Global life expectancy reached 73.8 years in 2023, up from 64.6 years in 1990, but the gains were accompanied by a widening morbidity gap, according to a report published in Lancet Public Health using Global Burden of Disease 2023 estimates.
The study found that the global morbidity gap—the difference between overall life expectancy and healthy life expectancy—increased from 8.8 years in 1990 to 10.7 years in 2023. While worldwide healthy life expectancy rose from 55.9 years to 63.1 years over the same timeframe, people spent an average of 14.5% of their lives in poor health in 2023, compared with 13.6% in 1990.
Regional Disparities and Demographic Trends
According to the Institute for Health Metrics and Evaluation (IHME) analysis, the largest morbidity gap in 2023 was recorded in the United States at 14 years. Australia followed closely with a gap of 13.9 years, while Canada registered 13.7 years.
“The central finding is that we are adding years to life faster than we are adding health to those years,” Simon I. Hays, DPhil, DSc, FMedSci, director of research strategy at IHME, told Healio.
The report also highlighted distinct demographic differences across regions. Women consistently lived longer than men across all studied areas, but they also experienced a higher number of years in poorer health. Data showed that women possessed an average morbidity gap of 12.1 years in 2023, compared with 9.3 years among men.
Drivers of Unhealthy Years
Researchers reported that mostly nonfatal conditions accounted for 57.4% of unhealthy years globally in 2023. These contributors included musculoskeletal disorders, depressive and anxiety disorders, age-related hearing loss, falls, and other noncommunicable diseases. In lower socio-demographic index contexts, nutritional disorders also contributed substantially to the total burden of unhealthy years.
Despite the rise in chronic nonfatal ailments, Hays noted an encouraging aspect for clinicians: the conditions driving the gap are largely preventable or manageable. Because these issues are rarely the primary causes of mortality, healthcare providers have clear avenues for intervention.
Clinical Guidance and Prevention Strategies
Based on the findings, researchers and clinical experts outline several approaches to narrow the morbidity gap and extend healthspan:
- Aggressive Upstream Management: Addressing modifiable drivers such as high blood sugar, obesity, high blood pressure, and tobacco use early through glycemic control, weight management, blood pressure control, and smoking cessation.
- Targeted Screening: Screening and treating mental health disorders, hearing loss, and falls risk among older adults.
- Conservative Pain Management: Treating low back pain with early activity, physiotherapy, and self-management rather than escalating directly to imaging or opioids.
- Holistic Patient Tracking: Asking patients about hearing, independence, mood, mobility, and pain, and tracking those areas over time rather than focusing exclusively on disease labels and biomarkers.
- System Preparation: Preparing healthcare systems for patients to live longer with multiple chronic conditions.
Complementing these clinical directives, John Findley, MD, CPE, representing the American College of Lifestyle Medicine, emphasized that lifestyle medicine pillars—optimal nutrition, regular physical activity, restorative sleep, stress management, connectedness, and avoidance of risky substances—work synergistically to preserve functional independence and quality of life.
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