People around the world are now living longer, even in some of the poorest countries, but a complex mix of fatal and nonfatal ailments cause a tremendous amount of health loss.

According to a new analysis of all major diseases and injuries in 188 countries and life expectancy is climbing higher worldwide, people are spending more years living with illness and disability.

This was contained in a report of a study titled: “Global, regional, and national Disability-Adjusted Life Years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition” published by the Lancet and copied to the GNA in Accra.

The study was conducted by an international consortium of researchers working on the Global Burden of Disease study and led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. It examined fatal and nonfatal health loss across countries.

IHME an independent global health research organisation at the University of Washington that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them.

The increase in healthy life expectancy according to the report has not been as dramatic as the growth of life expectancy, and as a result, people were living more years with illness and disability.

Healthy life expectancy takes into account not just mortality but also the impact of nonfatal conditions and summarizes years lived with disability and years lost due to premature mortality.

Global life expectancy has risen by more than six years since 1990 as healthy life expectancy grows; ischemic heart disease, lower respiratory infections, and stroke cause the most health loss around the world.

It observed that global life expectancy at birth for both sexes rose by 6.2 years (from 65.3 in 1990 to 71.5 in 2013), while healthy life expectancy, or HALE, at birth rose by 5.4 years (from 56.9 in 1990 to 62.3 in 2013).

For most countries, changes in healthy life expectancy for males and females between 1990 and 2013 were significant and positive, but in dozens of countries, including Botswana, Belize, and Syria, healthy life expectancy in 2013 was not significantly higher than in 1990.

In some of those countries, including South Africa, Paraguay, and Belarus, healthy life expectancy has actually dropped since 1990. People born in Lesotho and Swaziland in 2013 could expect to live at least 10 fewer years in good health than people born in those countries two decades earlier.

People in countries such as Nicaragua and Cambodia have experienced dramatic increases in healthy life expectancy since 1990, 14.7 years and 13.9 years, respectively.

The reverse was true for people in Botswana and Belize, which saw declines of 2 years and 1.3 years.

Professor Theo Vos of IHME, the study’s lead author, noted that, “The world has made great progress in health, but now the challenge is to invest in finding more effective ways of preventing or treating the major causes of illness and disability.”

The study noticed that as both life expectancy and healthy life expectancy increased, changes in rates of health loss became increasingly crucial.

The leading global causes of health loss, as measured by DALYs, in 2013 were ischemic heart disease, lower respiratory infections, stroke, low back and neck pain, and road injuries. These causes differed by gender: for males, road injuries were a top-five cause of health loss, but these were not in the top 10 for females, who lose substantially more health to depressive disorders than their male counterparts.

Ethiopia was one of several countries that have been rising to the challenge to ensure that people live lives that are both longer and healthier. In 1990, Ethiopians could expect to live 40.8 healthy years. But by 2013, the country saw an increase in healthy life expectancy of 13.5 years, more than double the global average, to 54.3 years.

The fastest-growing global cause of health loss between 1990 and 2013 was HIV and AIDS, which increased by 341.5 per cent. But this dramatic rise masks progress in recent years; since 2005, health loss due to HIV and AIDS has diminished by 23.9 per cent because of global focus on the disease.

Ischemic heart disease, stroke, low back and neck pain as well, road injuries, which have also caused an increasing amount of health loss since 1990.

The impact of other ailments, such as diarrhoeal diseases, neonatal preterm birth complications, and lower respiratory infections, has significantly declined.

Across countries, patterns of health loss vary widely.

The countries with the highest rates of DALYs were among the poorest in the world and include a number in sub-Saharan Africa: Lesotho, Swaziland, Central African Republic, Guinea-Bissau, and Zimbabwe whilst countries with the lowest rates of health loss included Italy, Spain, Norway, Switzerland, and Israel.

Country-level variation also contributed to the changing of disease burden, particularly for non-communicable diseases. For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers and age-standardized rates declined between 1990 and 2013.

While the number of DALYs for non-communicable diseases has increased during this period, age-standardized rates have declined.

In 2013, Lesotho had the lowest, at 42 years, and Japan had the highest globally, at 73.4 years. Even regionally, there was significant variation. Cambodians and Laotians born in 2013 would have healthy life expectancy of only 57.5 years and 58.1 years, but people born in nearby Thailand and Vietnam could live nearly 67 years in good health.

Dr Christopher Murray, IHME Director said “Factors including income and education have an important impact on health but don’t tell the full story, and looking at healthy life expectancy and health loss at the country level could help guide policies to ensure that people everywhere can have long and healthy lives no matter where they live.”