Living Longer But Sicker

This week's entire issue of The Lancet was devoted to a new global analysis of death and disease carried out as part of the Global Burden of Disease project at the Institute for Health Metrics and Evaluation at the University of Washington, funded by the Gates Foundation. The good news is that life expectancy has continued to increase over the past 20 years (the last global evaluation of this type was done in 1990). But the bad news is the emerging evidence that health levels among adults are generally getting worse, rather than better. BBC News summarizes the results (but keep in mind that this is a huge complex study with many authors in many countries):

The Lancet analysis shows high blood pressure, smoking and drinking alcohol have become the highest risk factors for ill health. They replace child malnourishment, which topped the list in 1990.

Prof Christopher Murray, from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, led the work.
He said: "There's been a progressive shift from early death to chronic disability.
"What ails you isn't necessarily what kills you."

This represents a new and potentially very important twist on the health and mortality transition. Up to this point, we have routinely assumed that health and mortality tracked each other very closely, so that an increase in life expectancy would be automatically associated with improvements in overall health. indeed, the idea was that improved health was an important cause of higher life expectancy. These new findings suggest that the linkage may not be as strong as we thought. Efforts put into improving health among children have been key contributors to higher life expectancy in many developing countries, but adult health levels are actually getting worse, not better. These global patterns reflect what my colleagues and I have been finding in our research in Ghana.