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Africa: Life Expectancy
Date distributed (ymd): 000703
Document reposted by APIC
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Region: Continent-Wide
Issue Areas: +economy/development+
Summary Contents:
This posting contains new data on life expectancy in
African and non-African countries, taken from the new
World Health Report of the World Health Organization
(WHO) released last month. It also contains a press
release from the WHO with an overview of the new statistics
for 'Disability-adjusted Life Expectancy.' The full
World Health Report text (in PDF format) is available
at the WHO web site (http://www.who.int).
Due primarily to the impact of the HIV/AIDS pandemic,
life expectancies for African children have dropped
significantly over the past ten years. Life expectancies
for children born in Africa in 1999, shown in the WHO
report, are far below those even in most other developing
countries. Only 9 of the 53 African countries for which
the WHO shows data have life expectancies of 50 years
and over, as compared to 130 of the 138 countries outside
Africa. Among the 52 countries with life expectancies
less than 50 years, 44 are African and only 8 are outside
Africa.
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Press Release WHO
Released in Washington, D.C. and Geneva, Switzerland
4 June 2000
WHO Issues New Healthy Life Expectancy Rankings Japan Number One in New 'Healthy Life' System
Press contact: Marshall Hoffman (703) 820-2244 Home (703) 533-8482
Japanese have the longest healthy life expectancy of 74.5 years among 191 countries, versus less than 26 years for the lowest-ranking country of Sierra Leone, based on a new way to calculate healthy life expectancy developed by the World Health Organization (WHO).
Previously, life expectancy estimates were based on the overall length of life based on mortality data only.
For the first time, the WHO has calculated healthy life expectancy for babies born in 1999 based upon an indicator developed by WHO scientists, Disability Adjusted Life Expectancy (DALE). DALE summarizes the expected number of years to be lived in what might be termed the equivalent of "full health." To calculate DALE, the years of ill-health are weighted according to severity and subtracted from the expected overall life expectancy to give the equivalent years of healthy life.
The WHO rankings show that years lost to disability are substantially higher in poorer countries because some limitations -- injury, blindness, paralysis and the debilitating effects of several tropical diseases such as malaria -- strike children and young adults. People in the healthiest regions lose some 9 percent of their lives to disability, versus 14 percent in the worst-off countries.
In terms of DALE, the rest of the top 10 nations are Australia, 73.2 years; France, 73.1; Sweden, 73.0; Spain, 72.8; Italy, 72.7; Greece, 72.5; Switzerland, 72.5; Monaco, 72.4; and Andorra, 72.3.
DALE is estimated to equal or exceed 70 years in 24 countries, and 60 years in over half the Member States of WHO. At the other extreme are 32 countries where disability-adjusted life expectancy is estimated to be less than 40 years. Many of these are countries with major epidemics of HIV/AIDS, among other causes.
The United States rated 24th under this system, or an average of 70.0 years of healthy life for babies born in 1999. The WHO also breaks down life expectancy by sex for each country. Under this system, U.S. female babies could expect 72.6 years of healthy life, versus just 67.5 years for male babies.
"The position of the United States is one of the major surprises of the new rating system," says Christopher Murray, M.D., Ph.D., Director of WHO's Global Programme on Evidence for Health Policy. "Basically, you die earlier and spend more time disabled if you're an American rather than a member of most other advanced countries."
The WHO cites various causes for why the United States ranks relatively low among wealthy nations. These reasons include:
* In the United States, some groups, such as Native Americans, rural African Americans and the inner city poor, have extremely poor health, more characteristic of a poor developing country rather than a rich industrialized one.
* The HIV epidemic causes a higher proportion of death and disability to U.S. young and middle-aged than in most other advanced countries. HIV-AIDS cut three months from the healthy life expectancy of male American babies born in 1999, and one month from female lives;
* The U.S. is one of the leading countries for cancers relating to tobacco, especially lung cancer Tobacco use also causeschronic lung disease.
* A high coronary heart disease rate, which has dropped in recent years but remains high;
* Fairly high levels of violence, especially of homicides, when compared to other industrial countries.
All of the bottom 10 countries were in sub-Saharan Africa, where the HIV-AIDS epidemic is rampant. In ascending order beginning with 191, those countries were Sierra Leona, 25.9 years of healthy life for babies born in 1999; Niger, 29.1; Malawi, 29.4; Zambia, 30.3; Botswana, 32.3; Uganda, 32.7; Rwanda, 32.8; Zimbabwe, 32.9; Mali, 33.1; and Ethiopia, 33.5. [see below for full list]
The overall life expectancy in sub-Saharan Africa has dropped precipitously over the past 10 years, mostly because of the AIDS epidemic, the WHO says. Life expectancy dropped for female babies from 51.1 years to 46.3 years. For males, the level dropped from 47.3 years to 44.8 years.
AIDS is now the leading cause of death in Sub-Saharan Africa, far surpassing the traditional deadly diseases of malaria, tuberculosis, pneumonia and diarrheal disease. AIDS killed 2.2 million Africans in 1999, versus 300,000 AIDS deaths 10 years previously.
"Healthy life expectancy in some African countries is dropping back to levels we haven't seen in advanced countries since Medieval times," says Alan Lopez, Coordinator of WHO's Epidemiology and Burden of Disease Team. "This is just one example why the WHO decided to measure healthy life expectancy for all member countries using DALE for the first time, to give a truer picture of where good health reigns, and where it doesn't."
Life expectancy in several countries in southern Africa has been cut 15-20 years off what the WHO would expect it to be in Africa without HIV. Other African countries have lost 5-10 years of life expectancy because of HIV.
"The DALE system is simple," says Dr. Lopez. "In the old system, we measured a total life expectancy based on the average numbers of years males and females could expect to live in each country. However, people don't live all those years in perfect health. At some point in your life, you will have some level of disability. These years with disability are weighted according to their level of severity to estimate the total equivalent lost years of good health. You subtract this from total life expectancy, and what remains is the expected number of years of healthy life."
This is the first time that anyone has measured every country's healthy life expectancy using the DALE system.
High-ranking countries
Several factors go into making Japan number one in the rankings. One is the low rate of heart disease, associated with the traditional low fat diet. The national diet is changing, with high fat foods such as red meat becoming common. The effect of tobacco has also been mild until recently, with low lung cancer rates. These rates for men are expected to jump in coming years as the long-term effects of the post-World War II smoking popularity begin to hit.
In Australia, smoking rates have dropped sharply from their earlier peaks, leading to lower lung cancer and heart problem rates. France registered high because of the health of its women, which pulled up the overall average.
French women never smoked in any large numbers until recently. Many young French women, however, have begun smoking, which will lead to rapid increases in lung cancer rates and other diseases associated with tobacco in 10 to 20 years. French men are already suffering from growing rates of these diseases from tobacco.
Sweden ranks high because of its health care system and because tobacco use is relatively low.
Women Living Longer, Healthier
Studies have shown consistently that as countries get richer, male mortality tends to decline less than female mortality. This WHO study shows that the same patterns hold when healthy life expectancies are measured.
In the early 1900s, the gap between female and male life expectancy was 2-3 years in richer countries around the world. By 1999, women were living on average 7-8 years more than men in those same countries.
Women are generally more health conscious while in rising economies, men have much higher smoking rates and exercise much less. Women have been living longer and healthier lives in richer countries basically because they have always smoked less than men, the WHO says. Women in these countries have been smoking much more in recent years, which will translate into higher disability and death rates in the coming years, the WHO warns. In addition, men in richer countries tend to have poorer diets than women do, and men exercise much less than did their grandfathers.
In poorer countries, men are victims of more disabling injuries than women. They also get more diseases than women, for a variety of reasons.
Regional Results
North African and Middle East -- Males and females have similar levels of healthy life expectancy, which is unusual. Also, the position of women in these societies is often not good, Less care is given to female children, and they have a higher risk for reproductive deaths than in other countries. In Saudi Arabia, the overall healthy life expectancy is 64.5 years -- 65.1 for male babies and 64.0 for female babies. In Bahrain, the overall healthy life expectancy is 64.4, but 63.9 for male babies and 64.9 for female babies; Qatar, 63.5 overall, and 64.2 for male babies, 62.8 for females; and Kuwait, 63.2 overall, with 63.0 for male babies and 63.4 for female babies.
East Asia -- China has 20 percent of the world population, so that it is of major significance that the Chinese have a fairly good healthy life expectancy, at 62.3 years, 63.3 years for women and 61.2 for men. "This is a very impressive performance for that level of income," says Dr. Lopez.
Russia -- Healthy life expectancy is a fair 66.4 for female babies but just 56.1 years for males. This is one of the widest sex gaps in the world. The most common explanation is the high incidence of male alcohol abuse, which led to high rates of accidents, violence and cardiovascular disease. From 1987 to 1994, the risk of premature death increased by 70% for Russian males. Since 1994, life expectancy has been improving for males.
Similar rates exist for other major countries of the former Soviet Union. In Ukraine, female babies can expect to live an equivalent of 67.5 years of healthy life versus 58.5 years for male babies. In Belarus, the rates are 67.2 years for female babies and 56.2 years for male babies.
Southeast Asia -- Countries of the region have produced very mixed results. Viet Nam has been improving dramatically in health profiles and healthy life expectancy, rising to 58.2 years, while Thailand has not improved significantly over the past decade, though it is still ahead of Viet Nam at 60.2 years. Myanmar has not done very well, with a healthy life expectancy of just 52 years, substantially behind its Southeast Asian neighbors. This shows that even countries with the same levels of income can have very different healthy life expectancies.
Latin America -- Cuba has the highest healthy life expectancy in the region, at 68.4 years, near U.S. levels. It is followed by Uruguay at 67.0 years; Argentina at 66.7 years and Costa Rica at 66.7 years. Brazil is split, with a high healthy life expectancy in its southern half, and a lower one in the north. The total average is a relatively low 59.1 years, at 55.2 for men and 62.9 for female babies.
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Disability-adjusted Life Expectancy
Source: World Health Report 2000 (Table 5)
24 Countries with DALE over 70
(24 non-African)
1 Japan 74.5
2 Australia 73.2
3 France 73.1
4 Sweden 73.0
5 Spain 72.8
6 Italy 72.7
7 Greece 72.5
8 Switzerland 72.5
9 Monaco 72.4
10 Andorra 72.3
11 San Marino 72.3
12 Canada 72.0
13 Netherlands 72.0
14 United Kingdom 71.7
15 Norway 71.7
16 Belgium 71.6
17 Austria 71.6
18 Luxembourg 71.1
19 Iceland 70.8
20 Finland 70.5
21 Malta 70.5
22 Germany 70.4
23 Israel 70.4
24 United States 70.0
78 Countries with DALE from 60 to 70
(3 African; 75 non-African)
25 Cyprus 69.8
26 Dominica 69.8
27 Ireland 69.6
28 Denmark 69.4
29 Portugal 69.3
30 Singapore 69.3
31 New Zealand 69.2
32 Chile 68.6
33 Cuba 68.4
34 Slovenia 68.4
35 Czech Republic 68.0
36 Jamaica 67.3
37 Uruguay 67.0
38 Croatia 67.0
39 Argentina 66.7
40 Costa Rica 66.7
41 Armenia 66.7
42 Slovakia 66.6
43 Saint Vincent 66.4
44 Georgia 66.3
45 Poland 66.2
46 Yugoslavia 66.1
47 Panama 66.0
48 Antigua & Barbuda 65.8
49 Grenada 65.5
50 United Arab Emirates 65.4
51 Republic of Korea 65.0
52 Venezuela 65.0
53 Barbados 65.0
54 Saint Lucia 65.0
55 Mexico 65.0
56 Bosnia 64.9
57 Trinidad and Tobago 64.6
58 Saudi Arabia 64.5
59 Brunei Darussalam 64.4
60 Bulgaria 64.4
61 Bahrain 64.4
62 Hungary 64.1
63 Lithuania 64.1
64 Macedonia 63.7
65 Azerbaijan 63.7
66 Qatar 63.5
67 Cook Islands 63.4
68 Kuwait 63.2
69 Estonia 63.1
70 Ukraine 63.0
71 Paraguay 63.0
72 Oman 63.0
73 Turkey 62.9
74 Colombia 62.9
75 Tonga 62.9
76 Sri Lanka 62.8
77 Suriname 62.7
78 Mauritius 62.7
79 Dominican Republic 62.5
80 Romania 62.3
81 China 62.3
82 Latvia 62.2
83 Belarus 61.7
84 Algeria 61.6
85 Niue 61.6
86 Saint Kitts & Nevis 61.6
87 El Salvador 61.5
88 Moldova 61.5
89 Malaysia 61.4
90 Tunisia 61.4
91 Russian Federation 61.3
92 Honduras 61.1
93 Ecuador 61.0
94 Belize 60.9
95 Lebanon 60.6
96 Iran 60.5
97 Samoa 60.5
98 Guyana 60.2
99 Thailand 60.2
100 Uzbekistan 60.2
101 Jordan 60.0
102 Albania 60.0
37 Countries with DALE from 50 to 60
(6 African; 31 non-African)
103 Indonesia 59.7
104 Micronesia 59.6
105 Peru 59.4
106 Fiji 59.4
107 Libyan Arab Jama. 59.3
108 Seychelles 59.3
109 Bahamas 59.1
110 Morocco 59.1
111 Brazil 59.1
112 Palau 59.0
113 Philippines 58.9
114 Syrian Arab Rep. 58.8
115 Egypt 58.5
116 Viet Nam 58.2
117 Nicaragua 58.1
118 Cape Verde 57.6
119 Tuvalu 57.4
120 Tajikistan 57.3
121 Marshall Islands 56.8
122 Kazakhstan 56.4
123 Kyrgyzstan 56.3
124 Pakistan 55.9
125 Kiribati 55.3
126 Iraq 55.3
127 Solomon Islands 54.9
128 Turkmenistan 54.3
129 Guatemala 54.3
130 Maldives 53.9
131 Mongolia 53.8
132 Sao Tome & Principe 53.5
133 Bolivia 53.3
134 India 53.2
135 Vanuatu 52.8
136 Nauru 52.5
137 Democratic PR Korea 52.3
138 Bhutan 51.8
139 Myanmar 51.6
20 Countries with DALE from 40 to 50
(13 African: 7 non-African)
140 Bangladesh 49.9
141 Yemen 49.7
142 Nepal 49.5
143 Gambia 48.3
144 Gabon 47.8
145 Papua New Guinea 47.0
146 Comoros 46.8
147 Lao People's DR 46.1
148 Cambodia 45.7
149 Ghana 45.5
150 Congo 45.1
151 Senegal 44.6
152 Equatorial Guinea 44.1
153 Haiti 43.8
154 Sudan 43.0
155 Cote d'Ivoire 42.8
156 Cameroon 42.2
157 Benin 42.2
158 Mauritania 41.4
159 Togo 40.7
29 Countries with DALE from 30 to 40
(28 African; 1 non-African)
160 South Africa 39.8
161 Chad 39.4
162 Kenya 39.3
163 Nigeria 38.3
164 Swaziland 38.1
165 Angola 38.0
166 Djibouti 37.9
167 Guinea 37.8
168 Afghanistan 37.7
169 Eritrea 37.7
170 Guinea-Bissau 37.2
171 Lesotho 36.9
172 Madagascar 36.6
173 Somalia 36.4
174 Dem. Rep. Congo 36.3
175 Central African R. 36.0
176 Tanzania 36.0
177 Namibia 35.6
178 Burkina Faso 35.5
179 Burundi 34.6
180 Mozambique 34.4
181 Liberia 34.0
182 Ethiopia 33.5
183 Mali 33.1
184 Zimbabwe 32.9
185 Rwanda 32.8
186 Uganda 32.7
187 Botswana 32.3
188 Zambia 30.3
3 Countries with DALE under 30
(3 African)
189 Malawi 29.4
190 Niger 29.1
191 Sierra Leone 25.9
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Message-Id: <200007031344.JAA24049@server.africapolicy.org> From: "APIC" <apic@igc.org> Date: Mon, 3 Jul 2000 10:28:19 -0500 Subject: Africa: Life Expectancy
Editor: Ali B. Ali-Dinar
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