We live longer but not better

A child born in 2012 can expect to live six years longer than a child born in 1990, but it comes with a caveat...

Young girls now have a life expectancy of 73 years and boys 68 years. The downside is that these extra years are wrought with illness and disability.  In a global study of 188 countries recently trending on ResearchGate, the authors show our aging population has an increasing amount of health problems, the top being lower back pain (see the complete breakdown).

We asked some of these researchers what this means for people in their countries, and what can be done to reduce the burden of ill-health.

Australia


RachelleBuchbinderRachelle Buchbinder, clinical epidemiologist and professor at the Monash University School of Public Health and Preventive Medicine in Victoria, Australia.

 

ResearchGate: Based on your research and contribution to the study, what does a longer life mean for people in Australia?

Rachelle BuchbinderMusculoskeletal conditions are a considerable burden for the people of Australia. Similar to most other countries, low back pain remains the number one ranked condition contributing to years lived with disability and if soft tissue injuries and fractures are included, then musculoskeletal conditions contribute about 20% of years lived with disability overall. Longer life in Australia means that many people are living with musculoskeletal conditions which are impacting upon their quality of life and function.

RG: How has this changed over time and how do you expect it to change in the future

RB: Due to an ageing population, and increasing rates of obesity as well as likely physical inactivity, this burden is increasing and likely to continue to increase in the future.

RG: What needs to be done to reduce illness and disability for people living in Australia?  

RB: While arthritis and musculoskeletal conditions are a national health priority area in Australia, much more needs to be done to address the burden of these conditions. They remain under-recognized and underfunded in relation to other chronic conditions. 

India


JemmonPanniyammakal Jeemon, Associate Professor, Public Health Foundation of India, Centre for Control of Chronic Conditions. New Delhi, India

 

RG: Based on your research and contribution to the study, what does a longer life mean for people in India?

Panniyammakal JeemonIt is indeed great news that people live much longer in India today in comparison to two decades earlier. However, they often live longer with chronic conditions. The rapidly rising chronic conditions in India and its negative effect on health now threatens to curtail further progress of an increase in life expectancy without disability.

RG: How has this changed over time and how do you expect it to change in the future?

PJ: The disease transition that we observe in India is much faster and occurred in a very short period of time in comparison to other Western industrialized countries. We see this rapid rise in disability due to chronic conditions in India when the Western world is experiencing a steady decrease in major chronic conditions such as ischemic heart disease. We are yet to learn from the Western experience and if we do not adopt appropriate policies to curtail the epidemic of chronic conditions in India, further gain in life expectancy without disability is unattainable.

RG: What needs to be done to reduce illness and disability for people living in India?

PJ: Effective policy measures such as taxation of tobacco products, alcohol, sweetened beverages and salt can curtail both morbidity and mortality attributable to chronic conditions such as cardiovascular diseases and cancer to a great extent. Furthermore, providing an enabling environment to practice a physically active life, choose a relatively healthier diet at no additional cost, and access primary health care services would certainly help Indians to lead a healthy life without the disability burden.

Colombia


CarlosCCarlos Castañeda-Orjuela, Technical Director at the Colombian National Health Observatory, Instituto Nacional de Salud, Bogotá, Colombia

 

RG: Based on your research and contribution to the study, what does a longer life mean for people in Colombia?

Carlos Castañeda-Orjuela: A longer life in Colombia means the Colombian population is dying less during childhood, adolescence, and early adulthood. It means that some diseases such as respiratory infections and diarrhea are decreasing in our country due to improvements in sanitary conditions, and a strengthened universal immunization program. Additionally, it is remarkable that a very huge impact of this decreasing trend is the interpersonal violence affecting younger men. However, this picture also means an elderly population with more frequent cases of non-communicable disease and disability.

RG: How has this changed over time and how do you expect it to change in the future?

CCO: Life expectancy in Colombia had a constantly increasing trend during the analysis period. Due to persistence of some avoidable deaths, we are expecting additional increments in the life expectancy in our country. For example, eradication of interpersonal violence could mean and additional one year of life for the general population. On the other hand, the aging population and better treatments will lead to an increased burden of disease due to non-communicable diseases, with an epidemiological profile similar to that of a developed country.

RG: What needs to be done to reduce illness and disability for people living in Colombia?  

CCO: In spite of the evident progress we need a more equitable public policies to positively affect the social health determinants.  A growing elderly population is a challenge with the increasing occurrence of non-communicable disease, and lead to a lot of avoidable disability and deaths. Its burden is avoidable with interventions that involve sectors different to health, including education and finance ministers. Additionally, there are disparities among the Colombian States’ health departments that need urgent intervention, because very different epidemiological profiles exist inside the country.

United States of America


TheoVosTheo Vos, Professor of Global Health at the Institute for Health Metrics and Evaluation, University of Washington.

 

RG: Based on your research and contribution to the study, what does a longer life mean for people in the USA?

Theo VosOur life span is increasing and the risk of picking up more serious disabling conditions also increases as we get older. Age by age, the rates for these disabling conditions are decreasing at a much slower pace than the rate at which people are dying. That means we see an increasing number of people with disabilities who need care. There are, however, a few diseases actually increasing in terms of rates, and diabetes is one of the more important of these.

RG: What needs to be done to reduce illness and disability for people living in the USA?  

TV: First, we should increase access and uptake of known interventions that have good credentials (in terms of cost and outcomes) in preventing disability or alleviating the severity of disability. That will bring us only so far, however, because large proportions of disability remain that we lack knowledge to effectively intervene, or can only manage partial effects (e.g. dementia, Parkinson’s disease, and many of the mental and musculoskeletal disorders). For those health problems we will need a concerted health research effort to find new ways of addressing the problems.

Sweden


JohanArnlovJohan Ärnlöv, Professor of Medical Sciences, Uppsala University and Dalarna University, Sweden

 

RG: Based on your research and contribution to the study, what does a longer life mean for people in Sweden?

Johan ÄrnlövSweden has for a long time been among the countries with the longest life expectancy in the world. The recent study shows that although life expectancy has increased since 1990, so has the years with illness and disability. This is true for both men and women. The main underlying diseases for the increase in years with disability in Sweden was back- and neck pain, cardiovascular disease, and chronic obstructive pulmonary disease.

RG: How has this changed over time and how do you expect it to change in the future?

JV: The increase in life expectancy will likely continue in the near future. With a growing elderly population the illness and disability will likely also increase

RG: What needs to be done to reduce illness and disability for people living in Sweden?  

JV: Our study is important as it points out areas where increased efforts of prevention will be necessary to reduce the burden of disease. In Sweden, a healthy lifestyle without smoking and with a high level of physical activity would likely be very important for an improved public health.

 Feature photo courtesy of Helen Cook