People around the world are living longer than ever before, but are spending many of those extra years in poor health, according to a new Global Burden of Disease (GBD) study published today. lancet public health. The researchers found that global incidence disparities widened in nearly every country and region analyzed between 1990 and 2023. Globally, the proportion of lifetimes spent in poor health increased, but trends varied by country, with a decline in this proportion in a minority of countries.
Within one generation, the global incidence gap widened by nearly two years, increasing from 8.8 years in 1990 to 10.7 years in 2023. Globally, people will spend an average of 14.5% of their lives in poor health by 2023, up from 13.6% in 1990. We observed that disparities in morbidity do not occur only late in life, but widen over the adult lifespan. This suggests that people are spending more years with illness or disability throughout their adult lives.
The analysis examined trends in healthy aging from 1990 to 2023, based on GBD 2023 estimates, and assessed changes in life expectancy, healthy life expectancy, and morbidity rates across countries, regions, genders, and socio-demographic development levels, as well as identifying the main conditions and risk factors that contribute to living in poor health.
Living a long life does not necessarily lead to a healthy life.
Between 1990 and 2023, global life expectancy at birth increased from 64.6 years to 73.8 years, and healthy life expectancy increased from 55.9 years to 63.1 years. Because increases in survival continue to outpace increases in healthy life expectancy, people are living an increasing number of years with chronic disease and disability. Although the COVID-19 pandemic temporarily disrupted life expectancy and healthy life expectancy, it did not reverse the broader trend of widening inequality in morbidity.
Our findings suggest that future improvements in population health will come from helping people not only live longer, but also healthier. Healthy aging is measured not only by lifespan but also by healthspan, and requires increased investment in prevention, long-term disease management, and chronic care to reduce the number of years spent in poor health. ”
Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME), University of Washington School of Medicine, and senior author of this study
High-income countries face the greatest incidence disparities.
The burden of poor health varies widely across countries and regions, and generally the longest periods of poor health occur where people live the longest. As of 2023, the United States had the largest difference in incidence rates at 14 years, followed by Australia at 13.9 years and Canada at 13.7 years. Countries with higher socio-demographic index (SDI) levels generally have longer life expectancies and spend more years in poor health. This reflects an increase in lifespan that is not comparable to an equivalent increase in healthy lifespan.
This pattern was consistent around the world. In all seven GBD superregions, both the number of years and the proportion of lifetimes spent in poor health increased between 1990 and 2023. The difference in incidence rates in 2023 was largest in high-income superregions at 12.7 years, and smallest in sub-Saharan Africa at 9.0 years.
Although women are living longer, they are also spending more years in poor health.
Across all regions and levels of development, women consistently lived longer than men, but also spent more years in poor health. This pattern shows that even though women’s life expectancy increases, it does not translate into the same life expectancy at a healthy age.
In 2023, the average incidence difference for women was 12.1 years, compared to 9.3 years for men. Women also have larger differences in prevalence than men across all SDI quintiles, indicating that while women consistently live longer, they also spend more years with illness and disability at different levels of socio-economic development.
“Women live longer than men almost everywhere in the world, but they spend many of those extra years in poor health,” said Katherine Bisignano, senior science writer at IHME and co-author of the study. “Improving healthy aging requires greater focus on the symptoms and risk factors that cause people to live with disabilities for many years. Addressing these early through prevention and better long-term care can have a meaningful impact on society, health systems, and the economy.”
Healthy aging requires an increased focus on prevention and chronic care.
More than half of the years of poor health worldwide are caused by a relatively small number of mainly non-fatal chronic diseases, which will account for 57.4% of the years of poor health in 2023. Musculoskeletal disorders, particularly low back pain, were the largest contributor to the prevalence gap, followed by psychiatric disorders such as depression and anxiety, age-related hearing loss, sensory disorders such as falls and other unintentional injuries, and other chronic non-communicable conditions. disease.
Living in poor health for many years is associated with preventable or manageable risk factors. Globally, high fasting plasma glucose levels, high body mass index, child and maternal malnutrition, and smoking are the main risk factors contributing to the morbidity gap. These patterns vary widely by region and level of development. In sub-Saharan Africa and other low-SDI settings, child and maternal malnutrition are the main risk factors, with air pollution also ranking in the top five.
As the population ages, greater emphasis must be placed on preventing chronic diseases, slowing the progression of disability, and ensuring access to rehabilitation, mental health services, and long-term chronic care. Addressing key risk factors, investing in prevention, and strengthening services to reduce years spent in poor health are essential to improving healthy aging and reducing the growing burden of disability on people, families, and health systems around the world.
sauce:
Health Index Evaluation Institute
Reference magazines:
Yes, there is. Others. (2026). Global, regional and national trends in morbidity gaps and contributing diseases, injuries and risk factors, 1990-2023: A systematic analysis for the Global Burden of Disease Study 2023. lancet public health. DOI: 10.1016/s2468-2667(26)00098-8. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00098-8/fulltext
