A global analysis published in The Lancet Public Health shows that while life expectancy has increased worldwide, people are now spending more years in poor health, according to a study released on July 26. Researchers examined changes in the morbidity gap—the difference between life expectancy and healthy life expectancy—between 1990 and 2023 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study.
The study found that global life expectancy rose from 64.6 years in 1990 to 73.8 years in 2023. However, healthy life expectancy (HALE) increased at a slower rate, from 55.9 to 63.1 years over the same period. As a result, the morbidity gap widened from 8.8 to 10.7 years globally.
Researchers said that "life expectancy gains were larger than HALE increases in all countries and territories except one." They also observed temporary disruptions during the COVID-19 pandemic: "in 2021, life expectancy and HALE decreased to 71.9 years and 61.7 years respectively," while "the morbidity gap slightly reduced to 10.3 years" during this time.
According to the study, high-income regions had the largest morbidity gaps—12.7 years on average—while sub-Saharan Africa had the smallest at nine years as of last year. At a country level, "the United States had the largest morbidity gap (14 years) in 2023," while Nauru recorded the smallest at just under seven years.
The researchers identified musculoskeletal disorders, mental disorders, sense organ diseases such as hearing loss, unintentional injuries like falls, and other noncommunicable diseases as accounting for over half of all unhealthy lifespan globally by last year: "The five leading cause groups accounted for 57.4% of the morbidity gap in 2023." Among risk factors contributing most were high body mass index (BMI), elevated fasting plasma glucose (FPG), child and maternal malnutrition, and tobacco use.
Females generally lived longer than males but spent more time with poor health across regions: "the morbidity gap increased from ten years in 1990 to twelve point one years in twenty twenty-three for females," compared with an increase from about eight to nine point three for males over three decades.
Researchers concluded that although longevity improved between nineteen ninety and last year almost everywhere studied—including among both sexes—the additional lifespan was not matched by reductions in unhealthy periods: “these results have important implications for built environment, labor markets, and social protection systems.”
