Two different years
In its latest Global Health Estimates, the World Health Organization put life expectancy at 73.3 years in 2023. That figure sits close to the 73.4 years estimated for 2019, before the COVID-19 pandemic. The same measure had fallen to 71.5 years in 2021. Healthy life expectancy recovered more slowly: it stood at 62.8 years in 2023, 0.4 years below its 2019 level. A restored lifespan and a year lived in good health are separate results when they stand side by side.[1]
Alain Labrique heads the organization’s data department. He described longer life as a public-health achievement. While health systems adapt to changing needs, he tied the next challenge to living the additional years in good health. I read that sentence as the gap between 73.3 years and 62.8 years. The collective choice is what those added years are for.[1]
However, a narrower reading stays open. These figures are estimates. The slower recovery of healthy life expectancy does not show which adaptation closes the distance. The same estimates also record that noncommunicable diseases rose from 58 per cent of deaths in 2000 to 74 per cent in 2023. Dementia deaths tripled over the period the estimates cover. Because the mix of deaths may have changed, the distance need not stand as the work of one adaptation.[1]
What the added years carry
There were 61 million deaths worldwide in 2023. The ten leading causes of death made up 33 million of them. Eight of those ten causes were noncommunicable diseases. Ischaemic heart disease remained first: approximately 9.5 million deaths, 16 per cent of all deaths. Stroke took approximately 11 per cent, and chronic obstructive pulmonary disease approximately 6 per cent.[1]
Lower respiratory infections ranked fourth and were the deadliest communicable disease. Alzheimer’s disease and other dementias ranked fifth, with approximately 2.1 million deaths. COVID-19 fell outside the ten leading causes of death for the first time since the pandemic began. Deaths attributed directly to it were approximately 900,000 in 2023, and the disease ranked fourteenth. That figure was 5.3 million in 2020 and 9.4 million in 2021. The estimates also show a sharp rise, since the pandemic, in health loss linked to anxiety and depression.[1]
You can set these two numbers side by side tonight. A lifespan looks restored at 73.3 years, while healthy life expectancy remains 0.4 years behind 2019. Dementia deaths have tripled, and health loss linked to anxiety and depression has risen. The estimates do not say which adaptation of health systems would close that difference. If a later estimate moves the healthy-life figure, that movement is what would show the added years lived in better health. For me the open question stays small: whose changing needs are these, and do the added years become that person’s healthy years?[1]