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Conclusions and Practical Recommendations

I. Nowadays such complex indicators as life expectancy and health-adjusted life expectancy go beyond the traditional measures of the demographic potential of a country.
Longevity progressiveness is important for driving economic progress and competitiveness—both for developed and developing economies. Many governments are putting policies on longevity at the center of their growth strategies and budget planning. The definition of longevity has broadened—it is no longer quantitative increase in life expectancy at birth. Today longevity is about social inclusiveness, high quality of life, technical innovations in care delivery and medical treatment, and modified business and governmental models.
II. The prevalence of NCDs are considered to be a “slow motion disaster” and rising challenge for life expectancy and health-adjusted life expectancy dynamics.
Noncommunicable diseases (NCDs) tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioral factors. Such diseases have common metabolic roots. They are the major reason of the increasing risk of premature death and result in more disability years in older age.
III.  All risk factors of NCDs lie in non-health sectors, requiring collaboration across all of government and all of society to combat them.
Noncommunicable diseases are driven by forces that include unplanned urbanization, globalization of unhealthy lifestyles and population aging. Unhealthy diets and a lack of physical activity may show up in people as raised blood pressure, increased blood glucose, overweight and obesity. These are called metabolic risk factors that can lead to cardiovascular disease, the leading NCD in terms of premature deaths.
IV. Healthy Longevity progressiveness is about the public-private balance in health care system.
It is important for longevity governance find effective combination of universal health coverage system, support from citizens and the private sector.
V. Low socioeconomic inequality and reduced disparity in health outcomes should be key goals in Healthy Longevity plans and healthcare policies.
Research shows that people living in more affluent areas live significantly longer than people living in deprived areas. Socio-economic inequalities in life expectancy are also widening in both sexes as a result of greater gains in life expectancy in less deprived populations. Many health outcomes — everything from life expectancy to infant mortality and obesity — can be linked to the level of economic inequality within a given population. Greater economic inequality appears to lead to worse health outcomes.
VI. Healthcare policies should be focused on the care delivery to improve healthcare outcomes and provide higher efficiency of healthcare expenditure.
Nowadays it is unclear why countries are investing so much money in research focused on reducing death rates in the elderly, if the consequence is advancing ageing, that can be described as the increase in disability years, plus pension, and social and medical costs, in an unsustainable way. The policy should be focused on health status for measuring efficiency ratio of healthcare system.
VII. A focus on national-level health status and its temporal trajectory is critical.
Health status is one of the most important indicators of well-being, and it predicts a large proportion of societal expenditures on health and social services for the elderly. It depends on individual lifestyle factors, social and community networks, general socioeconomic. Health status is also reciprocally affected by social and political policies and programs.
VIII. Corruption in healthcare is a barrier for improvements of care delivery and indirectly affects the slowdown of both life expectancy and health-adjusted life expectancy growth.
Corruption significantly weakens overall health system performance, and has been found by multiple studies to have a significant negative impact on important health outcomes. Corruption is a major reason of high administrative costs and wasteful healthcare expenditures in clinical care, operational activities and governance. It results in long waiting periods, unmet needs of population and high level of satisfaction of healthcare system performance in general.
IX. There is an evident linkage between level of income and health status: wealthier nation healthier population.
Healthcare performance is strongly dependent on the economy, but also on the health systems themselves. Investment in health is not only a desirable, but also an essential priority for most societies. Health status depends on the development of healthcare infrastructure, medical facilities, high qualification of medical staff, provision of healthcare coverage and competition in private insurance sector. All four pillars of Healthy Longevity Progressiveness, accessibility, affordability, health outcomes and spendings, depends on economic conditions, successful provision of reforms. However, health systems face tough and complex challenges, in part derived from new pressures, such as ageing populations, growing prevalence of chronic illnesses, and intensive use of expensive yet vital health technologies.

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X. Utilisation of Artificial Intelligence opportunities in preventive medicine to minimise costs and improve accessibility of healthcare services.
AI has great potential in terms of tackling the problem of bureaucracy and inefficient administration, relieving doctors from time-consuming administrative tasks and giving them more time to spend with their patients. By automating and improving processes, artificial intelligence can benefit both patients and medical staff. By optimising patient processing planning it can reduce the waiting time and length of stay for patients, and it can also help medical staff in their day-to-day work.
XI. Polluted environment and unfavorable climate conditions threaten average life span and health-adjusted life expectancy.
Countries are currently experiencing unusual environmental issues which provide serious health risks to people. Many developing countries lack the skill, technology and resources to handle climate change related problems like the developed countries. Hence, the outcome of the present research can aid in taking proactive measures which will put in check diurnal temperature variation, daily mean air temperature, relative humidity for Healthy Longevity increasing.

Countries with Low HALE and Life Expectancy and High Gap:


United States
In death ratio some improvements are observed owing to declining death rates from the three leading causes of death in the country -- heart disease, cancer and stroke. But in recent years, in United States costs of healthcare provision have started to rise much more quickly with greater use of modern technological medicine. While spending is highest, the United States ranks not in the top in the world for its levels of health care. So, first of all, in order to improve HALE government should improve health insurance for poor population as there is big income inequality and reduce high administrative costs for cost efficiency. The government should focus on medical advances, some improvements in lifestyle, and screening and diagnosis.
Estonia shows the trend of increase in HALE. Estonia implements e-health solutions but digital tools should not increase existing health inequalities. Rather, they should increase equity. One way to do this is to use health data for policy making.
The health system is one of the most complex systems with many variables and uncertainties. The management of this system needs trained managers. One of the current shortcomings is lack of those specifically trained for this purpose. There is all high income inequality in the country. Government should improve access in healthcare coverage for the families with a low income.
Turkey faces a health care system inefficiencies. Infant mortality rate is relatively high and not all population had health insurance, resulting in unequal healthcare access among different population groups. It is need to improve access for high-quality healthcare services and target the main causes of death through government initiatives.
United Arab Emirates
As residents have high HALE than non-residents in the country it is needed to enhance the health of individuals a through the provision of comprehensive health services for both residents and non-residents in order to decrease gap between levels of HALE, through implementing policies, legislations, programs and effective partnerships.

Countries with Low HALE and Life Expectancy and Medium Gap:


Socioeconomic inequality is one of the biggest problems. The wealthiest are less likely to need help, but when help is needed are more likely to receive formal care, while the poor relied on informal care. Brazil has to make progress towards providing healthcare for all, built on the solid foundations of primary care. It now needs to maintain momentum by exploiting the potential of digital services in healthcare.
The country faces public health challenges, particularly for the poor. These include child undernutrition, growth in obesity, diabetes, and tobacco use, leading to cancer and other diseases. There are targets to improve public health: accessible and affordable nutritious food, sanitary facilities, health centres in rural areas, affordable health care.
To improve public health it is needed to focus on health education, prevention programmes and purchasing of new equipment.
In Mexico the main challenge is to reduce inequality in healthcare and ensure that an important proportion of the population gain access to wide health coverage, including, access, quality, and costs. Mexico, due to its high prevalence of obesity, faces serious public health consequences, especially cardiovascular diseases and diabetes, that should also be addressed.
Saudi Arabia
The country need to reduce disparities in health and health care systems between poorer and richer families and underfunded health care systems that in many cases are inefficiently run and underregulated.
The most pressing issues to be addressed are enhancing the efficiency and quality of primary care, modernising hospital infrastructure and management, promoting better care access for the poor population and improving lifestyles through well-designed public health and disease-prevention policies.

Countries with Medium HALE and Life Expectancy and High Gap:


There are disparities in unmet care needs by income group. As cardiovascular diseases and cancer are the leading causes of death, the challenge is to strengthen prevention and primary care.
In order to improve public health and increase HALE policy should response to the obesity epidemic. Government should take actions for further development of epidemiological surveillance, costing strategy, stronger data governance.
Initiatives to reduce levels of drinking and promote healthy lifestyle in Denmark are a welcome development. The proportion of residents who report being in good health is high, although a gap exists between income groups that should be addressed.
It should be focused on the proportion of people who are healthy at all stages of life, reduction health inequalities, protection the public from threats to health and wellbeing.
Czech Republic
There is a regional variations in health outcomes in the country. It is important to develop targeted policy solutions, as institutions, life-style and socio-economic characteristics are considered to be the main explanatory factors that affect HALE.
Alcohol consumption should be considered as it remains an important public health issue in Finland, with more than one-third of adults reporting heavy alcohol consumption on a regular basis.
A balanced diet and sufficient physical exercise are important aspects of a health-promoting lifestyle in Germany. They can help to prevent the occurrence of obesity, lipid metabolic disorder and hypertension.
Medical workers must continue to be supported in delivering the best evidence-informed high-quality care through firm commitments to training, professional development and access to resources.

Countries with Medium HALE and Life Expectancy and Medium Gap:


Ageing, an increase in obesity and problems with tobacco and alcohol are main causes of death among Cuba's citizens. Cuban government should address to health challenge, which is a huge investment in public health education around smoking, alcohol, diet and exercise. The foundation of Cuban’s preventative health care model that is at primary care level should be in priority.
Creating an effective network of primary care services is one of the most urgent priorities to respond effectively to the needs of population and reduce overcrowding of emergency departments and unnecessary hospital admissions. Universal health coverage can be financially sustainable, to finance public spending.
Smoking, drinking and obesity are main behavioral factors of bad health which should be addressed. Large inequalities in health persist according to education and income. On the positive side, public health policies are starting to tackle this, but may need time to become effective.
Malta has the highest obesity rate in the EU, and this remains the major public health issue, both in adults and in children. Poor health behaviours tend to be most common among lower socio-economic groups. Policies should deal with encouragement of health behaviour and reduction of income inequality.
The prevalence of chronic diseases in the population means that Portugal, in common with many other countries, needs to introduce new service models that provide integrated care, focused on care delivery and creation of medical networks.
The government should focus on improvement of nutritions and promotion of healthy lifestyle, also pay attention to improvement of healthcare services and their accessibility to all income groups.
United Kingdom
The United Kingdom should address inequalities in health by socio-economic status as bad health is more prevalent among population with lower income and education

Countries with Medium HALE and Life Expectancy and Low Gap:


China faces many health challenges. These include increasing rates of cancer and cardiovascular disease linked to lifestyle factors like smoking, an ageing population. Therefore, a key component of healthcare should be the promotion of healthy lifestyles and physical fitness, including through the development of healthy cities, to ensure a greater focus on prevention rather than treatment. For greater reduction in infant mortality and rates of infectious diseases, government should invest in expanding health infrastructure, improvement quality of healthcare service and provision of affordable health care in rural areas across country.
Costa Rica
Diseases that most affect quality of life are heart disease, back pain, depressive disorders, hearing loss and diabetes. Inequalities also persist among the various population groups. Country needs to expand its efforts to promote healthy living, particularly young people. The health system needs to contribute to higher levels of equity and solidarity.
Improve access to health services, as it remains inequitable, a fact readily visible in the marked discrepancy between health outcomes in urban and rural settings. Health infrastructure should be developed more evenly, including availability of health workers, medicine and technological equipment, both urban centres and rural areas where populations face with limited access to health services now. The availability of water has been identified as one of the country’s leading environmental problems, that decrease average level of public health. Both the quantity and quality of available water during the dry season should be of concern. The lack of of professionals is also an issue limited to the health sector. The government needs commitments to increasing human resources for the healthcare sector, that will necessarily lead to expanding the capacity of the country’s medical faculties.

Countries with HIgh HALE and Life Expectancy and High Gap:


Australians are living longer and with more years in a good health. Heart disease is largest cause of death. Adults at high risk of heart attack or stroke should receive appropriate treatment and be aware of their risk factors. In order for the Australian healthcare system to handle the gradual population aging, government and administration must develop new policies and programs to accommodate the needs of changing demographics.
Behavioural risk factors are a major public health issue in Austria. Alcohol consumption and smoking rates are among the highest across the EU. To increase public health they should be addressed.
Recommendations suggested facilitating the exchange of information and interaction between health providers and government figures as well as flexible funding would also contribute to improvement and solve the problem of differences in regional care by allowing regions to determine the needs of their general populace and meet those needs more efficiently by allowing target-specific allocation of funds.
The main challenges are to promote prevention and healthy behaviour. Disparities of coverage across social groups suggest paying attention to co-ordination between universal healthcare provision and private insurance. The first government responsibility is fixing the rate at which medical expenses should be negotiated. The second government responsibility should be oversighting of health-insurance funds, to ensure that they are correctly managing the sums they receive, and to ensure oversight of the public hospital network.
Further efforts are needed to reduce smoking rates, so as to reduce deaths from lung cancer and other smoking-related deaths and the prevalence of overweight and obesity.
A set of health strategies, targeted health awareness promotion and prevention activities aims to address death risks and reduce level of chronic diseases. Also government should provide evidently a direct result in order to decrease high levels of consumption of harmful drinking patterns among people in Luxembourg.
The main causes of disability and reduced health are lack of physical activity, mental disorders, cardiovascular disease and cancer. The government should focus on providing effective care and primary care settings. Low back and neck pain has the highest share of total DALYs, but it is slightly decreasing. Therefore, targets that are likely to remain the focus of political attention and policy development are those relating to sustainable consumption and production, health and education, equality, employment, and migration.
Republic of Korea
The government should address the following challenges to improve public health and increase average life expectancy: reduce inequality in health coverage outcomes, improve primary health care and coordination between hospitals and long-term care facilities, meet the needs of the aged population.
The government should further develop following initiatives: improve health and medical care that more actively promotes good health, promote good eating habits and safe food to decrease obesity and overweight, reduced use of tobacco and alcohol.
The main challenge to improve public health is to reduce disparities of healthcare coverage across income groups groups. The ministry along with other government bodies should supervise activities at the lower levels, allocates grants and periodically evaluates services to ensure correspondence to national goals.

Countries with High HALE and Life Expectancy and Medium Gap:


To improve health and wellbeing of people living in Iceland government policies should be focused on obesity, tobacco, healthy workplaces, child wellbeing. eHealth initiatives should meet the needs of the aged population.
Life expectancy and HALE are increasing in Israel. The country has developed healthcare system, but some improvements should be done: enhance primary care services by expanding the number of chronic disease conditions covered through data monitoring and encouraging younger doctors to work in primary care, boost current efforts to tackle inequalities in health care coverage.
Japan is facing a rising burden of chronic disease, and a rising number of frail and elderly persons. In addition, Japan faces some relatively unique public health risks, notably a significant exposure to natural hazards such as earthquakes, floods, typhoons, and tsunamis. So, improvement of public health emergencies systems are in priority.
New Zealand
The government should commit to reduce smoking rates, the overall negative impact of alcohol, prevent and manage obesity, and to support and encourage healthy eating and physical activity, provide better access to primary health care.
The Spanish national health system is a comprehensive network, for its technological capacity and human capital, for the accessibility of its service network, for offering access to the latest advances in medicine and medical technology. There are several ways to improve public health and decrease gap between life expectancy and HALE at birth: increase the efficiency and effectiveness of the health provision system, support and encourage healthy eating and physical activity, address aging, customize healthcare services to meet needs of aged population.

Countries with High HALE and Life Expectancy and Low Gap:


Hong Kong, SAR
The government should provide strategic review of health care staff planning to reduce the shortage of healthcare staff. Timeliness for healthcare services is closely linked to staff shortages. In Hong Kong, the elderly population is particularly vulnerable, facing significant difficulties in accessing primary healthcare services. Given the need for improving Hong Kong’s health services, the biggest challenge the city will face in the near future is to keep delivering high quality healthcare in a timely fashion and to maintain and enhance the population’s health (e.g., health promotion and prevention).
Chronic disease care is a critical part of a people's health. The patient should be persuaded about exercise, diet and lifestyle change: all important for chronic disease control. Caregivers and patients should be empowered through education, information and communication. Further implementation of eHealth initiatives will lead to the reduction of number of patient visits to hospitals for routine checks, will free up healthcare resources, enabling healthcare staff to better manage their time and focus on priorities.
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