Rising Life Expectancy: A Human Success Story

 

With the constant barrage of negative news over the last few months, its time for some good news.  One of the great success stories of human achievement has been the increase in life expectancy at birth.  Once upon a time, as Thomas Hobbes wrote, the natural condition of mankind was “nasty, brutish and short” and one should emphasize the short part. And this shortness of life had been the normal situation for centuries.  What is a substantial achievement is the increase in life expectancy at birth over the course of two centuries because of improvements in nutrition and public health as part of a process of economic development and economic growth.  While improvements in medical care have been a factor, these other factors were much more important initially particularly as they reduced the high rates of child mortality. Anyone familiar with 19th century Canadian census data knows that at one time half of deaths were children under age five that were carried away by an assortment of maladies that today are in the distant past.

If one goes to Our World in Data and checks out the life expectancy calculators, one finds that in 1770, average world  life expectancy at birth was a mere 28.5 years.  By 1850, it had risen to 29.3 years and by 1900, 32 years.  By 1960 it had risen to 47.8 years, but a fair amount of divergence had emerged around the world.  For example, in 1900, life expectancy at birth was 42.7 years in Europe and 41.0 in the Americas but only 28.0 years in Asia. By 1960, Europe was at 68.7 years, the Americas at 60.8 and Asia at 41.8 years.  Fast forward to the present, and life expectancy at birth is 79.1 years in Europe, 77.3 years in the Americas and 74.6 years in Asia.  From 1850 to 1900, world life expectancy at birth went from 29.3 to 32 years and by 1960 it reached 47.8 years.  Amazingly, the period since 1960 has added another 25.4 years bringing world life expectancy at birth to 73.2 years.

Of course, the results of broad based economic and social development have played a major role in less developed parts of the world resulting in large gains in life expectancy at birth but even the developed world has seen substantial gains.  Figure 1 plots life expectancy at birth for OECD countries in 1960/61 and 2021/22 (taking the higher of the two-year spread as some years have missing data) and ranks them by life expectancy in 2021/22.  At the top is Japan with a life expectancy at birth for the total population (male and female rates differ) of 84.5 years followed by Switzerland at 83.9 and Korea at 83.6.  Canada ranks 18^th of these 30 countries while Mexico is at the bottom at 75.2 years.  Between these two time points, the average went from 68.7 years to 81.1 years for gain of 12.4 years.

 

 

Figure 2 plots the years of life expectancy at birth gained for these OECD countries between 1960/61 and 2021/22.  At the top are Korea, Turkey (Turkiye), Portugal and Mexico at 31.2, 28.5, 17.9 and 17 years respectively.  At the bottom are the Netherlands, Hungary, the Slovak Republic and the United States at 7.9, 7.1, 6.4 and 6 years respectively.  Canada managed to add 10.3 years to life expectancy at birth over this period which is just a bit below the average of 12.4 years.  The largest gains in years have accrued to countries that were at low points in the early 1960s not only in terms of life expectancy but also economic development. 

 

 

The rapid economic development Korea and Turkey were accompanied by spectacular gains in life expectancy.  Indeed Figure 3 shows the largest gains accrued on average to countries with lower life expectancy in 1960/61 – they simply had more to gain as economic development progressed.  In life expectancy, as in everything else, one expects there are diminishing returns over time.  Nevertheless, the performance of the world’s largest economy, the United States can be seen as a bit disappointing given as a share of GDP it spends the most on health of these OECD countries and ranked 28^th out of 30^th in terms of life expectancy in 2021/22 and dead last in terms of years gained since 1960/61.

 

 

In terms of what accounts for all this differential performance, that is of course a topic for another day.  However, the good news is that the human species during the 20^th century managed to escape from its Hobbesian fate and a child born today particularly in highly developed countries can expect a life expectancy at birth approximately double what was the case in 1900.  Despite all the doom and gloom, we should take that as a win.

Canada's Life Expectancy at Birth in Decline

 

Standards of living are marked by a number of indicators most upfront of which are economic measures such as per capita GDP or per capita wealth.  However, other indicators of the standard and quality of life include basic health indicator and life expectancy at birth has long been a marker of the average “quantity of life” a country provides.   Yet after the increases of the twentieth century and 21^st centuries which saw average life expectancy in the world rise from 32 years in 1900 to 71 in 2021, much of the world has seen a decline in recent years in the wake of the COVID-19 pandemic.   Statistics Canada has already noted that for three years in a row, life expectancy at birth for Canadians has declined from 2019 to 2022 with this decline being driven by an increase in unexpected deaths (such as substance related deaths, suicides and homicides) as well as the impact of COVID.

 

However, what is more interesting in the Canadian case is just as real per capita GDP growth slowed after 2010, so did the growth in life expectancy at birth which highlights the connection between economic growth and performance and ultimately health indicators such as life expectancy.  The accompanying figure plots life expectancy at birth for Canada and Ontario at assorted overlapping three-year intervals since 2005 and they show that life expectancy at birth grew from 2005/07 to 2011/13 from 80.51 years to 81.73 years for Canada and 80.86 years to 82.19 years for Ontario.  Growth then slowed and life expectancy at birth peaked at 81.94 years from 2015 to 2018 for Canada and 82.41 years for Ontario.  Since then, both have declined hitting 81.55 years for Canada and 81.97 for Ontario by 2020-22.

 

 

 

While much of the decline definitely coincides with the pandemic, life expectancy was essentially flat from approximately 2011/13 to 2017/19 when the decline begins but then accelerates during the 2019/2021 window as the pandemic strikes.  So, the takeaways I get from this is that the pandemic indeed is associated with a decline in life expectancy at birth, but growth had already plateaued and begun to slip well before this in the wake of the 2008/09 recession and the slower economic growth and performance since.  The pandemic appears to have strained or augmented whatever forces were already in play prior to 2020. 

 

Of course, one might ask if this has also occurred in other countries.  For example, a quick glance shows life expectancy at birth in Japan rising from 2012 until 2020 before a decline set in going from 83.1 years to peak at 84.56 in 2020 before declining to 84 by 2022.  From 2012 to the pandemic start in 2020, life expectancy at birth grew 1.8 percent in Japan but only 0.2 percent in Canada.  Germany, on the other hand from 2012 to 2020 grew by 0.6 percent (from 80.54 to 81.04) years.  The United States on the other hand saw life expectancy essentially flat since 2012 (growing just under 0.1 percent) to the pandemic with a decline during the pandemic.  These trends are food for thought indeed.