Over the past two decades, trends in life expectancy and health-adjusted life expectancy have revealed a growing disparity between the years people live and the years they live in good health, known as the healthspan-lifespan (longevity) gap. Singapore, with its rapidly aging population is working hard to address this issue.
This global phenomenon, documented across 183 World Health Organisation member states, highlights a critical issue: while people are living longer, they are spending more years burdened by disease. This widening gap - an area of public health focus in Singapore - underscores the urgent need to shift healthcare systems toward proactive, wellness-focused approaches.
As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to relevant studies and resources at bottom of page.
A Global Study
The study (Garmany et al) found significant disparities in this gap, with variations across sexes and regions. Women experience a more pronounced healthspan-lifespan gap due to their higher life expectancy and the greater burden of noncommunicable diseases, such as musculoskeletal conditions. The United States emerges as a striking outlier, with the largest gap and the highest burden of noncommunicable diseases, driven by mental health and substance use disorders as well as musculoskeletal issues. These findings highlight the interplay between increased longevity, disease burden and healthspan, especially in high-income nations.
Globally, health-adjusted life expectancy is becoming a key metric for understanding healthy longevity - how long people live free from disease - rather than just their total years of life. However, as this study demonstrates, the number of years people live with disease is growing, revealing a troubling paradox: reduced acute mortality rates are exposing more people to prolonged chronic disease burdens. This trend undermines the success of extended life expectancy and calls for urgent strategies to narrow the gap.
Addressing this challenge requires multifaceted solutions. Preventative measures, such as promoting healthier lifestyles and tackling risk factors like poor nutrition and physical inactivity, must complement advancements in curative treatments. Tailored interventions at national and regional levels can also address unique disease burdens, ensuring equitable and effective approaches to healthy ageing.
Importantly, the study advocates for a pivot in societal focus, from merely increasing longevity to enhancing the quality of those additional years.
A Focus on Singapore
Singapore is set to become the fastest ageing country by 2025, with 25% of its population projected to be over 65 years old by 2030.
While medical advancements have extended life expectancy among Singaporeans by 8.7 years to an impressive 84.8 years - one of the highest globally - healthy life expectancy, or healthspan, has only risen by 7.2 years to 74.2 years. This means Singaporeans are spending roughly a decade of their later years in poor health.
The Singapore government has implemented several key initiatives to enhance the healthspan of it's people: the Healthier SG initiative (for preventative health), establishing the Centre for Healthy Longevity at the National University of Singapore and numerous community based and workplace health initiatives.
The Role of the Individual in Narrowing the Gap
While systemic change is vital, individuals must also take responsibility for their own health by prioritising self-care. This includes adopting healthier behaviours such as regular physical activity, balanced nutrition and sufficient sleep, as well as managing stress and avoiding harmful habits like smoking or excessive alcohol consumption. Proactive engagement with one’s health through regular check-ups and early detection of diseases can make a substantial difference in extending healthspan.
By understanding the impact of daily choices on long-term health, individuals can take meaningful steps to reduce their personal healthspan-lifespan gap and contribute to the broader goal of sustainable healthy ageing.
Final Thoughts
The healthspan-lifespan gap is a universal challenge that demands coordinated global and local efforts. By prioritising health-adjusted life expectancy, fostering preventative care and addressing disparities in disease burdens, nations can work toward bridging this gap.
Equally, and more in our realm of immediate concern, individuals have a vital role to play in safeguarding their health through informed, proactive self-care.
Only by focusing on both the quantity and quality of life can we ensure sustainable and equitable healthy ageing for future generations. And this is both our personal area of focus and that of our clients and community.
Improving health is about finding motivation, prioritising self-care and taking action. If you want to take effective and targeted steps that fit into your unique lifestyle, The Whole Health Practice is here to help.
Whether your interest is healthspan and longevity, to beat chronic illness or to enhance your mental health and wellbeing, our consultations and programs deliver results that are tailored to your needs.
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Stay Healthy,
Alastair
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Related Studies and Resources
The study in question... Garmany A, Terzic A. Global Healthspan-Lifespan Gaps Among 183 World Health Organization Member States. JAMA Netw Open. 2024 Dec 2;7(12):e2450241. doi: 10.1001/jamanetworkopen.2024.50241. PMID: 39661386; PMCID: PMC11635540.
Centre for Healthy Longevity at the National University of Singapore
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