Life follows an unstoppable pattern. For all of us it is a journey we travel only once but it has a known end point. But, all the data suggests that the length of our lives is increasing. Not only that but life is extending with good years. We are blessed with an increasing period of healthy living; our Third Age is growing.
Most evidence suggests that the onset of disability is being pushed backwards. According to the United Nations, this is due to early diagnosis and treatment of diseases. Better housing and improved accessibility to public buildings and transport also helps. It makes it easier for older people to live normal lives. Beyond eighty five, disability does set in. Even then recent studies show that things are not so bad. Of nonagenarians in the USA and Scandinavia almost half need little or no help to live a normal life.
The changes are happening so quickly that the stereotypes of different ages are out of date. Dr Robert Butler is head of the “Alliance for Health and the Future”. He points out that “in terms of health, a woman who is sixty today is equivalent to a woman of forty in 1960”. That is a twenty-year improvement in a single generation. For men, the improvement is almost as large. “Today’s eighty- year- old American man is the same as a sixty- year- old as recently as 1975”. Such is the pace of medical science and its ability to extend the “healthy life”, the Third Age.
Policy makers are interested in the same issues. It has a major bearing on the costs of social and health care. To try to come up with a metric the United Nations have combined data on death and diseases. They have looked at hundreds of diseases. Each is weighted by the degree to which it compromises the quality of people’s lives. From this they can calculate the “Global Burden of Disease”. For any country they compute a “healthy ageing span” and “years lived with disability”.
The results show that as life expectancy goes up the majority of those extra years are healthy years. The global picture shows that between 1990 and 2016, global life expectancy went up by 7.4 years. 85% of the added years were “good” years. The figures for most countries are the same. Life expectancy in the UK went up by just over five years. Nearly ninety percent of them were “healthy ageing” years. China had a huge 12.4 year increase in life expectancy. Eight years of that was without disability.
We can expect to live longer, and to be healthier longer, than we would have thought as little as twenty years ago. Lifestyles, medicine, and nutrition all impact our “healthy life expectancy”. Changes in lifestyle are not always positive. The growth in obesity in many countries has had a knock on to diseases. Diabetes and cardiovascular failure have reduced life expectancy. Even before COVID life expectancy in the USA was falling.
Governments are launching all kinds of initiatives to improve healthy life expectancy. In Japan between 2013 and 2016, the average man gained an extra year of healthy life. At the same time total life expectancy at birth rose by only nine months. Older people were doing better. This was the result of a relentless focus by the Japanese government on reducing chronic diseases. They worked on smoking, diet and changes in lifestyle.
A UK Example
The General Household Survey of the UK Government is a regular measure of opinions and lifestyles. Amongst these are self-assessments of general health and “limiting long term illness”. The latter is a subjective measure of when poor health interferes with living a normal life.
In the past 20 years the changes in this measure have been profound. Let us look at those changes.
See "Numbers" Section for Chart
The yellow lines represents the results from the identical government survey taken twenty years later. The line has moved downwards. The trend lines are roughly parallel but the yellow line is lower. Now 60% of the eighty year olds, rather than 50% in 1997, are fit and active.
The changes are huge in twenty years. In 2017, our seventy-year-old man had a thirty two percent chance of feeling that his health was limiting his lifestyle. To get the same thirty two percent on the 1997 curve would make that man only fifty-seven years old. In only twenty years the onset of such a health condition has pushed back thirteen years.
That is a phenomenal rate of change and has huge implications for the size of the “healthy ageing” market. The number of people over sixty-five increased in those twenty years. There has been a multiplier effect on the size of the "market". The proportion of them healthy enough to maintain their lifestyle, as consumers, has increased as well.
It is not a surprise that the average seventy-year-old claims to feel only sixty. Relative to their parents they are “younger”.
“COVID Sparks Biggest Fall in Life Expectancy Since Second World War”
This Newsletter was stimulated by the recent spate of articles in the media about the impact of COVID on longevity. This was the headline of the article in the Financial Times. They are all interpreting a study published by an Oxford University Institute. However Life Expectancy is defined as how long you will live if current death rates continue throughout your whole life. Over the last two years COVID has increased the death rate. The current set of articles are reporting the extrapolation of those deaths. Many do not point out that these are transitory issues. The articles are factually correct but mis-leading. There will be an underlying impact but it will not be as big as we might expect. We will have regular vaccination and the effect may be limited. The bounce back may be even quick than we anticipate. For many frail older people COVID brought forward their deaths. The Oxford study was sensationalized.