Big rise in diseases linked to ageing and lifestyle increases healthcare burden

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The number of people becoming seriously ill or dying prematurely from conditions such as high blood pressure and obesity has risen 50 per cent since 2000, underlining the huge challenge diseases linked to ageing and lifestyle pose to overstretched health services.

The findings point to a big shift from an era in which infectious diseases and poor maternal and child health were among the biggest threats, to one where health systems must cope with “metabolism-related risk factors”, including high blood sugar and fat levels, that have led to a surge in “non-communicable” diseases such as heart disease, diabetes and cancer.

The survey, published on Thursday by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, also found life expectancy was likely to increase by nearly five years between 2022 and 2050, to just over 78. An expected rise of 9.2 years in sub-Saharan Africa is helping to drive the convergence in longevity between richer and poorer regions.

The expected global increase would be markedly slower than in the decades before the coronavirus pandemic. Between 1990 and 2019, global life expectancy increased 7.8 years, and 19.5 years between 1960 and 1990, according to the study data. The number of years lived in good health is also forecast to rise, but at a slower rate, with an increase of 2.6 years expected by 2050.

According to the study, between 2000 and 2021 there was a 49.4 per cent increase in the number of lost years of healthy life because of poor health and premature death resulting from metabolism-related factors. Ill health in people aged 15 to 49 was increasingly attributable to those factors, the researchers noted. 

In an article in The Lancet published alongside the findings, IHME director Professor Christopher Murray said “future trends might be quite different” as factors such as increased obesity, a rise in substance-use disorders and increased pollution and transmission of infectious diseases caused by climate change take their toll on public health.

Murray suggested that, to maintain progress, “adequate health workforces, policymakers who adapt to new situations and proactive strategies to deal with new threats as they emerge” would be required.

The reversal of the trends in life expectancy because of the Covid-19 pandemic — when delays to emergency care or treatment for chronic conditions were common — had been “remarkable given the nearly continuous pace of progress at the global scale otherwise seen over nearly seven decades”, he noted.

Even though the full impact of the pandemic would probably not be known for several years, it was “a stark reminder that health gains are precarious”, he added.

The study found the greatest declines in disease burden were related to maternal and child health and unsafe water, sanitation and handwashing. These numbers suggested public health measures as well as humanitarian schemes in poorer countries had been successful over the past three decades, the researchers said.

Murray told the Financial Times that “we have, except for Covid, seen progress”, partly through investment in preventive measures. This was particularly true in the poorest countries through international initiatives such as the Gavi vaccine alliance and programmes to combat malaria.

However, this preventive approach had been less apparent in “the middle income and high income world”, he said. “There has been progress but there has been less [anticipation of] where we’re going and trying to get ahead of these changes in those countries,” he said.

Data visualisation by Keith Fray