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Mortality and morbidity drivers of the global distribution of health

Iñaki Permanyer, Centre for Demographic Studies
Octavio Bramajo, Centre d'estudis Demogràfics, Universitat Autònoma de Barcelona

Increasing life expectancy (LE) and reducing its variability across countries (the so-called “International Health Inequality”, IHI) are progressively prominent goals in global development agendas. Yet, LE is composed of two components: the number of years individuals are expected to live in “good” and in “less-than-good” health. While the first component (“Health-adjusted life expectancy”, HALE) is normatively desirable, the second one (“Unhealthy life expectancy”, UHLE) is highly disputed – an issue that can muddy the waters when interpreting global health dynamics and calls for new conceptual approaches. Here we document how the evolution of HALE and UHLE between 1990 and 2019 have shaped (i) the trends and composition of LE both at the country, regional and the global levels, and (ii) the levels and trends in IHI. Our findings indicate that UHLE has tended to grow at a faster rate than HALE, thus leading to an expansion of morbidity in 75% of world countries. IHI tends to decline over time, and its values are mostly determined by the distribution of HALE across countries. Improvements in HALE for the world’s least longevous countries would be the most efficient way of increasing world’s life expectancy and reducing health differences between countries.

Keywords: Mortality, Health and morbidity, Longevity, Inequality

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  Presented in Session 122. Socioeconomic Inequality, Differentials and Mortality