Changes in Life Expectancy and Diseases Profile – Asrar Qureshi’s Blog Post #913

Changes in Life Expectancy and Diseases Profile – Asrar Qureshi’s Blog Post #913

Dear Colleagues!  This is Asrar Qureshi’s Blog Post #913 for Pharma Veterans. Pharma Veterans  aims to share knowledge and wisdom from Veterans for the benefit of Community at large. Pharma Veterans Blog is published by Asrar Qureshi on  WordPress, the top blog site. Please email to asrar@asrarqureshi.com for publishing your contributions here.

Credit: Yan Krukau

Erin Li

Credit: Ivan Smakov

Credit: Yan Krukau

“In many respects, health is a remarkable success story. Over the past century, life expectancy has dramatically increased in most parts of the world. But the portion of life we human beings spend in moderate and poor health has not changed, meaning we spend more years in poor health than at any point in history. Moreover, significant inequity continues to exist across and within countries”. 

What is good health? It is the state in which we are able to lead productive and enjoyable lives. WHO proposed back in 1948 that health is a “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity’. The sub-component of ‘spiritual health’ has also been recognized as relevant to health for a long time.

When we talk of endemic diseases, we talk of disease burden. For example, Hepatitis C, Malaria, and Typhoid are endemic to Pakistan. Every year millions of people suffer, productive days are wasted, and precious lives are lost. Disease burden therefore is calculated number of years lost and value of productivity loss.

Changes in Life Expectancy

Over the past centuries, there has been a steady global increase in life expectancy. Advances in healthcare, medical technologies, and improved living conditions have contributed to this positive trend. For example, between 1800 and 2019, average global life expectancy more than doubled, from 30 years to 73 years. Since 1900 in the US, infant mortality has fallen by 90% and maternal mortality has decreased by 99%. Pakistan still reports higher rate of maternal mortality – 186 deaths per 100,000 live births – which is higher than India and Bangladesh. Infant mortality at 56 deaths per 1,000 live births is also higher than comparable countries.

Since 1960, there has been a significant increase in average global life expectancy – from 54 years to 73 years in 2019. 

While life expectancy has risen globally, certain regions continue to experience disparities. Developed nations often witness more substantial gains, whereas some developing regions face challenges due to issues like infectious diseases, inadequate healthcare infrastructure, and socioeconomic disparities.

The world is also seeing a significant increase in the aging population. Factors such as declining fertility rates and advancements in healthcare that address age-related diseases contribute to this demographic shift.

Breakthroughs in medical research and technology have led to improved treatments, earlier disease detection, and enhanced management of various health conditions, contributing to increased life expectancy.

Successful vaccination programs targeting infectious diseases have played a crucial role in preventing the spread of certain illnesses and reducing mortality rates, especially among children and vulnerable populations.

Public health initiatives, such as smoking cessation campaigns, improved sanitation, and awareness programs, have had a positive impact on life expectancy by addressing lifestyle-related risk factors.

Increased global collaboration and information sharing have facilitated a more coordinated response to health challenges, enabling faster identification and containment of infectious diseases.

Persisting Poor Health Outcomes

While we may rightly celebrate the achievements above, the share of our lives we spend in poor health has remained consistent. On average, people spend about 50% of their lives in less than good health, including 12% in poor health. The best available data suggest that thus ration has not changed much in the past 50 years. However, due to longer lives, we spend more years in moderate and poor health. The situation is worsening in the affluent countries as chronic conditions now afflict growing numbers of people for a significant portion of their lives.

Literature on life satisfaction shows that having a substantial health problem, defined as declining from good health to poor health, reduces life satisfaction twice as much as losing a job, or becoming widowed, divorced, or separated, and five times as much as losing half of one’s income.

Still, numerous threats to human health remain insufficiently addressed. There are substantial unmet patient needs in cancer, diabetes, cardiovascular conditions, and brain disorders. In addition, mental health issues have increased by 55% since 1990, and researchers anticipate further 17% growth till 2040. Suicide rate has increased worldwide; in the US, it has become the second leading cause of death for people between the ages of 10 and 34. Global cases of dementia are expected to triple by 2050, affecting more than 150 million people. The rise in chronic, debilitating, lower back pain has tripled globally – from 4% to 13% of the world population. 

The decades have also witnessed an ongoing epidemiological transition, marked by a shift from infectious diseases to non-communicable diseases (NCDs). Cardiovascular diseases, diabetes, and cancer have become more prevalent, demanding a shift in healthcare priorities.

Despite advancements, the emergence of new infectious diseases, such as the SARS-CoV-2 virus causing COVID-19, highlights the dynamic nature of global health. The ability to respond swiftly to such challenges has become a critical aspect of public health.

Changes in lifestyle patterns, including diet, physical activity, and stress levels, have contributed to an increase in lifestyle-related diseases. Obesity rates have surged, leading to a rise in conditions like Type 2 diabetes and cardiovascular diseases.

Health inequity remains a major cause. There are disparities in access to healthcare, quality of healthcare, and affordability between and within countries and regions, and across gender and other demographic indicators. There is an 18-year gap in average life expectancy between low- and high-income countries, and a 30-year gap between the lowest and highest life expectancy. Maternal mortality rates are 50 or even 100 times higher in low-income countries. Childhood cancer survival is as low as 30% in LMICs. Globally, women’s mental health is at its lowest in 15 years and significantly below the overall population average. In New York City, Black non-Hispanic women are 8 times more likely to die of pregnancy-related complications than White women. In England, the residents of London have a life expectancy three years longer than the residents of Northeast.

What Can be Done?

“Humanity has the wealth, technology, capacity, and know-how to set and pursue a bolder aspiration for our health”. 

First, many countries across income levels have already made significant gains in healthy life expectancy within a decade. South Africa, Thailand, Oman, Ireland, and Bolivia are good examples. Five ‘Blue Zones’ are regions in the world where people are claimed to have longer than average. These are Sardinia, Italy; Okinawa, Japan; Nicoya, Costa Rica; Icaria, Greece; and Loma Linda, California.

Second, tremendous untapped potential exists in the systematic, equitable, and extensive application of existing knowledge. Previous research by McKinsey Global Institute in 2020 concluded that by applying existing and close-to-market therapies, we could eliminate abut 40% of the current global disease burden by 2040.

Third, global response to COVID-19 demonstrates that remarkable innovations and behavior changes can happen quickly when intense focus is combined with resources and collaboration across governments, businesses, nonprofits, and communities. Similar spirit should be applied to find cures and interventions to achieve equitable health for all.

Concluded.

Disclaimer. Most data in this article have been taken from McKinsey article titled ‘Adding years to life and life to years’ by Erica Coe, Martin Dewhurst, Lars Hartenstein, Anna Hextall, Tom Latkovic. Link to the article appears below.

Disclaimer: Pictures in these blogs are taken from free resources at Pexels, Pixabay, and Google. Credit is given where available. If a copyright claim is lodged, we shall remove the picture with appropriate regrets.

Reference:

https://www.mckinsey.com/mhi/our-insights/adding-years-to-life-and-life-to-years