Former president Jimmy Carter, sits to pose for photos after teaching Sunday School class at Maranatha Baptist Church in his hometown Aug. 23, 2015, in Plains, Georgia.
Former president Jimmy Carter, sits to pose for photos after teaching Sunday School class at Maranatha Baptist Church in his hometown Aug. 23, 2015, in Plains, Georgia.

There’s good news and bad news about life expectancy. The good news is people are living longer. The bad news is there’s a bigger risk for poor health.

Around the world, life expectancy has risen by six years since 1990.

A new study says much of that is due to advances against HIV/AIDS and malaria.  In addition, progress has been made in reducing deaths from communicable diseases and maternal, newborn and nutritional disorders.

The top 10 places with the highest life expectancies are Japan, Singapore, Andorra, which is a microstate near Spain and France, Iceland and Cyprus, followed by Israel, France, Italy, South Korea and Canada.

The United States ranks 34th in the World Health Organization’s rankings for life expectancy. That’s believed to be due to a wide range of health issues among a diverse population.

Mortality rates

Theo Vos is the lead author of the study and professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington.  He said there has been a marked reduction in mortality rates from almost all causes.

"Most importantly, all the infectious diseases that affect young children, the neonatal problems. The problems following birth; but, we’ve also seen very steady declines in injury deaths, and the rate of mortality from some of the big non-communicable diseases are slowly – or a bit more than slowly – declining, as well," Vos said.

For many, however, the quality of life in those extra years may be marred by health problems.

"You increase the average life span of people and with increasing age you are more likely to get diseases that impair your ability to function," he said.

"While we’ve been relatively successful at reducing the big causes of death, we’ve been less successful in making a dent in these causes of long-term disabilities," he added.

Some diseases and disabilities can be prevented, but Vos said investment in treating or curing them has not kept pace with investments for major diseases.

"So we make a plea to [the] medical research community to start thinking about investing more in those big causes of disability rather than mortality.  And hopefully that will lead to some of the breakthroughs that we’ve seen that have led to the reduction in mortality."

Sub-Saharan Africa

Nine out of the 10 countries with the lowest life expectancies are in sub-Saharan Africa. Lesotho is the worst with a life expectancy of just 42 years. It’s followed by Swaziland, Central African Republic, Guinea-Bissau and Zimbabwe, then Mozambique, Afghanistan, Chad, South Sudan and Zambia.

“The big common thread there is the extent of the HIV epidemic. I actually worked for 10 years in southern Africa myself and I worked in Lesotho before HIV had affected the country. There were already a lot of poverty-related diseases,” Vos said.

Ischemic heart disease, a reduced blood flow to the heart, is the leading cause of  what’s officially known as DALY or disability-adjusted life years.

At No. 2 is lower respiratory infection, followed by stroke, low back and neck pain and road injuries.

Then there are diarrheal diseases as well as chronic obstructive pulmonary disease, known as COPD, which includes chronic bronchitis and emphysema. There are also neonatal pre-term birth complications and HIV/AIDS, as well as vision and hearing loss and mental health disorders.

Study findings

The findings are based on an analysis of all major diseases and injuries in 188 countries.

Professor Vos said the goal is to find opportunities to improve health.

He said the research will help shape the new Sustainable Development Goals that replace the United Nations' Millennium Development Goals this year.