|
People around the world are living longer, even in
some of the poorest countries, but a complex mix of
fatal and nonfatal ailments cause a tremendous
amount of health loss, according to a new analysis
of all major diseases and injuries in 188 countries.
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, or HALE, at birth
rose by 5.4 years (from 56.9 in 1990 to 62.3 in
2013).
Healthy life expectancy takes into account both
mortality and the impact of non-fatal conditions and
chronic illnesses like heart and lung diseases,
diabetes and serious injuries. Those detract from
quality of life and impose heavy cost and resources
burdens.
Life expectancy (years) and HALE, healthy life
expectancy, at birth for 1990, 2005, and 2013 for
both sexes in Italy:
1990
male population life 73.60
male population HALE 64.47
female population life 80.23
female population HALE 68.12
2005
male population life 78.32
male population HALE 68.32
female population life 83.76
female population HALE 70.95
2013
male population life 79.45
male population HALE 69.11
female population life 84.60
female population HALE 71.36
Healthy life expectancy takes into account not just
mortality but also the impact of nonfatal conditions
and summarizes years lived with disability and years
lost due to premature mortality. The increase in
healthy life expectancy has not been as dramatic as
the growth of life expectancy, and as a result,
people are living more years with illness and
disability.
“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” examines fatal and nonfatal health loss
across countries. Published in The Lancet on August
27, the study 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.
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 has actually
dropped since 1990. People born in Lesotho and
Swaziland in 2013 could expect to live at least 10
fewer years in good health than people born in those
countries two decades earlier. People in countries
such as Nicaragua and Cambodia have experienced
dramatic increases in healthy life expectancy since
1990, 14.7 years and 13.9 years, respectively. The
reverse was true for people in Botswana and Belize,
which saw declines of 2 years and 1.3 years,
respectively.
The differences between countries with the highest
and lowest healthy life expectancies are stark. In
2013, Lesotho had the lowest, at 42 years, and Japan
had the highest globally, at 73.4 years. Even
regionally, there is significant variation.
Cambodians and Laotians born in 2013 would have
healthy life expectancies of only 57.5 years and
58.1 years, respectively, but people born in nearby
Thailand and Vietnam could live nearly 67 years in
good health.
As both life expectancy and healthy life expectancy
increase, changes in rates of health loss become
increasingly crucial. The study’s researchers use
DALYs, or disability-adjusted life years, to compare
the health of different populations and health
conditions across time. One DALY equals one lost
year of healthy life and is measured by the sum of
years of life lost to early death and years lived
with disability. The leading global causes of health
loss, as measured by DALYs, in 2013 were ischemic
heart disease, lower respiratory infections, stroke,
low back and neck pain, and road injuries. These
causes differed by gender: for males, road injuries
were a top-five cause of health loss, but these were
not in the top 10 for females, who lose
substantially more health to depressive disorders
than their male counterparts.
The fastest-growing global cause of health loss
between 1990 and 2013 was HIV/AIDS, which increased
by 341.5%. But this dramatic rise masks progress in
recent years; since 2005, health loss due to
HIV/AIDS has diminished by 23.9% because of global
focus on the disease. Ischemic heart disease,
stroke, low back and neck pain, road injuries, and
COPD have also caused an increasing amount of health
loss since 1990.The impact of other ailments, such
as diarrheal diseases, neonatal preterm birth
complications, and lower respiratory infections, has
significantly declined.
Across countries, patterns of health loss vary
widely. The countries with the highest rates of
DALYs are among the poorest in the world and include
several in sub-Saharan Africa: Lesotho, Swaziland,
Central African Republic, Guinea-Bissau, and
Zimbabwe. Countries with the lowest rates of health
loss include Italy, Spain, Norway, Switzerland, and
Israel.
“Factors including income and education have an
important impact on health but don’t tell the full
story,” said IHME Director Dr. Christopher Murray.
“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.”
Countries with highest healthy life expectancy,
both sexes, 2013:
1. Japan
2. Singapore
3. Andorra
4. Iceland
5. Cyprus
6. Israel
7. France
8. Italy
9. South Korea
10.Canada
Countries with lowest healthy life expectancy,
both sexes, 2013:
1. Lesotho
2. Swaziland
3. Central African Republic
4. Guinea-Bissau
5. Zimbabwe
6. Mozambique
7. Afghanistan
8. Chad
9. South Sudan
10.Zambia
Leading causes of DALYs or health loss globally
for both sexes, 2013:
1. Ischemic heart disease
2. Lower respiratory infection
3. Stroke
4. Low back and neck pain
5. Road injuries
6. Diarrheal diseases
7. Chronic obstructive pulmonary disease
8. Neonatal preterm birth complications
9. HIV/AIDS
10.Malaria
For more information
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
link...
MDN |