Healthy lifespan inequality: morbidity compression from a global perspective

Area of Science:

• Epidemiology
• Public Health
• Gerontology

Background:

• Current population health metrics overlook age-at-morbidity onset variability.
• Assessing health deterioration timing and morbidity compression requires new indicators.
• Healthy Lifespan Inequality (HLI) offers a novel approach to measure these patterns.

Purpose of the Study:

• To estimate global, regional, and national healthy lifespan inequality (HLI) from 1990 to 2019.
• To analyze trends in morbidity onset variability and its relationship with lifespan inequality (LI).
• To investigate the impact of increasing longevity on health inequality.

Main Methods:

• Utilized data from the Global Burden of Disease Study 2019.
• Reconstructed age-at-death and age-at-morbidity onset distributions.
• Calculated Lifespan Inequality (LI) and Healthy Lifespan Inequality (HLI) using standard deviation.

Main Results:

• Global HLI decreased from 24.74 to 21.92 years between 1990 and 2019.
• HLI decreased in most regions, except high-income countries where it remained stable.
• HLI is generally higher than LI, particularly for females, and shows increasing inequality at age 65.

Conclusions:

• Morbidity is compressing globally, but this trend stagnates in high-income countries.
• Health inequality is shifting from mortality to morbidity and disability.
• Further reductions in HLI are not guaranteed with increasing longevity, even in leading nations.