Females in India can expect on average to live almost three years longer than males. But when it comes to living a healthy life, the difference almost vanishes. This pattern of large gender differences in life expectancy but much smaller ones in healthy life expectancy is not unique to India. Public health experts say this global phenomenon could be due to poorer access to healthcare and attention to health, especially among older women.
According to the World Health Statistics report of 2021 released recently, globally, women can expect to live an average five years longer than men, but when it comes to healthy life expectancy, that advantage shrinks to less than half as much at 2.4 years. The data also shows that the global average difference between life expectancy and healthy life expectancy is around nine years, which means that though life expectancy might be high, the last nine years would not be healthy.
Many health experts have expressed concern that health and medical research has focused overly on prolonging life rather than on living healthier by slowing down aging to improve the quality of old age. This matters most in the 30-odd countries that have life expectancy of 80 years or more. They witnessed a small improvement in life expectancy in the 2012-19 period, but healthy life expectancy either remained stagnant or even declined.
However, in less developed countries still struggling to increase life expectancy, the improvements in life expectancy and in healthy life expectancy seem to keep pace. In fact, several countries have recorded greater improvement in healthy life expectancy than in life expectancy.
In just two countries, Oman and Afghanistan, do men have higher life expectancy than women. But in about a dozen other countries, men have higher healthy life expectancy than women. Most of these are also those with poor gender equality. Countries where the difference in healthy life expectancy between men and women is most narrow include India, Pakistan and Bangladesh, several sub-Saharan African countries and those in the Middle East.
“Women’s life expectancy is significantly higher than men’s, but this advantage does not translate to women having healthier lives. There are several reasons for this disparity, including women’s lack of access and decision-making about their health and bodily autonomy. The recently released Longitudinal Aging Survey of India reveals a high prevalence of reproductive health problems among older women beyond the childbearing age group. Older women also have a higher incidence of cardiovascular diseases and suffer from poor nutritional status as compared to their male counterparts,” explained Poonam Muttreja, executive director of the Population Foundation of India.
Interestingly, in some of the most developed countries with the highest life expectancy, like Sweden, the Netherlands and Switzerland, the difference in healthy life expectancy between men and women is very slim compared to the difference in life expectancy. This seems to be because of them hitting a sort of ceiling when it comes to healthy life expectancy, which seems to be about 71-72 years for both sexes.
Of the 30 countries at the top of the life expectancy table, Japan, Singapore and South Korea alone have a healthy life expectancy over 73. Life expectancy is currently increasing more rapidly than healthy life expectancy, so that morbidity (average number of years lived in poor health) is slowly expanding, pointed out Guy Brown of the University of Cambridge in his paper titled “Living too long” published in 2014 in the journal Embo Reports. He urged a switch in medical research funding from causes of death to causes of aging and age-related morbidity.
“The effort is to reduce the gap between life expectancy and healthy life expectancy. Over time, we can surely reduce this gap though pace of reduction will be slower. But finally, there is a limitation to how much you can expand the healthy years,” explained Dr K S James, director of the International Institute of Population Sciences.