WHO data reveals growing global inequities between life expectancy and years in good health

Although research shows that people are living longer, a study on 183 WHO member countries reveals a widening gap between lifespan and healthspan — the number of years lived in good health. The data also shows a 25% gender disparity worldwide, with women experiencing a more significant gap than men.

In 2019, the average global gap between lifespan and healthspan was 9.6 years, a 13% increase since 2000. The US recorded the world’s most considerable divide, with people living an average of 12.4 years with disability or illness, according to the researchers from the Mayo Clinic in Minnesota, US. 

“The data show that gains in longevity are not matched with equivalent advances in healthy longevity. Growing older often means more years of life burdened with disease,” says senior author Dr. Andre Terzic, director of the Marriott Heart Disease Research program at the Mayo Clinic. 

“This research has important practice and policy implications by bringing attention to a growing threat to the quality of longevity and the need to close the healthspan-lifespan gap.”

The authors note that this growing gap implicates a disease paradox, where “reduced acute mortality exposes survivors to an increased burden of chronic disease.” 

Longevity challenge

The researchers used statistics from the WHO Global Health Observatory for the study published in JAMA Network Open. This resource provides data on life expectancy, health-adjusted life expectancy, years lived with disease and years lost among 183 member states. 

They calculated a healthspan-lifespan gap for each country by subtracting health-adjusted life expectancy from life expectancy. 

From 2000 to 2019, average life expectancy increased by 6.5 years, but healthspan grew at a slower rate of 5.4 years in the same period, leading to an average gap of 9.6 years. 

“The widening healthspan-lifespan gap globally points to the need for an accelerated pivot to proactive wellness-centric care systems,” says Armin Garmany, first author and an M.D. and Ph.D. student in Mayo Clinic Alix School of Medicine and Graduate School of Biomedical Sciences. 

“Identifying contributors to the gap unique to each geography can help inform healthcare interventions specific to each country and region.”

The researchers note that proactive wellness-centric care systems are crucial to close the widening healthspan-lifespan gap.In a recent interview with Nutrition Insight, Aquil Harjivan, head of front-end innovation at Bayer Consumer Health, underscored the importance of improving people’s healthspan instead of their lifespan through personalized nutrition.

An increasingly older population is also driving nutrition and supplement innovations for healthy and active aging, looking to improve physical, cognitive function and overall well-being. 

Global differences

The smallest gaps were observed in Lesotho (6.5 years), the Central African Republic (6.7 years), Somalia (6.8 years), Kiribati (6.8 years) and Micronesia (7 years). 

According to the research authors, the US recorded a 29% higher gap than the global average. The country also reported the highest burden of chronic disease. Mental health, substance-use disorders and musculoskeletal disease contributed the most to years lived with a disability in the US. 

According to WHO estimates, life expectancy in the US grew from 79.2 to 80.7 years for women and from 74.1 to 76.3 years for men. However, the healthspan did not increase for women and only grew by 0.6 years for men. 

Next to the US, the most significant gaps were found in Australia (12.1 years), New Zealand (11.8 years), UK (11.3 years) and Norway (11.2 years). 

Women experienced a larger gap, partly due to their higher life expectancy and a distinctly higher non-communicable disease burden.Gender disparity

Across the globe, women experienced an average 2.4-year larger gap between lifespan and healthspan than men. The researchers note that this disparity was partly underpinned by women’s higher life expectancy and a “distinctly higher non-communicable disease burden.” 

The researchers say they observed the most significant gender gaps in Germany (3.6 years), Spain (3.4 years), France (3.3 years), Portugal (3.2 years) and Libanon (3.2 years). 

Meanwhile, the authors observed the smallest inequalities among men and women in Brunei Darussalam, Timor-Leste, Albania, Afghanistan and Burundi, all between 1.0 and 1.4 years. 

In the US, neurological, musculoskeletal, urinary and genital tract disorders contributed the most to extended years of poor health among women. 

The researchers recommend additional research exploring demographic, health and economic characteristics by geography to better define how disease patterns shape lifespan-healthspan disparities.