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Longevity Governance


Longevity Progressiveness Ranking of 50 Regions

Longevity Progressiveness Ranking is affected by various factors and their impact varies across countries. For this reason, Aging Analytics Agency’s Longevity Progressiveness Ranking is based on the quantitative analysis of seven domains: economy, health status, ecology, society, demography, government care and policy. 


These domains consist of 50 indicators derived from international data sources, including the World Bank, the World Health Organization (WHO), the International Labour Organization (ILO), Organization of Economic Cooperation and Development (OECD).


The rankings show how countries compare in terms of health and wellbeing. The values, on which the rankings are based, show how countries are performing. In particular, they show how different countries compare with the best-performing countries and their potential for improvement. The difference in Metrics values between countries is sometimes minimal, as there are several countries with a high level of life expectancy and of the same level of development. A difference of 0.1 or more points can be considered statistically significant.


The Ranking has been calculated using the most relevant, reliable data for 2019 from international sources that is comparable across countries. Data from national sources is often more up to date than international data sets because of the time it takes to process, standardize and introduce data into international data sets.

This means that the Ranking does not necessarily reflect the current situation, such as the outcomes of policies that have recently been introduced.

  • Economy

Measured by the unemployment rate, the poverty rate in old age, living standards using GDP per capita, income Gini coefficient.

  • Health status

Measured by life expectancy at birth, healthy life expectancy at birth, chronicle disease burden, healthcare expenditures and psychological well-being. Good physical and mental health is critical to the social and economic engagement of people.

  • Ecology

Quantifies and numerically marks the environmental performance of a state's policies. Research reveals that when sustainable efforts are applied to policy and business, it typically bodes well for longevity developments. Ecology metrics can be critical to measuring national sustainability efforts.

  • Society

Measured by social connection and development of human capital. The metrics of this group take into account the gender gap, corruption perceptions, Human Development Index Score and 

R&D Personnel per Thousand Total Employment across the countries in question. 

  • Demography

Measured by major demographic indicators.

  • Government care 

Metrics that were taken into account involve among others immunization, healthcare expenditures, international health regulations, effectiveness ratios. 

  • Government policy

Involves mainly the operational programs and initiatives launched by national governments for the purpose of improving the longevity performance of the states.

To conduct an in-depth analysis of Global Healthy Longevity, we applied a compound annual growth rate (CAGR) to several metrics from 1-3 levels of key importance. What is CAGR? The compound annual growth rate is a business and investing specific term for the geometric progression ratio that provides a constant rate of return over the time period. It could be calculated using the following formula:
 Therefore, we were able to explore different dimensions of countries’ performance in some of the crucial indicators. As a result, the following 4-6 levels of metrics have been set up to evaluate countries’ performance over a set period of time through CAGR evaluation. 

Longevity Ranking of 50 Countries

Inequality in health, education and income levels of the population across countries are increasing between top-ranked, high-income countries and bottom-ranked, predominantly low-income countries. The countries doing best in the Ranking have social and economic policies to improve healthcare systems, and wellbeing, decrease disease burden and engage healthy lifestyle. They have long-standing social welfare policies on better access to healthcare, as well as, minimization of behavioral risk factors including smoking and alcohol use, as well as diet and low physical activity.
At the same time, bottom-rank low-income countries care about their citizens less than countries doing best in the Ranking. It comes out of medicine, insurance, policies, and dealing with economic issues. This complex is a reason for inequality in health.

Japan has got the highest score of the Ranking thereby significantly improving its position from 16th place to 1st from the time of the last evaluation of countries progressiveness. The list of the states which have the highest performance over the last publication of the report include India, Spain, Canada, Italy and Iran. On the contrary, Argentina, Qatar, Mexico, Ireland are the states that have sharply lost positions in the final rating.

Health Status

Japan is the first in health and healthcare ranking with the highest life expectancy in the world. Denmark is the second and the Republic of Korea is the third. These countries has developed an effective healthcare system, developed medical facilities and improved access to healthcare infrastructure, relatively low level of chronic disease. Although it is worth noting that the difference in Index values between top-ranked countries is not large. Chile leads the Latin America and Caribbean region (Panama was the leader in the previous Rankings). The relatively high scores are due in large part to the existence and effectiveness of government policies, with an orientation towards social policy in general and policies on aging in particular.

Both Sexes HALE





The ranking is correlated with health-adjusted life expectancy (HALE) across observed countries. It means that a combination of macroeconomic indicators influences the span of living in good health. 

Among observed countries, Japan has the highest HALE and topped the ranking with Singapore at second place. It prioritized health and education and established universal health insurance and social pensions. South Africa, India and Indonesia have the lowest HALE and score. Older people in the country experience many hardships, with few able to access basic services. Family ties remain strong, but traditional support systems are changing and older people are increasingly left with the responsibility of childcare without any formal support. Low quality of healthcare services and poverty contribute to low HALE and high mortality.

Both Sexes Life Expectancy

This metric assumes that the age-specific death rates for the year in question will apply throughout the lifetime of individuals born in that year. The estimate, in effect, projects the age-specific mortality (death) rates for a given period over the entire lifetime of the population born (or alive) during that time. The measure differs considerably by sex, that’s why the report also takes into account the difference of value between sexes:

Hong Kong, Japan, Switzerland have received the highest scores of the life expectancy of the population. South Africa, India and Indonesia have been placed on the bottom of both sexes life expectancy subrating. 


DALY Rates per 100 000 Population

DALYs for a disease or health condition is the sum of the years of life lost due to premature mortality (YLLs) and the years lived with a disability (YLDs) due to prevalent cases of the disease or health condition in a population attributed to leptospirosis.

DALYs for a specific cause is calculated as the sum of the years of life lost due to premature mortality (YLLs) from that cause and the years of healthy life lost due to disability (YLDs) for people living in states of less than good health resulting from the specific cause.


DALY represents the loss of the equivalent of one year of full health. The highest burden of disease among chosen countries is in India and China. The burden of disease, expressed in DALYs per 1000 population, has decreased in all regions during the beginning of the 21st century. The Ranking Report reveals that Iceland, Malta and Luxembourg have the best performance as DALYs rates of these countries are the lowest while the values of India, China and the USA  are the highest.

Government care


This category comprises 40 metrics involving among others Healthcare levels, Immunization, Healthcare Expenditures, and key International Health Regulations in fields of food safety, risks communication, chemical safety, etc.

Switzerland, the Republic of Korea, and Singapore are leaders in terms of longevity regulations at national levels. That means that public healthcare expenditures of top countries are reasonable, have a definite strategy, and directed into promising programs. Argentina has been placed on the bottom of the rating. The country also has a high incidence of non-communicable diseases, with a mortality rate of 434.9 per 100,000 members of the population.

Healthcare Efficiency Index

Efficiency score based on three weighted metrics: life expectancy (60%), relative and absolute health expenditure (30% and 10% respectively). 

HAQ (The Healthcare Access and Quality Index)

Based on 32 causes from which death should not occur in the presence of effective care to approximate personal healthcare access.


The following chart represents the correlation between DALY Rates per 100,000 Population on the one side and Healthcare Efficiency Index and The Healthcare Access and Quality Index) on the other. 


Current Health Expenditure per Capita (Current US$)

This indicator shows the average expenditure on health per person which contributes to understanding the health expenditure relative to the population size and is especially helpful when comparing countries.

The highest level of per capita expenditure is in Hong Kong with a remarkable spending equivalent of $23815 for each resident, which is more than twice as much compared to the second country in this regard – the USA. 

An opposite picture is observed in countries with big populations like India which spent less than 10% of the average per capita spending level in selected countries.


Public Health Care Expenditure (as % of GDP)

The indicator provides information on the level of resources channeled to health, relative to a country's wealth. Increasing health expenditure significantly benefits the economy and is associated with better health outcomes, especially in low-income countries.

On average, selected countries spent 8.24% of their GDP on healthcare and only the United States with its immense spending level of 17.07% stands out, especially considering the size of the country's economy.


Domestic Private Health Expenditure (% of Current Health Expenditure)

This metric is useful to assess the structure of health expenditure. For the vast majority of the selected countries the level of private health expenditure is in the 15-45% range and only for Indonesia, Brazil, and India this indicator crossed the 50% mark. India is an interesting case that stands out with 73.55% share funded from domestic private sources such as funds from households, corporations and non-profit organizations.

Out-of-Pocket Expenditure (% of Current Health Expenditure)

Reliance on out-of-pocket payments varies considerably across the globe. It is used to monitor how well a health system is performing in terms of financial protection.


The highest level of out-pocket expenditure across chosen countries is in India. The Indian government is unable to cover the full spectrum of healthcare needs because of persistently low public investment in health, a lack of human resources and poor health infrastructure, which increase the cost and the financial burden of care.


GERD as % of GDP

GERD reflects the research intensity within a national economy, and hence its capacity to develop new and innovative products or services. Economically advanced countries have a tendency to spend more resources on Research and Development projects but the unambiguous leader in this regard is Israel with 4.94% of GDP, followed by the Republic of Korea – 4.5%. It is also worth highlighting Austria, Denmark, Germany, Japan, Sweden, and Switzerland with values above 3%. Compared to those mentioned, all the other countries, among the selected, spend close to average values.



Due to the changes in our methodology, Demography rankings changed quite substantially. The main pattern is the shift from quantity to quality and as a result, two countries of the Nordic region, known for their high quality of life – Finland and Sweden occupy the highest positions in Demography. Although the annual growth rate in Finland has been declining over the past few years, it is still positive, meaning that the population is increasing. The life expectancy of the population has risen steadily and equals an above-average level of 81.3 for Finland and 82.5 for Sweden. In contrast, birth rates have been falling at the same time, which leads to population aging but this is compensated by the best retirement security, which is expressed in the highest positions in Global Retirement Index.

Age Dependency Ratio

The age dependency ratio is the ratio of the number of elderly and young people at an age when they are generally economically inactive, compared to the number of people of working age. Age composition of population is among determinants of development in the country. This indicator implies the dependency burden that the working-age population bears in relation to children and the elderly.


The average value for selected countries is 49.21 and the highest level of 65 is reached by Japan and Israel. The lowest ratio is observed in Qatar and the United Arab Emirates, which is equal to 18.

Age Dependency Ratio, Old

Old age dependency ratio is a good indicator of how many potential retirees a potential worker has to support. It also illustrates aging populations.

The evolution of dependency ratios depends on mortality rates, fertility rates and migration. Developed countries have seen prolonged increases in life expectancy, which most analysts project to continue, implying an increasing number of older people and most likely of pensioners too. 

There have also been substantial declines in fertility, which, of course, will eventually diminish the number of workers entering the labor market. Developing countries' opposite trend of an increase in birth rate and relatively low old-age dependency ratio. Japan has the highest old-age dependency ratio among chosen countries, it equals 439. High old-age dependency ratios in Finland, Italy, Germany, France suggest increases in economic activity at older ages may help to offset the impact of population aging on the economy in the future.



Hong Kong is the first in Ecology followed by Spain, UAE and Chile. The leader of the former ranking, Israel, has lost its leading position.  All countries at the top of the ranking have a high level of usage of adequate sanitation facilities and improved water sources. Favorable climate conditions are major factors that affect sub ranking. 

Hong Kong maintains a high standard of ecological facilities to better protect public health. This relates in particular to issues of air pollution, using safely managed sanitation services by the population. Moreover this category of metrics also accounts the climate’s impact on people: e.g. the climate of Hong Kong is subtropical, with very mild winters and hot, rainy, and muggy summers.

Mortality Attributable to Ambient Air Pollution (per 100 000 Population)

Ambient air pollution results from emissions from industrial activity, households, cars and trucks which are complex mixtures of air pollutants, many of which are harmful to health. Of all of these pollutants, fine particulate matter has the greatest effect on human health. Countries with higher level of environmental pollution have lower public health and health-adjusted life expectancy.


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By economic factors, the United States has the highest score. the United States has the leading level of GDP per capita, which measures the level of living standards. Switzerland, Japan and Norway go further on in the subrating. Leading states prioritize health and education while developing national economic strategies. Developing countries have lower scores as in developing countries level of poverty is higher compared to developed. Poland have the worst score according to the ranking. The highest income inequality, low level of GDP per capita are the major factors that contribute to such results.

Gross Domestic Product and Healthy Longevity

There is a relationship between GDP per capita and health-adjusted life expectancy. Economic growth not only through an increase in total GDP but also through long term gains in human and physical capital that raise productivity leads to better health. The population of wealthy nations lives longer and healthier life comparing to low-income countries, such as India, Indonesia, South Africa. There is also an inverse relationship. Better health and longer life lead to an increase in the economy’s health, which is measured by gross domestic product. That is why the promotion of better health both in developed and developing countries is in priority for their potential economic benefits.

Government Policy

This category of metrics evaluates the existence or non-existence of operational strategies or programs on a national level that directly or indirectly influences the state’s performance in longevity governance. Such programs should comprise mainly transmission of non-communicable diseases, reduction of population salt consumption, cancer, diabetes, chronic respiratory diseases national plans. This is a newly introduced group of indicators to Longevity Progressiveness Ranking as the abovementioned national initiatives appear to be crucial while evaluating efforts of governments in terms of longevity performance.
The Ranking reveals that Japan, France and Portugal have the best performance of Government policies. That means that top countries have operational plans developed at the governmental level and what is more crucial, these plans are effective and are reconsidered according to existing conditions. 


By evaluation of society, the first country is Norway, accompanied by Sweden, Switzerland and Finland. These states have the largest network of age-friendly cities and communities among chosen countries. The main purpose of such public and private initiatives is to create age-friendly environments fostering healthy and active aging. They enable older people to age safely, continue to develop personally. Moreover, they have a relatively high level of gender equality and place higher positions in Human Development Index. These countries have relatively advanced opportunities for the development of human potential. They divide well their resources and opportunities among their male and female populations

WHO Age-Friendly Cities and Communities

There is the relationship between GDP per capita and health-adjusted life expectancy. Economic growth not only through an increase in total GDP, but also through long term gains in human and physical capital that raise productivity leads to better health. The population of wealthy nations lives longer and healthier life comparing to low-income countries, such as India, Indonesia, South Africa.


There is also an inverse relationship. Better health and longer life lead to an increase in the economy’s health, which is measured by gross domestic product. That is why the promotion of better health both in developed and developing countries is in priority for their potential economic benefits.

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