A new global analysis from the Global Burden of Disease Study 2023 reveals that although people are living longer, they are spending more years with chronic illness and disability. Learn why healthspan is becoming just as important as lifespan.
- Global life expectancy increased by more than nine years between 1990 and 2023, but healthy life expectancy has not kept pace
- People worldwide now spend an average of more than 10 years living with illness or disability.
- Obesity, high blood sugar, smoking, musculoskeletal disorders, and mental health conditions are among the leading contributors to poor health in later life
Over the past three decades, remarkable advances in medicine, vaccination, sanitation, and healthcare have helped people live longer than ever before. However, a new global analysis suggests that these additional years are increasingly being spent living with illness rather than in good health ().
Researchers analysing data from the Global Burden of Disease (GBD) Study 2023, published in The Lancet Public Health, found that although life expectancy has increased substantially since 1990, healthy life expectancy has not improved at the same pace.
This means that while many people are living longer, they are also spending more years managing chronic diseases, disability, pain, and reduced quality of life.
The findings highlight a growing challenge for healthcare systems worldwide: extending healthspan, not just lifespan.
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What Is the ‘Morbidity Gap’?
Researchers use the term morbidity gap to describe the number of years a person spends living in poor health.
It is calculated by subtracting Healthy Life Expectancy (HALE) from Life Expectancy.
For example, if someone is expected to live until 75 years but remains healthy only until 64 years, they spend approximately 11 years living with illness or disability.
Understanding the Terms
| Term | Meaning |
|---|---|
| Life Expectancy | Average number of years a person is expected to live. |
| Healthy Life Expectancy (HALE) | Years expected to be lived in good health. |
| Morbidity Gap | Years lived with disease, disability, or poor health. |
According to the researchers, this gap has widened in nearly every country over the past three decades.
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The Gap Between Living and Living Well Is Growing
The study showed that both life expectancy and healthy life expectancy have improved globally. However, healthy years have increased much more slowly than total lifespan.
Global Trends
| Year | Life Expectancy | Healthy Life Expectancy (HALE) | Years Lived in Poor Health |
|---|---|---|---|
| 1990 | 64.6 years | 55.9 years | 8.8 years |
| 2023 | 73.8 years | 63.1 years | 10.7 years |
In other words:
- Life expectancy increased by 9.2 years.
- Healthy life expectancy increased by 7.2 years.
- Years spent in poor health increased by nearly 2 years.
Researchers found this pattern in almost every country studied.
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Which Health Problems Keep People Unwell for Longer?
The study found that a relatively small number of conditions account for most years spent in poor health.
Leading Contributors to the Morbidity Gap
| Condition | How It Affects Healthy Aging |
|---|---|
| Musculoskeletal Disorders | Chronic pain, arthritis, and reduced mobility. |
| Mental Disorders | Depression, anxiety, and long-term disability. |
| Hearing and Vision Disorders | Loss of independence and communication. |
| Falls and Other Injuries | Disability and reduced mobility in older adults. |
| Other Chronic Non-Communicable Diseases | Reduced quality of life and long-term illness. |
Together, these conditions accounted for more than half of the years’ people spent living in poor health.
The findings suggest that preventing disability is becoming just as important as preventing premature death.
Which Risk Factors Can Be Changed?
Many of the factors contributing to poor health later in life are preventable or manageable. Researchers identified several leading modifiable risk factors.
Major Risk Factors
| Risk Factor | Potential Impact on Healthspan |
|---|---|
| High Body Mass Index (BMI) | Increases obesity, diabetes, heart disease, and joint problems. |
| High Fasting Blood Glucose | Raises the risk of diabetes and cardiovascular disease. |
| Tobacco Use | Damages nearly every organ and increases multiple chronic diseases. |
| Child and Maternal Malnutrition | Affects lifelong health and development. |
| Air Pollution | Contributes to heart and lung disease, especially in lower-income countries. |
The importance of these risk factors varied across regions. In higher-income countries, obesity, smoking, and diabetes contributed more strongly to years lived with poor health, while malnutrition and air pollution remained major concerns in lower-income settings.
Women Live Longer, but Spend More Years in Poor Health
One of the study’s most notable findings was the difference between men and women. Women consistently lived longer than men but also spent more years living with illness or disability.
Years Lived in Poor Health
| Sex | 1990 | 2023 |
|---|---|---|
| Women | 10.0 years | 12.1 years |
| Men | 7.6 years | 9.3 years |
Researchers believe this reflects a combination of factors, including women’s longer life expectancy and the greater burden of chronic disabling conditions such as arthritis and osteoporosis.
Why Healthy Aging Matters More Than Ever
As populations age, healthcare systems face a growing challenge. Living longer is undoubtedly a public health success, but those additional years should ideally be lived independently and with a good quality of life.
Healthy aging involves more than avoiding disease. It also includes:
- maintaining physical strength
- preserving memory and cognitive function
- staying socially connected
- remaining independent
- enjoying emotional wellbeing
Improving healthspan benefits not only individuals but also families, healthcare systems, and society.
How Can You Protect Your Healthspan?
Although aging cannot be prevented, many chronic diseases that reduce quality of life can be delayed.
Healthy Habits That Support Healthy Aging
| Healthy Habit | Potential Benefit |
|---|---|
| Exercise Regularly | Maintains muscle strength, balance, and heart health. |
| Eat a Balanced Diet | Reduces the risk of obesity, diabetes, and heart disease. |
| Maintain a Healthy Weight | Lowers the risk of several chronic illnesses. |
| Quit Smoking | Reduces cardiovascular disease, cancer, and lung disease. |
| Control Blood Pressure, Cholesterol, and Blood Sugar | Helps prevent long-term complications. |
| Sleep Well | Supports brain function and immune health. |
| Stay Socially Active | Promotes mental wellbeing and cognitive health. |
| Attend Regular Health Check-Ups | Enables early detection and treatment of disease. |
Small lifestyle changes adopted earlier in life can significantly improve health during older age.
What This Global Study Means
The findings suggest that the world’s biggest health challenge has shifted. Instead of focusing only on helping people live longer, healthcare systems must also ensure those additional years are lived in good health.
The researchers conclude that progress should increasingly be measured by improvements in healthspan rather than lifespan alone. Reducing chronic disease, preventing disability, promoting healthy lifestyles, and improving access to preventive healthcare will be essential if future generations are to enjoy not just longer lives, but healthier ones.
Reference:
- Global, regional, and national trends in the morbidity gap and contributing diseases, injuries, and risk factors, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023 – (https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00098-8/fulltext)
Source-Medindia