Global life expectancy reached 73.8 years in 2023, up from 64.6 years in 1990, but people are spending a larger proportion of those extended lives coping with chronic illnesses and disabilities, according to a study published in The Lancet Public Health by researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine.
Global Morbidity Gap Widens Across 203 Countries
The “morbidity gap”—defined as the number of years individuals spend dealing with poor health—widened across 203 of the 204 countries and territories analyzed between 1990 and 2023. According to the IHME findings, humans globally spent an average of 14·5% of their lives in poor health in 2023, compared to 13·6% in 1990. While healthy life expectancy rose from 55.9 years to 63.1 years over the same period, survival gains consistently outpaced improvements in healthspan.
In the United States, the morbidity gap stands at approximately 14 years, representing 17.8% of the expected lifespan, making it the most pronounced in the world. Researchers observed that the gap widened most in wealthy nations where populations benefit from life-extending resources. Furthermore, data shows that women live longer than men but also spend more years in poor health.
Drivers of Chronic Disease and Functional Decline
A small group of predominantly non-fatal chronic conditions accounted for roughly 57% of all years lived in poor health worldwide, according to the IHME dataset. Musculoskeletal disorders—chiefly low back pain—along with mental health conditions like depression and anxiety, hearing loss, and falls drive the global morbidity burden. Additional major contributors include high fasting plasma glucose, obesity and aging populations.
Dr. Antony Chu, a clinical assistant professor at Brown University’s Warren Alpert School of Medicine, noted that modern medicine has excelled at delaying death from cardiovascular disease, cancer, trauma, and infectious illnesses. However, Chu stated that many of those added years involve managing chronic pain, sensory loss, and reduced independence.
“To me, the most important message of this study is not that people are living longer — it is that we have become far better at delaying death than delaying functional decline,” Chu said.
Shifting Focus From Lifespan to Healthspan
Dr. Christopher Murray, director of the IHME and senior author of the study, emphasized that future improvements in population health depend on extending healthspan rather than lifespan alone. Murray argued that healthcare systems must prioritize prevention, long-term disease management, and chronic care.
According to Chu, clinical practice should transition toward preserving physical and cognitive function by routinely assessing mobility, muscle strength, balance, and resilience alongside standard metrics like blood pressure and cholesterol. Incorporating progressive resistance training, fall prevention, and early mental health interventions can help mitigate the compounding effects of loneliness, depression, and physical decline.
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