Tuesday, February 28, 2017

Life expectancy will approach the 90-year mark in some countries by 2030, with a persistent female advantage.

courtesy: Pathfinder.gr
Projection of life expectancies is necessary for healthcare policy planning, social services, social security and pension. It also reflects the patterns of health and disease prevailing in the society. A recent paper published online February 21 in Lancet aims to forecast future life expectancy in 35 industrialized countries using the Bayesian model.

Instead of using a single model, the researchers developed an ensemble of 21 forecasting models to  eliminate the uncertainty associated with a single prediction model.

The authors say "Taking model uncertainty into account, we project that life expectancy will increase in these 35 countries with a probability of at least 65% for women and 85% for men, although the increase will vary across countries.”

South Korean women are projected to have the highest life expectancy of more than 86·7 years in 2030 with 90% probability. This is equivalent to current highest life expectancy worldwide. The model also indicated that there is 57% probability that the life expectancy at birth for South Korean women will be higher than 90 years in 2030, "a level that was considered virtually unattainable at the turn of the 21st century by some researchers," the authors write.

Earlier gain in life expectancy in South Korea is due to decrease in infectious disease rate in infant and young adult but the increased longevity of the older groups is due to decrease in death rate from chronic diseases. Other contributing factors include improved nutrition, better access to health care, new medical technologies and control of many infectious diseases. South Korean and Japanese women also have lower BMI, and lower B.P than western counterparts.

South Korean women are followed by women from France, Spain, and Japan and are expected to occupy the top 3 spots in the 2030 list.

Men still lag in this projection with 95% probability of surpassing 80 years in 2030, and a greater than 27% probability that it will surpass 85 years in South Korea, Australia, and Switzerland. Similarly, Men in South Korea and many central European emerging economies like Hungry and Slovenia are going to make large gains in life expectancy by 2030 similar to men in Denmark, Ireland, and a few other western European nations. Currently Australia has the highest life expectancy for men.

In 2010, women had a higher life expectancy than men by 3·9 to 8·5 years. This gap will be narrowed and men will catch up with the female life expectancy by 2030 in every country expect Mexico where female life expectancy is predicted to increase more than male life expectancy.

Most of the projected gains in   life expectancy is due to enhanced longevity in older ages specially women, increasing the aging trends of industrialized countries. In 19 countries, one in two 65-year-old women have another 23 years to live and in other 11 countries 24 years to live.

Similarly, Male life expectancy at age 65 years is projected to surpass 20 years in 22 countries by 2030, “a level that has not been achieved so far” says the authors.

Of the 35 countries studied, the USA, Japan, Sweden, Greece, Macedonia, and Serbia have the lowest projected life expectancy both for men and women.

Currently USA, has the lowest life expectancy at birth than other high income countries and is expected to fall back further in 2030.  USA has the highest Maternal and infant mortality rate, Homicide index and BMI for any high-income country. The life expectancy in US has also stagnated or have declined for few population groups in recent years.  The authors quote "The USA is also the only country in the OECD [Organization for Economic Cooperation and Development] without universal health coverage, and has the largest share of unmet healthcare needs due to financial costs." 

In an accompanying editorial Dr. Santosa write “Forecasting life expectancy at birth and at age 65 years can help governments and health services to make the right investments in health, such as averting deaths due to infectious diseases and reducing maternal and child mortality. Achieving universal health coverage is worthy, plausible, and needs to be continued.”

Full text of the article here.
Full text of the editorial here.

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