2040: A health odyssey

November 9, 2018 Lianne Jacobs

The growing necessity of prevention in the health landscape in 20 years

Life expectancy is widely considered a barometer of a country’s health and an indicator of economic measures of prosperity. As of 2016, life expectancy in the United States was 78.7 years, compared to 83.7 years in Japan, and 76.3 years in China. A recent study was published in The Lancet forecasting the life expectancy and causes of death looking out to 2040. We were intrigued and decided to look at how these numbers may change by the time babies born today enter the workforce in the year 2040.

By 2040, global life expectancy is projected to increase by 4.4 years for both men and women to 74.3 years and 79.7 years, respectively. But, when we look at each country individually, we see the emergence of a more nuanced story. China’s life expectancy is expected to surpass that of the United States in 2040, and Spain is projected to overtake Japan as the top-ranked country for life expectancy. Spain’s relaxed culture, featuring leisurely lunches with a glass of wine, siestas in the afternoons, and multi-generation family get-togethers on the weekends is likely a contributor to their impressive increase in longevity. Several studies have found a link between lifestyle factors, such as stress[1], sleep[2], social connectivity[3] and mortality, lending support to one potential reason as to why Spain is projected to have a life expectancy of 85.8 years in 2040. While the life expectancy gap between the countries with the best and worst life expectancies is expected to narrow by over five years to a still-alarmingly high gap of 28.4 years by 2040, it is important to remember that these rankings are constantly in flux. No country’s fate is sealed by these predictions, and countries must address their unique obstacles with action.

The projections for 2040 show a continued shift toward an increasing number of deaths caused by non-communicable diseases (NCDs), also known as chronic diseases, which are in large part linked to our behaviors. While the study anticipates that 81 percent of global diseases will be attributable to NCDs, poorer nations will still be greatly impacted by communicable diseases. Despite anticipated progress in south and southeast Asia, Latin America, North Africa and the Middle East, sub-Saharan Africa is still projected to carry a larger burden of deaths due to communicable diseases. Several non-profit and governmental organizations are tackling these health issues with interventions that extend from improved healthcare facilities to ready access to malaria vaccinations. These essential interventions – paired with robust funding, infrastructure and education – are critical given that these poorer nations are going to have to grapple with both infectious and chronic diseases.

The fact that a staggering 81 percent of deaths in 2040 will be attributable to non-communicable diseases highlights not only the opportunity, but the necessity for effective preventive measures and behavioral interventions to facilitate adherence to such measures. Our actions will impact the future state of the world; we cannot afford to stand by and do nothing when it comes to our own health, the health of our loved ones, and the health of the companies at which we work. The top five global health drivers that explain most of the future trajectory for premature death are high blood pressure, high body mass index, high blood sugar, tobacco and alcohol use, with air pollution ranking sixth. Several of these metabolic conditions are easily managed with medication, while behavioral interventions aiming to improve diet and exercise, and reduce smoking and alcohol intake are of critical importance to help lower rates of premature death. Vitality’s multifaceted approach to health and well-being leverages robust clinical, actuarial and behavioral science not only to educate members about their risks, but also simultaneously incentivizes them to make sustained improvements to their health.

The 2040 study gives us pause for reflection and allows us to understand what our world might look like in the future. With the blessing of longer life comes the potential curse of more years lived with disease, with projections showing an increased burden due to Alzheimer’s disease and other dementias associated with aging. Several studies have shown that living a healthy lifestyle can not only prolong life expectancy by over a decade[4], but also that healthy lifestyle factors are associated with lower disease burden, and longer life lived in good health[5]. We must act now to create a better future for ourselves. Tackling the longevity problem cannot occur in siloes – collaboration across industry, government, communities and academia is crucial to develop and scale interventions that can lead to meaningful change. This is no small task, but our future life years and our economic prosperity are at stake.

1 Cohen S, Janicki-Deverts D, Doyle WJ, Miller GE, Frank E, Rabin BS, Turner RB. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proceedings of the National Academy of Sciences. April 2012; 109 (16) 5995-5999; doi:10.1073/pnas.1118355109.  Accessed from: http://www.pnas.org/content/109/16/5995
2 Ackermann K, Revell VL, Lao O, Rombouts EJ, Skene DJ, Kayser M. Diurnal rhythms in blood cell populations and the effect of acute sleep deprivation in healthy young men. Sleep. July 2012; 1;35(7):933-40. doi: 10.5665/sleep. 1954. Accessed from: https://www.ncbi.nlm.nih.gov/pubmed/22754039
3 Berkman LF, Syme SL. Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda county residents. American Journal of Epidemiology, Volume 109, Issue 2, 1 February 1979; Pages 186–204. doi:10.1093/oxfordjournals.aje.a112674.  Accessed from:  https://academic.oup.com/aje/article-abstract/109/2/186/74197
4 Li Y, Pan A, Wang D, Liu X, Dhana K, Franco OH, Kaptoge S, Di Angelantonio E, Stampfer M, Willett WC, Hu FB. Impact of healthy lifestyle factors on life expectancies in the US population. Circulation. April 2018; 138:345–355.  Accessed from: https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.117.032047
5 May AM, Strujik EA, Fransen HP, Onland-Moret NC, de Wit GA, Boer JM, van der Schouw YI, Hoekstra J, Bueno-de-Mesquita HB, Peeters PH, Beulens JW. The impact of a healthy lifestyle on Disability-Adjusted Life Years: a prospective cohort study.  BMC Medicine, February 2015; 13:39. doi: 10.1186/s12916-015-0287-6. Accessed from: https://www.ncbi.nlm.nih.gov/pubmed/25858161

Lianne Jacobs, Product Analyst, has a Master’s in Public Health from Yale University. She is the only indoor cycling instructor who can’t ride a bike. She enjoys traveling the world, laughing at her own jokes, and tricking her husband into eating baked goods made with hidden vegetables.

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