A new study reveals people worldwide are living longer, but spending more years in poor health. The global "morbidity gap," the difference between total life expectancy and healthy life expectancy, increased by 1.9 years between 1990 and 2023. This means people now spend an average of 10.7 years living with illness or disability, up from 8.8 years in 1990.The research, published in The Lancet Public Health journal, found this gap widened in nearly all 204 countries and territories analyzed.[news-medical+3]
Healthspan Lags Lifespan Gains
Researchers from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington led the study. They based their findings on the Global Burden of Disease (GBD) 2023 estimates.Globally, people spent an average of 14.5% of their lives in poor health in 2023, an increase from 13.6% in 1990.This trend shows that while medical advances help people live longer, these extended years are not always healthy ones.[health+4]
The study found total life expectancy at birth increased from 64.6 years in 1990 to 73.8 years in 2023. Over the same period, healthy life expectancy only rose from 55.9 years to 63.1 years.This means gains in survival have consistently outpaced gains in healthy years of life.The widening morbidity gap is not just affecting the elderly; it is observed across the entire adult lifespan. This suggests people are living with more disease and disability throughout their adult years.[news-medical+6]
Christopher Murray, director of the IHME and senior author of the study, emphasized the need for a new focus. "Our findings suggest that future gains in population health will come not only from helping people live longer, but from helping them live healthier," Murray said.He added, "Progress in healthy aging should be measured not only by lifespan, but by healthspan, with greater investment in prevention, long-term disease management, and chronic care to reduce years lived in poor health."[health+5]
Women Face Larger Health Gaps
The study highlighted significant differences between men and women. Women consistently live longer than men in almost every region globally.However, they also experience a larger morbidity gap.In 2023, women globally had an average morbidity gap of 12.1 years, compared to 9.3 years for men.This means women spend more years living with disease and disability despite their longer lifespans.[health+10]
Catherine Bisignano, a senior scientific writer at IHME and co-author, commented on this finding. "Women are living longer than men almost everywhere in the world, but they are also spending more of those additional years in poor health," Bisignano said.She noted that improving healthy aging requires more attention to the conditions and risk factors that lead to years lived with disability.[health+5]
In India, for example, the morbidity gap for women increased from 9.4 years in 1990 to 12 years in 2023. For men in India, the gap grew from 7.5 years to 9.1 years over the same period.[health]
Leading Causes of Poor Health
The research identified the main conditions contributing to these years spent in poor health. Musculoskeletal disorders were the largest contributor to the morbidity gap for both sexes worldwide. Low back pain was a particularly significant factor.Mental disorders, such as depression and anxiety, also played a major role.Other key contributors included sense organ diseases, like age-related hearing loss, and falls and other unintentional injuries.These largely non-fatal chronic conditions accounted for 57.4% of unhealthy years in 2023.[health+16]
Many years spent in poor health are linked to preventable or manageable risk factors. Globally, high fasting plasma glucose (blood sugar) and high body mass index (BMI) were the leading risk factors contributing to the morbidity gap.In lower-income countries, child and maternal malnutrition, along with air pollution, were also significant risk factors.[health+6]
Wealthier Nations Face Wider Gaps
The burden of poor health varied across countries and regions. High-income countries generally experienced the widest morbidity gaps.This reflects a pattern where gains in lifespan have not been matched by similar gains in healthspan.[news-medical+3]
The United States recorded the largest national morbidity gap, with Americans spending an average of 14 years in poor health.Australia followed with a 13.9-year gap, and Canada with 13.7 years.Sub-Saharan Africa, in contrast, had the smallest morbidity gap at 9.0 years.[news-medical+6]
The COVID-19 pandemic caused temporary disruptions in global life expectancy and healthy life expectancy. However, it did not reverse the broader trend of a widening morbidity gap.[news-medical+1]
Focus on Prevention and Chronic Care
The findings suggest that future health strategies must prioritize not just extending life, but also improving its quality. Bisignano emphasized the importance of early intervention. "Addressing these earlier through prevention and better long-term care could have meaningful social, health system, and economic impacts," she stated.[health+1]
Experts recommend greater investment in prevention, long-term disease management, and chronic care. This approach could help reduce the years people live in poor health.
