Life expectancy gains in Pakistan lag behind much of the world, reveals new study

Islamabad
Gains in life expectancy and healthy life expectancy in Pakistan are almost equal, but significantly lower than global averages. Globally, people gained 6.2 years of life expectancy between 1990 and 2013, and 5.4 years of healthy life. In Pakistan, life expectancy increased by only 3.4 years, and health life expectancy increased by 3.3 years, reveals a new study led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
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,’ this is the first study to examine fatal and nonfatal health loss across countries. The analysis was published in The Lancet on August 27.
In simpler terms, the study reveals that people in Pakistan are living longer, but both life expectancy and healthy life expectancy have increased more slowly than in most countries in the world. Healthy life expectancy takes into account, not just mortality but the impact of nonfatal conditions and summarises years lived with disability and years lost due to premature mortality. The increase in healthy life expectancy has not been as dramatic as the growth of life expectancy, and as a result, people are living more years with illness and disability.
Moreover, according to the analysis, a complex mix of fatal and nonfatal ailments cause a tremendous amount of health loss.
There are also significant gender differences, with Pakistani women outpacing men in terms of health gains. Life expectancy gains for women 4.7 years, exceeded those for men, only 2.2 years, and while women gained 4.3 years of healthy life expectancy, men gained only 2.4 years. Life expectancy for women in Pakistan still outpaces that of men, 67.3 years compared to 64.4 years.
A press release issued by IHME and the University of Washington quotes Dr. Anwar Rafay, a medical specialist and assistant professor in epidemiology and biostatistics at Contech School of Public Health and a co-author of the study, as saying: “It’s encouraging to see life expectancy for people in Pakistan steadily climbing but healthy life expectancy needs to keep pace if we are going to live both long and healthy lives. These data give us a big-picture view of Pakistani health scenario to address the causes of health loss that are having the most severe impact.”
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.
“Thanks to marked declines in death and illness caused by HIV/AIDS and malaria in the past decade and significant advances made in addressing communicable, maternal, neonatal, and nutritional disorders, health has improved significantly around the world,” the press release adds. According to the study, 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 at birth rose by 5.4 years (from 56.9 in 1990 to 62.3 in 2013).
The study’s researchers use disability-adjusted life years (DALYs) to compare the health of different populations and health conditions across time. One DALY equals one lost year of healthy life and is measured by the sum of years of life lost and years lived with disability.
In Pakistan, the leading causes of health loss, as measured by DALYs, in 2013 were lower respiratory infections, neonatal encephalopathy, diarrheal diseases, ischemic heart disease, neonatal preterm birth complications, neonatal sepsis, stroke, meningitis, road injuries, and congenital abnormalities. Some of these conditions, including lung cancer and Alzheimer’s disease, were not among the leading causes of health loss globally.
The study also examines the role that socio-demographic status – a combination of per capita income, population age, fertility rates, and average years of schooling – plays in determining health loss. Researchers’ findings underscore that this accounts for more than half of the differences seen across countries and over time for certain leading causes of DALYs, including maternal and neonatal disorders. But the study notes that socio-demographic status is much less responsible for the variation seen for ailments including cardiovascular disease and diabetes.
IHME director Dr. Christopher Murray believes that “Factors including income and education have an important impact on health but don’t tell the full story. Looking at healthy life expectancy and health loss at the country level can help guide policies to ensure that people everywhere can have long and healthy lives, no matter where they live.”