I’m one of life’s optimists. When I think about living to be 100 years old, I picture a birthday party where I am surrounded by my devoted descendants, perhaps followed by a commercial space flight as a celebratory treat.
But I’m in the minority here. A lot of people would rather be dead. In a recent UK poll by Ipsos, only 35 per cent of people said they wanted to become centenarians.
Men were keener on the idea than women (43 per cent to 28 per cent) — a shame really, since women are more likely than men to achieve it. Age is a factor too: older people are less likely to want to live to 100 than younger ones, perhaps because they have already had a taste of poor health, or have gone through the experience of caring for elderly parents who suffered in their later years. In the poll, fewer than one in five people thought they would have a good quality of life if they reached 100.
We all know that life expectancy has risen globally over the last century thanks to advances in healthcare and medicine as well as improvements in education and living standards. In the UK in 2020, the number of centenarians reached more than 15,000, up almost a fifth on the year before. But — as is clear by how many don’t want to live to be 100 — “healthy life expectancy” is probably a better measure of what people actually want.
Healthy life expectancy — a measure of the number of years someone is expected to live in good health — is not a perfect metric, since it’s based on health and mortality rates now rather than projections of how they might change. But it’s still useful. What can it tell us?
First, while it has been rising globally, it has not kept pace with improvements in overall life expectancy, according to a study of 195 countries between 1995 to 2017.
Second, women might outlive men, but the number of years they can expect to live in good health is very similar. In the EU, for example, life expectancy for women in 2020 was 5.7 years longer on average than for men, but the healthy life expectancy gap was only one year.
Third, as with overall longevity, the correlation between healthy life expectancy and gross domestic product per head becomes pretty loose once countries have passed a certain level of development. Greece and Germany have very similar healthy life expectancy numbers, for example, even though Germany is significantly richer.
There are some stark differences between neighbours, too. In 2020, a man born in Finland or Denmark could expect to live between 73 and 74 per cent of their lives free from health limitations, a raw deal compared with the 90 per cent on offer in Sweden. Cultural factors play a role, from the Mediterranean diet in Greece to alcohol use in Finland.
In the UK, which ranked in the middle of the EU countries before Brexit, things aren’t looking good. In the years before the pandemic, healthy life expectancy had stagnated for men at 62.9 years and had begun to fall slightly for women to 63.3 years.
The differences between rich and poor are also vast. In England, women living in the most deprived areas have a healthy life expectancy at birth of 51.4 years compared with 71.2 years for women living in the least deprived areas.
David Finch, an assistant director at the Health Foundation, says UK policymakers should be “very worried” about the trend, given the country was hardly top of the league table to begin with. “When you can see that clear space for improvement and we stop improving, it’s particularly concerning.”
There are plenty of possible reasons why health has worsened, from rising obesity and alcohol misuse to the impact of government spending cuts after 2010 and the broader impact of a decade without any real wage growth.
Britons’ fraying health has now become a problem for the labour market, with a rising share of people too sick to work. That is a reason to pay attention, of course. But we should have been paying attention anyway. Health doesn’t just matter because it has an impact on the economy; it matters because it’s what people want.
The government has set an ambitious target to increase healthy life expectancy by five years by 2035. Such rapid improvements are possible: it increased by four years in the first decade of the millennium. But that was a time of sustained economic growth and higher social spending. It’s hard to imagine that’s what the next decade will look like, even for an optimist like me.