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This report examines one of the most pressing demo This report examines one of the most pressing demographic questions in modern Europe: As Europeans live longer, are they gaining more years of healthy life—or simply spending more years in poor health? Using high-quality, internationally comparable data from the Global Burden of Disease (GBD) project for 43 European countries (1990–2019), the authors analyze trends in:
Life expectancy (LE)
Healthy life expectancy (HALE)
Unhealthy life expectancy (UHLE)
The central aim is to determine whether Europe is experiencing compression of morbidity (more healthy years) or expansion of morbidity (more unhealthy years) as longevity rises.
🔍 Key Findings
1. All European regions show rising LE, HALE, and UHLE
Across Central/Eastern, Northern, Southern, and Western Europe, both life expectancy and years lived in poor and good health have increased. But the balance differs sharply by region and over time.
2. Strong regional disparities persist
Southern & Western Europe enjoy the highest HALE levels.
Central & Eastern Europe consistently show lower HALE, strongly affected by the post-Soviet mortality crisis in the early 1990s.
Northern Europe sits between these groups, gradually converging with Western/Southern Europe.
3. Women live longer but spend more years in poor health
Women have higher LE, HALE, and UHLE, but their extra years tend to be more unhealthy years. The expansion of morbidity is more pronounced among women than men.
4. Countries with initially lower longevity gained more healthy years
The study finds a strong pattern:
Countries with low LE in 1990 (e.g., Russia, Latvia) gained longevity mainly through increases in HALE—over 90% of LE gains came from added healthy years.
Countries with high LE in 1990 (e.g., Switzerland, France) gained longevity with a larger share of new years spent in poor health—only around 60% of gains came from healthy years.
This reveals a structural limit: as countries approach high longevity ceilings, further gains tend to add more years with illness, because the remaining room for improvement lies in very old age.
5. Europe is experiencing a partial expansion of morbidity
The results align more closely with Gruenberg’s morbidity expansion hypothesis (1977) than with Fries’ compression of morbidity theory (1980).
Why?
Because at advanced ages—where further mortality reductions must occur—chronic disease and disability are common. Thus, more longevity increasingly means more years with illness, unless major health improvements occur at older ages.
6. Spain stands out as a positive case
Spain shows:
One of the highest life expectancies in Europe
A very high proportion of years lived in good health
A favorable balance between HALE and UHLE increases
Spain is a standout example of adding both years to life and life to years.
🧠 Interpretation & Implications
If longevity continues rising beyond 100 years (as some projections suggest), Europe may face:
More years lived with multiple chronic conditions (co-morbidity)
Increasing pressure on health and long-term care systems
A widening gap between quantity and quality of life
Policy implications
The authors emphasize the need to:
Delay onset of disease and disability through public health and prevention
Promote healthy lifestyles and supportive socioeconomic conditions
Invest in new medical treatments and technologies
Improve the quality of life among people living with chronic illness
Without such interventions, rising longevity may come at the cost of substantially more years lived in poor health.
🏁 Conclusion
Europe has succeeded in adding years to life, but is only partially succeeding in adding life to those years. While life expectancy continues to rise steadily, healthy life expectancy does not always rise at the same pace—especially in already long-lived nations.
For most European countries, the future challenge is clear:
How can we ensure that the extra years gained through rising longevity are healthy ones, not years spent in illness and disability?... |