Healthy Life Expectancy vs Life Expectancy: The Years That Count
Most people spend 10 or more years of life in poor health. Here is how healthy life expectancy compares with life expectancy, by country, sex and income.
Picture two women born in the same year, in the same town, who both live to 84. The first is still walking to the shops at 82, still doing the crossword in pen, still taking the bus to see her grandchildren. Her decline comes late and fast, over a few months. The second has type 2 diabetes from her late fifties, a hip replacement at 66, worsening sight and breathlessness through her seventies, and spends her last six years mostly indoors.
On paper, these two lives are identical. They have the same life expectancy and the same age at death, and they would add the same number to national statistics. In reality, one of them had something like 80 good years and the other closer to 60. That difference is what healthy life expectancy tries to measure, and it is arguably the number that matters most. While you think about your own, you can watch the world's running death total on our live death counter.
Two numbers, one life
Life expectancy tells you how long people live. Healthy life expectancy tells you how long they live in good health.
| Measure | What it counts | Who publishes it |
|---|---|---|
| Life expectancy at birth | Average years a newborn would live at current death rates | WHO, ONS, CDC, national statistics offices |
| Healthy life expectancy (HLE) | Years expected in self-reported "good" or "very good" health | ONS (UK) |
| Health-adjusted life expectancy (HALE) | Years in full health, with years lived with illness weighted down | WHO |
| Disability-free life expectancy | Years expected without a limiting long-term illness or disability | ONS |
The gap between life expectancy and healthy life expectancy is, roughly, the number of years a typical person can expect to spend living with illness or disability. Worldwide, according to the World Health Organization, that gap is close to 10 years.
The global picture
WHO estimates that global life expectancy rose from about 66.8 years in 2000 to 73.1 in 2019, before falling during the COVID-19 pandemic. Healthy life expectancy rose too, but by slightly less.
| Year | Global life expectancy | Global healthy life expectancy (HALE) | Years in poor health |
|---|---|---|---|
| 2000 | ~66.8 | ~58.1 | ~8.7 |
| 2010 | ~70.0 | ~61.0 | ~9.0 |
| 2019 | ~73.1 | ~63.7 | ~9.4 |
| 2021 | ~71.4 | ~61.9 | ~9.5 |
Source: WHO World Health Statistics; figures rounded.
The 2021 drop, about 1.8 years in both measures, wiped out roughly a decade of progress and was driven mainly by the pandemic. Recovery since has been under way. You can see the longer story of global lifespans on our life expectancy page and in life expectancy by country in 2026.
The key point is in the last column. We have added years to life faster than we have added healthy years, so the time people spend unwell at the end of life has crept upward.
The UK: a gap of 17 to 21 years
The UK measures healthy life expectancy more strictly than WHO, using people's own rating of their general health. On that measure, the gap is much bigger.
| England (ONS, 2021 to 2023) | Men | Women |
|---|---|---|
| Life expectancy at birth | ~78.8 | ~82.8 |
| Healthy life expectancy at birth | ~61.5 | ~61.9 |
| Years expected in poor health | ~17 | ~21 |
| Share of life in good health | ~78% | ~75% |
Rounded from ONS health state life expectancies; the latest three-year figures were the lowest since the series began.
Healthy life expectancy in England has fallen in recent releases, by around a year or more from its pre-pandemic level, while life expectancy has partly recovered. A typical English person can now expect to start describing their health as less than good in their early sixties, years before the state pension age of 66. That has big implications for work, care and families, and it lines up with the long rise in conditions like diabetes and COPD described in the leading causes of death in the UK.
Notice that women's healthy life expectancy is barely higher than men's, even though women live four years longer. Women spend more of their extra years living with conditions such as arthritis, osteoporosis, depression and dementia. We look at that in the leading causes of death in women.
The postcode gap is bigger for health than for life
Inequality shows up in both measures, but it is far sharper in healthy life expectancy.
| England, most vs least deprived areas | Life expectancy gap | Healthy life expectancy gap |
|---|---|---|
| Men | ~10 years | ~19 years |
| Women | ~8 years | ~19 years |
In other words, people in the poorest neighbourhoods of England die around a decade earlier than those in the richest, and they start living with poor health around two decades earlier. In the most deprived areas, healthy life expectancy is often in the low fifties. In the least deprived, it is approaching 70.
This pattern appears in almost every country that measures it. We examine the wider relationship between money and lifespan in how income affects life expectancy.
Healthy life expectancy around the world
The WHO's HALE measure allows comparison across countries. The pattern at the top is very similar to the ordinary life expectancy ranking, with Japan in first place.
| Country | Life expectancy (approx.) | HALE (approx.) | Years in poor health |
|---|---|---|---|
| Japan | ~84.3 | ~74.1 | ~10 |
| Singapore | ~83.2 | ~73.6 | ~10 |
| South Korea | ~83.3 | ~73.1 | ~10 |
| Switzerland | ~83.4 | ~72.5 | ~11 |
| United Kingdom | ~81.4 | ~70.1 | ~11 |
| United States | ~78.5 | ~66.1 | ~12.4 |
| India | ~70.8 | ~60.3 | ~10.5 |
| Nigeria | ~62.6 | ~54.4 | ~8 |
Based on WHO 2019 estimates, the most recent comparable year before the pandemic; figures rounded.
Two things stand out. First, every country has a gap of roughly 8 to 12 years, rich or poor. Living longer has not, so far, meant escaping a period of illness at the end. Second, the United States has one of the largest gaps of any country on earth. A 2024 study by researchers at the Mayo Clinic, comparing 183 countries, found Americans spend about 12.4 years of life in poor health, the widest gap of any nation they analysed, driven by high rates of chronic disease such as diabetes, obesity and mental illness.
Japan's long healthy lifespan is explored in Japan's secret to living past 100, and the places with the most healthy centenarians in Blue Zones: what the longest-living people on earth eat.
What fills the unhealthy years
The conditions that take healthy years away are not always the ones that kill. Many of the biggest causes of disability are rarely written on a death certificate.
| Leading causes of years lived with disability (global) | Kills many people? |
|---|---|
| Low back pain | No |
| Depressive disorders | Indirectly, through suicide |
| Headache disorders, including migraine | No |
| Diabetes | Yes |
| Age-related hearing loss | No |
| Falls and injuries | Yes, in older age |
| Chronic obstructive pulmonary disease (COPD) | Yes |
| Osteoarthritis | No |
| Anxiety disorders | No |
| Dementia | Yes |
Based on Global Burden of Disease study rankings of years lived with disability; exact order varies by year and age.
This is why healthy life expectancy and life expectancy can move in different directions. Better heart treatment keeps people alive, but it does not prevent back pain, arthritis or hearing loss. Rising obesity, by contrast, may not shorten life much on average in rich countries, thanks to modern drugs, but it adds years of living with diabetes and joint pain. Our diabetes page and dementia page cover two of the biggest overlaps.
Can you extend your own healthy years?
The good news is that the habits linked to a longer life are, almost without exception, also linked to a longer healthy life. Several large studies suggest they compress the unhealthy period rather than simply stretching it.
| Habit | Effect on healthy years (approx., from major cohort studies) |
|---|---|
| Never smoking | Several extra years free of heart disease, cancer and COPD |
| Regular physical activity | Lower disability risk and later onset of chronic disease |
| Healthy body weight | Fewer years with diabetes and joint problems |
| Moderate or no alcohol | Fewer years with liver disease and some cancers |
| Strong social connections | Lower risk of depression and dementia |
A Harvard study of more than 100,000 adults, published in the BMJ in 2020, found that people following five healthy habits lived around 7 to 10 more years free of cancer, heart disease and diabetes than those following none. The same habits we discuss in the 5 habits that add the most years to your life appear to buy healthy years, not just extra ones.
Two of the simplest measures of how your body is ageing are also among the best predictors of future disability: how far you walk and how strong your grip is. We look at both in how many steps a day to live longer and grip strength and how long you will live.
Why this matters more than the headline
For governments, healthy life expectancy decides how long people can work, how much social care costs and how many families become carers. For individuals, it decides how much of retirement is actually lived. If you expect to live to 85 but your health becomes limited at 62, that changes everything from when to travel to when to put plans in place for the people you love.
The Life Clock shows how much of an average lifespan you have already used, and the Death Clock estimates your own expected lifespan from your age, sex and habits. As a rough rule, subtract ten years from either number and you have a sense of how many healthy years most people get. The habits above are how you beat that rule.
While you were reading this
You have spent about 12 minutes with this article. In that time, roughly 1,400 people have died around the world. Most of them spent their last years living with at least one long-term illness. For a typical person in a wealthy country, that period lasted about a decade. For some it was a few weeks; for others it was half their adult life.
You can watch the total keep rising on our live death counter, or see the key global numbers side by side on our statistics page.
Data sources: World Health Organization (World Health Statistics, Global Health Observatory HALE estimates), Office for National Statistics (health state life expectancies, England), Global Burden of Disease study (Institute for Health Metrics and Evaluation), Garmany and Terzic (JAMA Network Open, 2024) on the global healthspan-lifespan gap, Li et al. (BMJ, 2020) on healthy lifestyle and disease-free life expectancy. Figures are rounded and estimates vary by method and year. This article is for informational purposes only and does not constitute medical advice.
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