Longevity Governance

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Current Trends in Life Expectancy and Healthy Longevity

Developed countries have higher life expectancy comparing to developing countries. Life expectancy at birth in countries varies significantly. Dut the differences among high-income countries differences in life expectancy have narrowed over time. The highest value is in Japan and the lowest value is in South Africa, they equal 84.2 and 63.6 years accordingly. The United States is the high-income country where life expectancy is marginally low the average level of chosen countries (72.3 years).

Difference between Female and Male Life Expectancy at birth

Female life expectancy exceeds male life expectancy in all countries. In 2016 in the United States male life expectancy was 76 years for males and 81 years for females, a difference of 5 years, whereas in France it was 5.6 years and in the United Kingdom., 3.5 years. The discrepancy was much greater in some countries, with the difference in Russia reaching more than 10.8 years, but in others, such as India 2.9 or United Arab Emirates (2.2 years) it was much less. The female advantage in life expectancy used to be very small, but it grew substantially over the last century. These two points also apply to the other countries with available data, Sweden, France and the UK.

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Indicators Dynamics: of Life Expectancy at birth

High-income European countries and countries beyond Europe, Canada and Australia experienced a slowdown in life expectancy improvements in recent years. The slowdown in improvement since 2011 has been greatest in the USA, where life expectancy improvements have not just slowed but have reversed in the most recent years. The exception is Japan which experienced increase in life expectancy. Advancing in expectancy improvements is observed in Mexico, Brazil and Argentina.

Health-Adjusted Life Expectancy at birth

Developed countries have higher health-adjusted life expectancy comparing to developing countries. HALE at birth in countries varies significantly. The highest value is in Singapore and the lowest value is in South Africa, they equal 76.2 and 55.7 years accordingly. The United States is the high-income country where life expectancy is marginally low the average level of chosen countries (70 years). Poland has the lowest HALE among European Union countries presented in the report.

Difference between Female and Male HALE at birth

The highest difference between female and male health-adjusted life expectancy among chosen countries is in Russian Federation and it equals 8.4 years. Among high-income countries the highest difference is in Japan. Women tend to engage in fewer behaviors that are bad for health than men do. They also better profit from current advances in health care and living conditions.

Indicators Dynamics: HALE at birth

Two Opposite Trends in the United States: Surge in Healthcare 142 Expenditure and Slowdown in Life Expectancy

The US currently has a significant gap between its healthy-adjusted life expectancy (HALE) of 70 years and life expectancy at birth of 77 years, compared to a gap of 4 years in Singapore (78 years and 82 years, respectively). Its life expectancy at birth ranks 25th globally, yet its health care expenditures are the highest among all developed countries.
 
The situation in the US does not stem from the developed state of its science, technology or medicine. Rather, it is rooted in policy. This report seeks to analyze specific policy initiatives that can enable the US to turn its health deficit around.
 
In the United States, there has been a rapid increase of total national health expenditure (millions $) over time. In 2017, this figure reached an enormous value of almost 3.5 trillion dollars. There is a trend of further expenditure increase in this field.
 
Despite the increasing total national health expenditure, there is an opposite trend in life expectancy at birth (years). The amount of decrease in life expectancy is less alarming than the fact that addiction and a decline in the emotional wellbeing of Americans have contributed significantly to decrease of the average length of life in the United States.

Life Expectancy Slowdown in the United States

The average life expectancy in the US has been on the decline for three consecutive years since 2014.
A baby born in 2017 is expected to live to 78.6 years, which is down from 78.7 years in 2016, according to data from the Centers for Disease Control and Prevention’s National Center for Health Statistics. The last three years represent the longest consecutive decline in the American lifespan at birth since the period between 1915 and 1918, which included World War I and the Spanish Flu pandemic, events that killed many millions worldwide.
 
Before the recent decline, life expectancy had been steadily rising in the US — which is to be expected of an advanced nation, particularly one that spends more money per citizen on health care than any other country. But high health care expenditure does not indicate better health care coverage and improved care delivery system. Health care in the US is about twice as expensive as it is in any other developed country. The cost of this financial burden for every household because of lost wages, higher premiums, taxes and additional out-of-pocket expenses is huge.
 
Even with all this money being spent on health care, the World Health Organization ranked the US 37th in health care systems, and The Commonwealth Fund placed the US last among the top 11 industrialized countries in overall health care.

United States: Life Expectancy (LE), Causes of Death & 144 Disability, Risk Factors – Global Comparison

Main Factors Contributing to the Decline of Life Expectancy in  the United States

1. A rise in drug overdoses
In 2017, more than 70,000 deaths occurred because of drug overdoses. Opioids were involved in more than 47,000 of those. The age-adjusted death rate for drug overdose in the U.S. rose 72% within a decade. Opioids continue to be prescribed at triple the amount they were in 1999, but many are hoping to change that. The federal government has spent more than $2.4 billion in state grants since 2017 in a bid to curb the epidemic.
 
2. An increase in liver disease
Over a 10-year period, the death rate for chronic liver disease and cirrhosis among men aged 25 to 34 increased by nearly 8% per year, while women in the same age group increased more than 11% per year. The causes of liver disease can vary, from genetics to alcohol consumption and obesity.
 
3. A rise in suicide rates
The national suicide rate has increased by 33% since 1999. In 2017 alone, that rate went up by 3.7%. The global suicide rate, meanwhile, has declined by almost 30% since 2000, with the rates in Russia, Japan, South Korea and India falling significantly over the last decade.

Life Expectancy Slowdown in the United Kingdom

The 20th century saw dramatic improvements in life expectancy resulting from public health measures such as childhood immunisations, the introduction of universal health care, medical advances (such as in treatment of heart disease and cancer) and lifestyle changes, including a decline in smoking. By 2018 life expectancy at birth in England had increased to 79.6 years for males and 83.2 years for females. The gender gap has narrowed since 2000, with mortality falling faster in males than females as a result of decreases in the high rates of smoking and mortality from cardiovascular diseases among men. In recent years we observe the slowdown in life expectancy improvements both for male and female population. First of all such a trend is caused by the slowdown in mortality improvements. Stopped improvement in mortality is a result of a constellation of demographic factors such as ageing population and burden of age-related disease. It signals about exhausted demographic potential of the United Kingdom to further quantity improvements in life expectancy.

Health Status in the United Kingdom

The leading causes of death for both female and male population are age-related diseases, they are heart diseases and brain dysfunctions, such as dementia and alzheimer’s disease. Among other risks of death are factors that associate with winter and cold weather. There has been a substantial shift in the age structure of the population in recent decades: the number and proportion of people at older ages has increased. There are likely to be more people living with dementia and other long-term conditions that may make them particularly vulnerable to the effects of flu and other winter risk factors, and who may be particularly reliant on health and social care services.

Main Factors Contributing to the Slowdown in Life Expectancy 148 in the United Kingdom

1. Inequalities in life expectancy
People living in more affluent areas live significantly longer than people living in deprived areas. In 2015–17. Much of this inequality is caused by higher mortality from heart and respiratory disease, and lung cancer, in more deprived areas. The gap in healthy life expectancy at birth is even greater – about 19 years for both males and females, and those living in the most deprived areas spend nearly a third of their lives in poor health, compared with only about a sixth for those in the least 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. Between 2012–14 and 2015–17, the difference in life expectancy between the most and least deprived widened by 0.3 years among males and 0.5 years among females. Among females living in the most deprived areas life expectancy fell by 100 days over this period, in contrast to the gain of 84 days among females living in the least deprived areas.
 
2. A slowdown in improvement in mortality rates for heart disease and stroke
Reductions in mortality from heart disease and stroke, which are leading causes of death, have historically driven improvements in life expectancy. Since 2011, there has been a slowdown in improvement in mortality rates for these causes which has therefore had a large impact on the trend in life expectancy. Up to 80% of these premature heart attacks and strokes are avoidable and this highlights the importance of focusing on preventative interventions such as stopping smoking, getting more physically active and lowering blood pressure and cholesterol levels. Stepping up efforts to reduce the risk of heart disease and stroke will also mean addressing the underlying wider determinants of health.
 
3. No improvement in death rates in young adults
While flu, heart disease and stroke have partly determined the trend in mortality rates in older adults, other causes of death have influenced the trend in younger people. Mortality rates among younger adults made almost no positive contribution to trends in life expectancy between 2011 and 2016, despite making small positive contributions in earlier years. The cause of death that had the biggest negative impact was accidental poisoning, with 70% of these deaths due to drug misuse and 10% due to alcohol. In the age group 20 to 34 years the leading causes of death are suicide & injury or poisoning of undetermined intent, accidental poisoning, transport accidents.

Life Expectancy Slowdown in Mexico

Life expectancy, just like malnutrition and infant mortality statistics, shows how well a certain country is living. Between 2005 and 2015, average life expectancy in Mexico fluctuated. Life expectancy in the country was 77.8 years for women and 72.6 for men in 2005, but by 2010 the figures decreased to 78.1 for women and 72.3 for men. This is in stark contrast to most of the world where life expectancies are rapidly increasing elsewhere, which have gone up continuously since 2000, according to the WHO, which cites improvements in health care and the development of medical devices and pharmaceutical products. According to the National Population Council (CONAPO) report, recent fluctuations in life expectancy are a reflection of changes in mortality levels due to the increase in older adults and deaths related to diabetes mellitus and violent causes.

Health Status in Mexico

Risk Factor: Mexicans have the second highest prevalence of obesity in the OECD (33% of adults), and highest overall share of population overweight or obese (73%). However, the country also has the lowest rates of daily smoking (7.6% compared to an OECD average of 18.4%) and consumes little alcohol (5.2 litres of annual pure alcohol per capita compared to an OECD average of 9.0 litres).
 
Resources: health spending averages $1 080 per person (adjusted for local costs), four times lower than the OECD average of $4 003. Mexico has 2.4 doctors per 1000 population relative to 3.4 on average across the OECD, and less than one-third the number of nurses and hospital beds per 1000 population than the OECD average.

Main Factors Contributing to the Slowdown in Life Expectancy 148 in the United Kingdom

1. Inequalities in life expectancy
People living in more affluent areas live significantly longer than people living in deprived areas. In 2015–17. Much of this inequality is caused by higher mortality from heart and respiratory disease, and lung cancer, in more deprived areas. The gap in healthy life expectancy at birth is even greater – about 19 years for both males and females, and those living in the most deprived areas spend nearly a third of their lives in poor health, compared with only about a sixth for those in the least 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. Between 2012–14 and 2015–17, the difference in life expectancy between the most and least deprived widened by 0.3 years among males and 0.5 years among females. Among females living in the most deprived areas life expectancy fell by 100 days over this period, in contrast to the gain of 84 days among females living in the least deprived areas.
 
2. A slowdown in improvement in mortality rates for heart disease and stroke
Reductions in mortality from heart disease and stroke, which are leading causes of death, have historically driven improvements in life expectancy. Since 2011, there has been a slowdown in improvement in mortality rates for these causes which has therefore had a large impact on the trend in life expectancy. Up to 80% of these premature heart attacks and strokes are avoidable and this highlights the importance of focusing on preventative interventions such as stopping smoking, getting more physically active and lowering blood pressure and cholesterol levels. Stepping up efforts to reduce the risk of heart disease and stroke will also mean addressing the underlying wider determinants of health.
 
3. No improvement in death rates in young adults
While flu, heart disease and stroke have partly determined the trend in mortality rates in older adults, other causes of death have influenced the trend in younger people. Mortality rates among younger adults made almost no positive contribution to trends in life expectancy between 2011 and 2016, despite making small positive contributions in earlier years. The cause of death that had the biggest negative impact was accidental poisoning, with 70% of these deaths due to drug misuse and 10% due to alcohol. In the age group 20 to 34 years the leading causes of death are suicide & injury or poisoning of undetermined intent, accidental poisoning, transport accidents.