there’s a high investment in health care,” says Byass, who wrote a commentary accompanying the Lancet study. “You’re never going to have a disease-free population. Maybe part of it is that medical services can prolong unhealthy lives.”
Countries where people die the youngest have the highest rates of communicable diseases like AIDS, malaria and tuberculosis as well as high rates of maternal and childhood mortality and malnutrition. “If we want to have a healthier global population, more equal health, the world has got to invest in getting rid of those avoidable problems in poorer countries, mainly in Africa,” says Byass.
Then those people in developing nations, given the opportunity to live, on average, an additional 10 or 20 years, would confront the same health declines faced by people in richer countries. “Let’s say Bill Gates waves his magic wand and gets rid of those problems in Africa — which to be fair, he’s trying to do — you’d have a rapid aging of the population,” says Byass. “The consequences of that would be more older people getting strokes and heart disease and cancer. But at least that would be a more equal global scenario.”