# Healthy Life expectancy, what we achieved and past patterns

Life expectancy at birth can be used as a proxy for the overall mortality level, it gives us a measure of how many years of life a child born in a certain country would live, if mortality rates were constant in the future. It’s a matter of fact that since 20 years ago the world life expectancy has increased of 6 years reaching a level of 70 years on average in 2011[1]. But looking at this data my question is: have we achieved a longer life to spent in a good health? Or the extra years we are expected to live are likely to be spent in a state of illness? Literature has not reached a uniform outcome on this question, some argue that improvements in healthcare had led to a decrease in disability (Fries) some others that instead the good achievement in mortality rates is due to an improvement in health of the poor population (Kramer and Gruenberg). That’s why has been necessary the calculation of the healthy life expectancy as indicator: Sullivan used data on total years lived and extracted from them, using health data, the number of years lived without a disability. Then for a given age summed the former and divided for the number of survivors in that time and obtained the healthy life expectancy. I present here a graph made with data on healthy life[2] compared to the total life expectancy[3] for some countries:

[1] World Bank data on life expectancy

[2] World AgeWatch Index

[3] World Bank

(The Blue pile represent the healthy life expectancy, the blue plus the red pile represent the total life expectancy.)

As we can see from the graph, considering the 2012 data, the Japan is the country where the healthy life expectancy has reached the highest value in the world, 75 years, and only 8 years of difference with the total life expectancy. The result is similar for Italy and Portugal, but for the latter the calculated average years in which someone can expect to live in a state of morbidity is 12 years. The country that scored the lowest value of healthy life is Sierra Leone, with only 29 years and only 47 expected years of life. If instead we try to move to a time series comparison, although the analysis is difficult because healthy life was calculate for developed countries only since ’70s and for developing and the Sub-Saharan region only starting from 20 years ago, we can find general patterns. Industrialized countries have reached a stagnation in the growth of life expectancy, for example in Europe is increasing slowly but is contrasted by mortality trends in the ex-Soviet Union and healthy life is moving up but slowly. In the developing countries the life and healthy life expectancy are moving faster than the former (they increased on average 6 years expectancy from 2000 to 2011, instead Europe achieved this result only in 20 years) and this is due to better medical condition, for example in Africa the antiretroviral therapy has decreased the diffusion of HIV.  Moreover the availability of vaccines in that countries is having an effect on both measures increasing their upward trends, but due to this effect we can see that, compared to the industrialized countries where the two indicators are moving approximately at the same velocity, in the developing countries the healthy life expectancy is moving faster than life expectancy alone, in fact the effects due to better health on total life of the population will have an effect only when the recent cohorts will be old.

Angelo Saponara