“Life expectancy and healthy life expectancy (HALE) have both increased by over 8% globally between 2000 and 2016, and remain profoundly influenced by income. Despite the largest gains in both indicators being due primarily to the progress made in reducing child mortality and fighting infectious diseases, low-income and lower-middle-income countries continue to suffer from the poorest overall health outcomes, lagging far behind the global average.”

Source: World health statistics 2020: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2020.
Licence: CC BY-NC-SA 3.0 IGO.

“In 2017, life expectancy at birth was 80.7 years on average across OECD countries, over 10 years higher than it was in 1970 (Figure 3.1).

“Japan, Switzerland and Spain lead a large group of 26 OECD countries in which life expectancy at birth exceeds 80 years. A second group, including the United States and a number of central and eastern European countries, has a life expectancy between 77 and 80 years. Latvia, Mexico, Lithuania and Hungary have the lowest life expectancy, at less than 76 years in 2017.

“Among OECD countries, Turkey, Korea and Chile have experienced the largest gains since 1970, with increases of 24, 20 and 18 years respectively. Stronger health systems have contributed to these gains, by offering more accessible and higher quality care. Wider determinants of health matter too – notably rising incomes, better education and improved living environments. Healthier lifestyles, influenced by policies within and beyond the health system, have also had a major impact (James, Devaux and Sassi, 2018[1]).”

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

“Circulatory diseases – notably heart attack and stroke – remain the main cause of mortality in most OECD countries, accounting for almost one in three deaths across the OECD. While mortality rates have declined in most OECD countries over time, population ageing, rising obesity and diabetes rates may hamper further reductions (OECD, 2015[1]). Indeed, slowing improvements in heart disease and stroke are one of the principal causes of a slowdown in life expectancy gains in many countries (Raleigh, 2019[2]).

“Heart attacks and other ischaemic heart diseases (IHDs) accounted for 11% of all deaths in OECD countries in 2017. IHDs are caused by the accumulation of fatty deposits lining the inner wall of a coronary artery, restricting blood flow to the heart. Mortality rates are 80% higher for men than women across OECD countries, primarily because of a greater prevalence of risk factors among men, such as smoking, hypertension and high cholesterol.

“Among OECD countries, central and eastern European countries have the highest IHD mortality rates, particularly in Lithuania where there are 383 deaths per 100,000 people (age-standardised). Rates are also very high in the Russian Federation. Japan, Korea and France have the lowest rates among OECD countries, at about one quarter of the OECD average and less than a tenth of rates in Lithuania and the Russian Federation (Figure 3.10).”

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

“In partner countries, life expectancy remains well below the OECD average except in Costa Rica. Still, levels are converging rapidly towards the OECD average, with considerable gains in longevity since 1970 in India, China, Brazil, Indonesia, Colombia and Costa Rica. There has been less progress in the Russian Federation, due mainly to the impact of the economic transition in the 1990s and a rise in risky health behaviours among men. South Africa has also experienced slow progress, due mainly to the HIV/AIDS epidemic, although longevity gains over the last decade have been more rapid.

“A closer look at trends in life expectancy at birth shows a considerable slowdown in gains in recent years. Comparing the last five years (2012-17) with a decade earlier (2002-07), 27 OECD countries experienced slower gains in life expectancy (Figure 3.2). This slowdown was most marked in the United States, France, the Netherlands, Germany and the United Kingdom. Longevity gains were slower for women than men in almost all OECD countries.

“Indeed, life expectancy fell on average across OECD countries in 2015 – the first time this has happened since 1970. Nineteen countries recorded a reduction, widely attributed to a particularly severe influenza outbreak that killed many frail elderly people and other vulnerable groups (Figure 3.3). Most of these were European countries, with the exception of the United States and Israel. The largest reductions were in Italy (7.2 months) and Germany (6 months).”

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

“More broadly, economic recessions and related austerity measures, as in the 2008 global economic crisis, have been linked to deteriorating mental health and increased suicide rates, but with a less clear-cut impact on overall mortality (Parmar, Stavropoulou and Ioannidis, 2016[3]). What is clear is that continued gains in longevity should not be taken for granted, with better protection of older people and other at-risk populations paramount to extending life expectancy.

“Higher national income is generally associated with greater longevity, particularly at lower income levels. Life expectancy is also, on average, longer in countries that invest more in health systems – although this relationship tends to be less pronounced in countries with the highest health spending per capita (see Chapter 1 for further analysis).”

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

“Women live longer than men do in all OECD and partner countries. This gender gap averaged 5.3 years across OECD countries in 2017 – life expectancy at birth for women was 83.4 years, compared with 78.1 years for men (Figure 3.4). The gender gap in life expectancy, though, has narrowed by one year since 2000, reflecting more rapid gains in life expectancy among men in most countries.

“In 2017, life expectancy at birth for men in OECD countries ranged from around 70 years in Latvia and Lithuania to 81 years or higher in Switzerland, Japan, Iceland and Norway. For women, life expectancy reached 87.3 years in Japan, but was less than 80 years in Mexico, Hungary and Latvia.

“Gender gaps are relatively narrow in Iceland, the Netherlands, Norway, Sweden, New Zealand, Ireland, the United Kingdom and Denmark – at less than four years. However, there are large gender differences in many central and eastern European countries, most notably in Latvia and Lithuania (around ten years), Estonia (around nine years) and Poland (around eight years). In these countries, gains in longevity for men over the past few decades have been much more modest. This is partly due to greater exposure to risk factors among men – particularly greater tobacco use, excessive alcohol consumption and less healthy diets – resulting in more deaths from heart diseases, cancer and other diseases. For partner countries, the gender gap is around ten years in the Russian Federation, and just over seven years in Colombia, Brazil and South Africa. China and India have small gender gaps, of about three years.

“Socioeconomic inequalities in life expectancy are also evident in all OECD countries with available data (Figure 3.5). On average among 26 OECD countries, a 30-year-old with less than an upper secondary education level can expect to live for 5.5 fewer years than a 30-year-old with tertiary education (a university degree or equivalent). These differences are higher among men, with an average gap of 6.9 years, compared with an average gap of 4.0 years among women.”

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

“In 2017, almost 3 million premature deaths across OECD countries could have been avoided through better prevention and health care interventions. This amounts to over one quarter of all deaths. Of these deaths, about 1.85 million were considered preventable through effective primary prevention and other public health measures, and over 1 million were considered treatable through more effective and timely health care interventions.

“Some cancers that are preventable through public health measures were the main causes of preventable mortality (32% of all preventable deaths), particularly lung cancer (Figure 3.8). Other major causes were external causes of death, such as road accidents and suicide (25%); heart attack, stroke and other circulatory diseases (19%); alcohol and drug-related deaths (9%); and some respiratory diseases such as influenza and chronic obstructive pulmonary disease (8%).

“The main treatable cause of mortality is circulatory diseases (mainly heart attack and stroke), which accounted for 36% of premature deaths amenable to treatment. Effective, timely treatment for cancer, such as colorectal and breast cancers, could have averted a further 26% of all deaths from treatable causes. Diabetes and other diseases of the endocrine system (9%) and respiratory diseases such as pneumonia and asthma (9%) are other major causes of premature deaths that are amenable to treatment.

“The average aged-standardised mortality rate from preventable causes was 133 deaths per 100,000 people across OECD countries. Premature deaths ranged from under 96 per 100,000 in Israel, Switzerland, Japan, Italy, Spain and Sweden to over 200 in Latvia, Hungary, Lithuania and Mexico (Figure 3.9). Higher rates of premature death in these countries were mainly due to much higher mortality from ischaemic heart disease, accidents and alcohol-related deaths, as well as lung cancer in Hungary.

“The mortality rates from treatable causes across OECD countries was much lower, at 75 per 100,000 population. It ranged from less than 50 in Switzerland, Iceland, Norway, Korea, France and Australia, to over 130 deaths per 100,000 people in Latvia, Mexico, Lithuania and Hungary. Ischaemic heart diseases, strokes and some types of treatable cancers (e.g. colorectal and breast cancers) were the main drivers in Latvia, Lithuania and Hungary, countries with some of the highest treatable mortality rates.”

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

“Most OECD countries conduct regular health surveys that include asking respondents how, in general, they would rate their health. For international comparisons, socio-cultural differences across countries may complicate cross-country comparisons of self-assessed health. Differences in the formulation of survey questions, notably in the survey scale, can also affect comparability of responses. Finally, since older people generally report poorer health and more chronic diseases than younger people do, countries with a larger proportion of elderly people are likely to have a lower proportion of people reporting that they are in good health.

“With these limitations in mind, almost 9% of adults consider themselves to be in poor health, on average across OECD countries (Figure 3.23). This ranges from over 15% in Korea, Lithuania, Latvia and Portugal to under 4% in New Zealand, the United States, Canada, Ireland and Australia. However, the response categories used in OECD countries outside Europe and Asia are asymmetrical on the positive side, which introduces a comparative bias to a more positive self-assessment of health (see the box on “Definition and comparability”). Korea, Japan and Portugal stand out as countries with high life expectancy, but relatively poor selfrated health.”

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.

“Between 2000 and 2018, the under-five mortality rate fell from 76 [75–78]¹ per 1000 live births to 39 [37–42], and the neonatal mortality rate declined from 31 [30–31] per 1000 live births to 18 [17–19] (Figure 2.1). This represented an estimated 5.3 [5.1–5.7] million under-five deaths and 2.5 [2.4–2.7] million neonatal deaths in 2018 (5).

“One hundred and twenty-one countries² have already met the SDGs target for under-five mortality, and a further 21 countries are expected to do so by 2030 if current trends continue. Efforts to accelerate progress need to be scaled up in the remaining 53 countries, two thirds of which are in sub-Saharan Africa (5).

“Many child deaths can be prevented through interventions such as immunization, exclusive breastfeeding, proper nutrition, and prompt and appropriate treatment of common childhood illnesses. Reductions in air pollution and greater access to basic hygiene, safely managed drinking-water and sanitation also contribute to save many young lives.

“In 2018, global coverage rates for the third dose of the diphtheria, tetanus- and pertussis-containing vaccine (DTP3) reached 86%, up from 72% in 2000. However, progress has stalled during the current decade and 83 countries have yet to reach the Global Vaccine Action Plan target of at least 90% coverage. Similar levels of coverage were achieved for a single dose of the measles-containing vaccine (86%), while coverage of a second-dose reached 69% in 2018 (up from 18% in 2000) (6). Despite progress, disparities in measles vaccine access and use persist across and within countries of all income levels, resulting in new measles outbreaks (7). Pneumococcal conjugate vaccine coverage increased more than 10-fold since 2008, but was still below 50% globally in 2018 (Figure 2.2).

“Global coverage of immunization of children against polio has also been a major success, reducing reported wild poliovirus cases by 99.9% since 1988 (from an estimated 350 000 cases to 175 in 2019) (8), and rendering 210 countries, territories and areas polio-free.³ About 84% of infants globally received the hepatitis B vaccine (3rd dose) in 2018, compared with 30% coverage in 2000 (6). Hepatitis B prevalence among children under 5 years of age declined from 4.7% in the pre-vaccine era to 0.8% in 2017 (9).

“More than half (55%) of the global population was estimated to lack access to safely-managed sanitation services in 2017, and more than one quarter (29%) lacked safely-managed drinking-water. In the same year, two in five households globally (40%) lacked basic hand-washing facilities with soap and water in their home (10,11). Globally in 2016, unsafe drinking-water and sanitation, and lack of hand hygiene were responsible for nearly 1.2 million deaths, including almost 300 000 of children aged under 5 years who died due to diarrhoea (12).”

Source: World health statistics 2020: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2020.
Licence: CC BY-NC-SA 3.0 IGO.

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and several other nations.

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Page last updated August 17, 2021 by Doug McVay, Editor.