Health and Healthcare Systems

We’re spending more years in poor health than at any point in history. How can we change this?

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We are now spending more years in poor health than at any time in our history. Image: UNSPLASH/ Emma Simpson

Douglas Broom
Senior Writer, Forum Agenda
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  • Life expectancy is rising, but we are also spending more time living in poor health.
  • It doesn’t have to be this way, according to a new study from the McKinsey Health Institute.
  • Medical advances and lifestyle changes could give us an extra six years of quality life.

Rising life expectancy is rarely seen as a bad thing, but what if those extra years are spent in bad health?

We are now spending more years in poor health than at any time in our history, according to a new report from the McKinsey Health Institute (MHI). But it also says things don’t have to be that way.

Making medical advances more widely available and adopting healthier lifestyles could enable us all to enjoy six more years of quality life, MHI says. Yet we have to be willing to embrace change to achieve this.

Although average global life expectancy more than doubled between 1800 and 2017 – from 30 to 73 years – the report says the proportion of people’s lives lived in poor or moderate health has remained unchanged at 50%.

An infographic showing the proportion of our lives that are spent in poor health.
We are living longer, but still spending 50% of our lives in poor or moderate health. Image: McKinsey Health Institute

Health inequality is still a major problem, the report adds. “There is an 18-year gap in average life expectancy between low- and high-income countries and a 30-year gap between the lowest and highest life expectancy,” it says.

Maternal mortality rates in low-income countries are up to 100 times higher than in high-income nations. And while 80% of children with cancer survive in developed nations, as few as 30% do in low-income nations.

Lessons from the pandemic

But the response to COVID-19 – with rapid medical innovation and the willingness of people to change their behaviour – shows that we can quickly make the changes needed to live longer, healthier lives, says the study.

“Humanity mobilized against COVID-19 at a speed and scale previously unseen,” says the report. “While far from perfect, our success should inspire us to challenge what we think is possible.”

MHI says we need to radically rethink our view of what it means to be healthy. The conventional definition of good health as simply the absence of illness no longer fits with individual aspirations and the latest scientific research.

The report says we need to go back to an idea that is over 70 years old. In 1948, the World Health Organization’s founding constitution defined health as a “state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity”.

An infographic showing different dimensions of health.
Health is not just physical, but mental, social and spiritual too. Image: Mckinsey Health Institute

McKinsey says this definition “recognizes the relevance and interdependencies of physical, mental, social, and spiritual dimensions”, and that such a view should be the foundation of a new approach to healthier living.

Six steps to a healthier life

The report outlines six steps that it says would result in a total of 45 billion extra years of higher-quality human life globally. These are:

1. Invest disproportionately more in preventing and promoting healthy behaviour
The economic benefits of improving the health of the global population would be up to four times the costs involved, says the report. OECD countries currently spend just 2.8% of their health budgets on prevention, vaccination and health education.

2. Improve the measurement and understanding of health with better data
“Measurement is foundational to improvement,” says the report. It can help understand what works and drive allocation of resources. Only 5% of the factors that influence a holistic view of health are being measured systematically.

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3. Scale what works
Simply applying existing medical treatments more widely would cut the impact of health problems by 40%, the report says. Scaling up their use could reduce child mortality by 65% and help a typical 65-year-old be as healthy as the average 55-year-old today.

4. Innovate more and faster
Before COVID-19, the fastest time to develop a vaccine was four years. COVID vaccines were ready in just 12 months, demonstrating that innovation can happen at speed. The pandemic also saw a doubling of investment in digital health tools.

An infographic showing how companies have an impact on health.
Every part of the global economy can play a part in improving human health. Image: McKinsey Health Institute

5. Unleash the potential of all industries
Every part of the global economy has a part to play in improving human health, from food and drink producers to the transport sector, says the report. All companies could also do more to promote the health and mental wellbeing of their employees.

6. Empower individuals to steward their own health
Unhealthy diets, low activity levels, lack of sleep, medication use and smoking contribute to up to 60% of deaths worldwide, the report says. Nudging people through social media could play a part in changing unhealthy behaviour.

“This is a decisive moment in the history of human health,” the report says, adding that a dramatic improvement in health would “require unprecedented collaboration to shift society’s mindsets and actions enough to realize possible gains in life expectancy and quality of life”.

The World Economic Forum’s Global Risks Report 2022 ranks deteriorating mental health as one of the top five global risks that have worsened as a result of the pandemic. The threat from infectious disease is listed at number eight in the same category.

Among the top 10 critical threats facing the world over the next two years, the report ranks infectious diseases at number five and deteriorating mental health at six. It says the pandemic has widened health inequalities and put acute stress on health systems globally.

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