New research has found that the gap between lifespan and “healthspan” – the years of life lived in good health – in the USA is the widest in the world. Using data from the World Health Organization (WHO), the study authors found that the average American will live 12.4 years with disability and/or illness, up from 10.9 years in 2000.
Globally, we’re living longer than ever before in human history. The drive towards extending life has become an obsession for some, who turn to any number of bizarre medical interventions to try and slow the hands of time. But we don’t always consider what those extra years of life will actually look like.
“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,” said Dr Andre Terzic, senior author of the new study, in a statement.
“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.”
Terzic and first author Armin Garmany examined data for 183 WHO member states, covering life expectancy and health-adjusted life expectancy and comparing results for men and women. The findings cover an almost two-decade period, from 2000 to 2019.
Globally, they found that lifespan increased from 79.2 years to 80.7 years for women, and from 74.1 years to 76.3 years for men. The greatest lifespan increases were seen in the African nations of Rwanda, Malawi, Burundi, Ethiopia, and Zambia.
However, the same level of increase was not seen in healthspan. This resulted in an average gap of 9.6 years between lifespan and healthspan, an increase of 13 percent since 2000.
On a country-by-country basis, the US comes out on top for the gap between lifespan and healthspan – 29 percent higher than the global mean. The US also reported the most chronic disease among the population, with significant factors including mental health issues, substance abuse disorders, and musculoskeletal conditions.
What this boils down to is that, on average, Americans spend more of their lives in poor health than their counterparts in other countries. Australia was next on the list, and was not far behind, with a lifespan-healthspan gap of 12.1 years. Next were New Zealand and then the UK, at 11.8 and 11.3 years respectively.
The results may not come as a complete surprise to anyone who read the recent report from the Commonwealth Fund, which concluded that the US had the worst healthcare system among 10 wealthy nations. The lack of universal access to care was highlighted in the report as a major contributor to this, with tens of millions of Americans currently uninsured.
Other countries will have their own unique factors at play, and it’s important for future planning to dig deeper into these. “Identifying contributors to the gap unique to each geography can help inform healthcare interventions specific to each country and region,” said Garmany.
As well as these differences between nations, the data showed a global disparity between men and women, with women experiencing a 2.4-year greater gap between lifespan and healthspan than men. Big contributors were neurological disorders, musculoskeletal issues, and problems with the genitourinary tract.
According to the authors, the results point to a “paradox”. People today are more likely to survive the acute illnesses that might have done for their ancestors – such as vaccine-preventable diseases – but this, in turn, means they’re living long enough to develop more chronic diseases.
Crucially, Garmany points out, not enough is being done to combat that: “The widening healthspan-lifespan gap globally points to the need for an accelerated pivot to proactive wellness-centric care systems.”
The study is published in JAMA Network Open.
