Health and Healthcare Systems

This is where people live the longest in the EU

An elderly women plays a game in a care home setting

The secret to a long life? Live in Spain. Image: REUTERS/Eddie Keogh

Alex Thornton
Senior Writer, Forum Agenda
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  • Spain and Italy have the longest-lived populations in the EU.
  • There are large variations in life expectancy across Europe, a new Organisation for Economic Co-operation and Development (OECD) report shows.
  • The data reflects the situation prior to the COVID-19 pandemic. It is possible that in the worst-hit countries, 2020 could see a decline in life expectancy for the first time in decades.

“In this world nothing can be said to be certain, except death and taxes,” as Benjamin Franklin remarked. But just as tax rates differ depending on the jurisdiction, so life expectancy varies across borders.

As the chart below shows, there are big gaps in longevity even between the relatively affluent countries of Europe, where a Spanish woman can expect to live more than 16 years longer than a Latvian man.

a graph showing life expectancy in Europe
Life expectancy varies greatly access Europe's different economies. Image: OECD

So what makes some countries more conducive to a long life than others?

What people eat is a major factor. Long life is more common in places where the Mediterranean diet is the norm, such as Spain, Italy and Cyprus. Numerous scientific studies have proved the benefits of the typical Mediterranean diet: high in vegetables, fruits, nuts, olive oil and fish, and low in meat (especially red meat) and most dairy products. The combination reduces the risk of strokes and heart attacks, the two biggest killers worldwide. At the other end of the scale, there is a much higher incidence of heart and circulatory diseases in Eastern Europe, the Balkans and the Baltic states.

Health spending also plays a significant role. Switzerland and the Scandinavian countries spend three or four times the amount of money per capita on healthcare than the average in Eastern Europe. This mirrors the situation in the rest of the world, where there is a strong correlation between health and wealth.


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Other factors that can affect longevity include lifestyle choices such as alcohol consumption and smoking, environmental issues like air pollution, and genetics. In every country, women tend to live significantly longer than men, with the biggest gaps in the Baltic states, and the smallest in the Netherlands.

A long life doesn’t necessarily mean a healthy old age, as the chart below demonstrates.

Life expectancy and healthy life years at birth, by gender, 2018 (or nearest year)

a graph showing life expectancy in Europe
Women are expected to live longe than men. Image: OECD

For example, both men and women in Bulgaria are healthy and active for longer than in Portugal, even though their overall life expectancy is less. As more nations have ageing populations, getting more out of later life is becoming an increasingly important challenge.


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There is a caveat to the data in the OECD report: it all predates the COVID-19 pandemic. Until 2018, life expectancy had been increasing across the EU, although more slowly in recent years. It is possible that in the worst-hit countries, among them Spain and Italy, 2020 could see a decline in life expectancy for the first time in decades.

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Related topics:
Health and Healthcare SystemsGeographies in Depth
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