Japanese Shown to Have Longest Healthy Life Expectancy - Brief Article

AORN Journal, Sept, 2000

World Health Organization (WHO) scientists have developed a new healthy life expectancy indicator named Disability Adjusted Life Expectancy (DALE), according to a June, 4, 2000, news release from the World Health Organization. In the past, life expectancy has been calculated on the overall length of life based on mortality data. This new indicator, however, calculates life expectancy based on the expected number of years to be lived in full health.

To calculate DALE, scientists weigh ill-health years according to severity and subtract these years from the expected overall life expectancy. The result is the equivalent years of healthy life.

According to WHO rankings, lost years due to disability are substantially higher in poorer countries. Several factors contribute to this trend, including injury, blindness, paralysis, and the debilitating effects of tropical disease.

Of the 191 countries ranked by WHO, Japan has the highest healthy life expectancy (ie, 74.5 years). The remainder of the top 10 are Australia, 73.2 years; France, 73.1 years; Sweden, 73.0 year; Spain, 72.8 years; Italy, 72.7 years; Greece, 72.5 years; Switzerland, 72.5 years; Monaco, 72.4 years; and Andorra, 72.3 years.

Factors such as a low rate of heart disease associated with a traditional low fat diet and relatively low smoking rates contribute to Japan's ranking. Scientists at WHO, however, note that the Japanese national diet is changing as red meat becomes more common, and lung cancer rates are expected to increase as the long-term effects of post-World War II smoking popularity begin to hit.

The United States ranked 24th in the DALE rankings, with an average healthy life expectancy of 70.0 years. In further classification, US women are expected to outlive US men by 5.1 years, as the life expectancy for women in the United States is 72.6 years versus 67.5 years for men. This trend, however, is seen in most advanced countries.

Researchers found life expectancy for Americans to be rather surprising, as it is lower than most other advanced countries. Reasons given for this include high coronary heart disease rates; high levels of violence, particularly homicide; the HIV epidemic; high tobacco use leading to lung cancer and chronic lung disease; and groups such as Native Americans, rural African Americans, and inner city poor having extremely poor health more characteristic of a developing country.

The 10 lowest ranking countries are located in sub-Saharan Africa, where AIDS is rampant. Currently, AIDS is the leading cause of death in this part of the world, killing 2.2 million Africans in 1999 versus 300,000 in 1989 and surpassing the number of deaths from the traditional deadly diseases of malaria, tuberculosis, pneumonia, and diarrheal disease.

The 10 lowest ranking countries in ascending order are Sierra Leone, 25.9 years; Niger, 29.1 years; Malawi, 29.4 years; Zambia, 30.3 years; Botswana, 32.3 years; Uganda, 32.7 years; Rwanda, 32.8 years; Zimbabwe, 32.9 years; Mali, 33.1 years; and Ethiopia, 33.5 years.

WHO Issues New Healthy Life Expectancy Rankings; Japan Number One in New `Healthy Life' System (news release, Washington, DC: World Health Organization, June 4, 2000) 1-5. Available from http://www.who.int/ inf-pr-2000/en/pr2000-life.html. Accessed 8 June 2000.