A new scientific study on projections and alternative scenarios for life expectancy and major causes of death in 2040 shows that life expectancy will at least increase slightly in all countries. In contrast, in one scenario, almost half of all nations have a lower life expectancy.
The ranking of the life expectancy of nations provides new insights into their health status.
China ranked 68 out of 1
In contrast, the United States ranked 43rd in 2016 with an average life expectancy of 78.7 years. In 2040, life expectancy is expected to rise by only 1.1 years to 79.8 but fall to 64th. For comparison, the United Kingdom had a life span of 80.8 years in 2016 and is expected to rise to 83.3, which will increase its rank from 26 to 23 in 2040.
In addition, the study published today in the international medical journal The Lancet published a significant increase in deaths from non-communicable diseases (NCDs), including diabetes, chronic obstructive pulmonary disease (COPD), chronic Kidney disease and lung cancer, and worsening health outcomes related to obesity
However, there is "great potential to change the downward trend in health" by addressing key risk factors, level of education and per capita income.
"The future of world health is not over" There are a number of plausible trajectories, "said Dr. Kyle Foreman, director of data science at the Institute for Health Metrology and Assessment (IHME) at the University of Washington and lead author of the study "However, whether we see significant progress or stagnation depends on how well or poorly health systems address key health determinants."
The top five health workers, who account for much of the future development of premature mortality, are high blood pressure and high body mass -Mass index, high blood sugar, tobacco use and alcohol consumption, said Foreman.Air pollution ranked 6.
In addition to China, in 2040 several other nations are expected to significantly improve their life expectancy rankings, including:  Syria is expected to rank highest worldwide worldwide own – from 137. in 2016 to 80. 2040 – according to the authors, due to a conservative conflict model;
In contrast, Palestine is expected to decline the most in its life expectancy list – from 114 in 2016 to 152 in 2040. In addition, several countries are expected to join high incomes will significantly decrease their rankings, including:
- United States, most for high-income countries, from 43rd in 2016 to 64 in 2040;
- Canada from the 17th to the 27th,
- Norway from the 12th to the 20th,
- Taiwan (Province of China) from the 35th to the 42th
- Belgium from the 21st to the 28th  Netherlands from 15th to 21st
The ranking also shows that Spain is expected to take first place in the world in 2040 (average lifetime of 85.8 years), a rise of fourth in 2016 (average lifespan of 82.9 years). Japan, the first place in 2016 (average life 83.7 years), will fall to second place in 2040 (average life 85.7 years).
Rounding out the top 10 for 2040 are:
- Singapore (average lifetime 85.4 years) ranked third, compared with 83.3 years in 2016 and ranking also the third
- Switzerland (average lifetime 85.2 Years), compared with 83.3 years in 2016 and ranking the second
- Portugal (average lifetime 84.5 years), compared with 81.0 years in 2016 and ranking of 23.
- Italy (average lifespan 84.5 years), compared with 82.3 years in 2016 and ranking the seventh
- Israel (average lifetime 84.4 years), compared with 82.1 years in 2016 and ranking of 13th
- France (average life 84.3 years), compared with 82.3 years in 2016 and ranking also by eighth
- Luxembourg (average lifetime 84.1 years) compared to 82.2 years in 2016 and ranking the 10th.
- Australia (average lifespan r 84.1 years), compared to 82.5 years in 2016 and fifth place
Among these top 10 nations, even their "worse" scenarios will remain over 80 years old in 2040. By contrast, the lowest nations, which include Lesotho, Swaziland, the Central African Republic and South Africa, are in the "better" and "worse" scenarios of 2040 from a high of 75.3 years in South Africa ("better" scenario) a low of 45.3 years in Lesotho ("worse scenario"), a 30-year difference.
"Inequalities will continue to be great," said IHME Director Dr. Christopher Murray. "The gap between the" better "and" worse "scenarios will narrow but still be significant: in a significant number of countries, too many people will continue to earn relatively low incomes, stay poorly educated and die prematurely, but nations could do making faster progress by helping people tackle the main risks, especially smoking and poor nutrition. "
In a" worse "scenario, life expectancy is falling in almost half of all countries in the next generation. Specifically, 87 countries will experience a decline, and 57 will experience an increase of one year or more. In the "better" scenario, on the other hand, 158 countries will reach a life expectancy of at least five years, while 46 nations may expect gains of ten or more years.
The future shift towards increased premature mortality from NCDs and injuries and communicable diseases is evident in the changing proportions of the top 10 causes of premature death.
In 2016, four of the top 10 causes of premature mortality were NCDs or injuries; In contrast, this number will rise to eight in 2040. The eight NCD or injury causes in the Top Ten in 2040 are expected to be ischemic heart disease, stroke, COPD, chronic kidney disease, Alzheimer's disease, diabetes, traffic accidents and lung cancer.
The study is unprecedented in scope, Foreman said, offering more robust statistical modeling and more comprehensive and detailed estimates of risk factors and diseases than previous United Nations forecasts and other population studies institutes.
IHME researchers used data from the Global Burden of Disease (GBD) study to create predictions and alternative "better" and "worse" scenarios for life expectancy and mortality due to 250 causes of death for 195 countries and territories.
The researchers produced predictions for independent health determinants, including socio-demographic fertility measurements per capita income, and years of education, along with 79 independent drivers of health such as smoking, high body mass index, and lack of clean water and hygiene. They then used information on how each of these independent factors influences certain causes of death to develop mortality forecasts.
"The range of" better "and" worse "scenarios allows stakeholders to explore possible changes to improve local health systems, nationally and globally," said Murray. "These scenarios provide new insights and help plan health planning, particularly with regard to the long wait between initial investment and its impact, such as drug discovery and development."
In addition to paying attention to the growing importance of noncommunicable diseases, the analysis highlights a significant risk that HIV / AIDS mortality is recovering, which could undermine recent life expectancy in some sub-Saharan African countries.
In addition, many low-income countries are projecting an increase in noncommunicable diseases: transmissible, maternal, neonatal and nutritional disorders are likely to continue to be among the main causes of early death, thereby causing a "double burden" of the disease.
The study is titled "Predicting Life Expectancy, Years of Lifetime and Overall and Cause-Specific Mortality for 250 Causes of Death: Reference and Alternate Scenarios for 2016-40 for 195 Countries and Territories."
The study is available at http : //www.healthdata.org
Accompanying materials, including comprehensive lists and supporting data on the rankings of all countries, are under the embargo https://cloud.ihme.washington.edu/index.php/s/AkAfRKXFaKwLpFr disposal
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Kyle J Foreman et al, Life expectancy, life expectancy, and total and cause-specific mortality prognosis for 250 causes of death: Reference and alternative scenarios for 2016-40 for 195 countries and territories, The Lancet (2018). DOI: 10.1016 / S0140-6736 (18) 31694-5