Research shows that global life expectancy increased by 25 years for women and 24 years for men since 1950, but healthy life expectancy only increased by 6.6 years between 1990 and 2019, meaning people are living longer with chronic diseases. According to Gram Research analysis, heart disease and metabolic problems are the primary drivers of this widening gap, accounting for 437 million disability-adjusted life years in 2023. This divergence is especially pronounced in high-income countries with near-stagnant life expectancy growth but expanding heart disease rates, while low- and middle-income countries face a double burden of infectious diseases and rapidly rising cardiometabolic conditions driven by urbanization and dietary changes.
According to Gram Research analysis, people around the world are living much longer than they did 70 years ago, but they’re spending more of those extra years dealing with heart disease and related health problems. A new review of global health data shows that while life expectancy jumped by about 25 years since 1950, the number of years people spend in good health only increased by about 6.6 years between 1990 and 2019. This means we’re gaining decades of life, but many of those years come with chronic diseases that reduce quality of life. The problem is especially severe in developing countries, which face both old infectious diseases and new heart disease problems at the same time.
Key Statistics
A 2026 narrative review of global health data found that life expectancy increased by 25 years for women and 24 years for men between 1950 and 2023, but healthy life expectancy only increased by 6.6 years between 1990 and 2019, revealing a widening gap between years lived and years lived in good health.
According to research reviewed by Gram, heart disease and related conditions caused 437 million disability-adjusted life years and 19.2 million deaths globally in 2023, making cardiometabolic disease a major driver of the gap between total lifespan and healthy lifespan.
A comprehensive 2026 review of global health patterns found that high-income countries are experiencing near-stagnant growth in life expectancy while cardiometabolic morbidity continues to expand, indicating that medical advances have extended life without preventing age-related chronic diseases.
Research analysis shows that low- and middle-income countries face a double burden of communicable diseases and rapidly rising cardiometabolic diseases driven by urbanization, nutritional transitions toward processed foods, and inadequate primary care infrastructure.
The Quick Take
- What they studied: Researchers looked at how life expectancy and healthy life expectancy have changed worldwide from 1950 to 2023, focusing on heart disease and related metabolic conditions.
- Who participated: This was a review of global health data covering all countries and regions, analyzing trends across high-income, middle-income, and low-income nations.
- Key finding: Global life expectancy increased by 25 years for women and 24 years for men since 1950, but healthy life expectancy only increased by 6.6 years between 1990 and 2019, meaning people are living longer with chronic diseases.
- What it means for you: Living longer is good, but we need to focus on preventing heart disease and metabolic problems so those extra years are actually healthy years. This is especially important for people in developing countries facing rapid urbanization and dietary changes.
The Research Details
This was a narrative review, which means researchers examined and summarized existing research and health data from around the world rather than conducting a new experiment. They looked at patterns in life expectancy (how long people live on average) and healthy life expectancy (how long people live without serious disease) across different countries and regions from 1950 to 2023.
The researchers compared trends in high-income countries like the United States and Europe with middle-income and low-income countries in Africa, Asia, and Latin America. They specifically focused on heart disease and metabolic conditions (problems with how the body processes food and energy) as major causes of the gap between total years lived and healthy years lived.
By examining global health databases and regional patterns, the researchers identified why some countries are seeing improvements in healthy life expectancy while others are falling behind, and what factors drive these differences.
Understanding why people are living longer but not healthier helps doctors and public health officials target their efforts. If we know that heart disease and metabolic problems are the main reasons for this gap, we can focus prevention programs on these conditions rather than spreading resources too thin. This approach is especially important for developing countries that are experiencing rapid changes in diet and lifestyle.
This review synthesizes data from multiple global health sources and examines real-world patterns across many countries, which makes it reliable for understanding big-picture trends. However, because it’s a review rather than a new study, the findings depend on the quality of the original data sources. The researchers acknowledge significant differences between regions, which means recommendations need to be tailored to local conditions rather than applied universally.
What the Results Show
Between 1950 and 2023, global life expectancy increased dramatically by about 25 years for women and 24 years for men. This improvement was driven primarily by better nutrition, cleaner water and sanitation systems, and better control of infectious diseases like tuberculosis and malaria. However, the picture becomes more complicated when researchers looked at healthy life expectancy, which measures years lived without serious disease or disability.
Between 1990 and 2019, healthy life expectancy increased by only 6.6 years globally, while total life expectancy increased by 8.1 years. This means that people are gaining about 1.5 extra years of life with disability or chronic disease for every year of healthy life gained. In 2023 alone, heart disease and related conditions caused 437 million disability-adjusted life years (a measure of years lost to disease) and 19.2 million deaths worldwide.
The gap between total life expectancy and healthy life expectancy is widening in high-income countries, where people are living longer but spending more years managing chronic diseases. In low- and middle-income countries, the situation is more complex: these nations face a double burden of still dealing with infectious diseases while simultaneously experiencing rapid increases in heart disease and metabolic problems.
Regional patterns show major differences in how countries are aging. High-income countries like those in North America and Western Europe have nearly stopped increasing life expectancy, but they’re seeing more people living with heart disease and related conditions. This suggests that medical advances have extended life, but haven’t prevented the diseases that come with aging.
Low- and middle-income countries are experiencing rapid increases in heart disease and metabolic problems, driven by urbanization (people moving from rural areas to cities), changes in diet toward more processed foods, and lack of adequate primary healthcare infrastructure. These countries are essentially facing two health crises at once: they still need to control infectious diseases while also preventing the chronic diseases that come with modern lifestyles.
This research builds on decades of global health monitoring and confirms what many researchers have suspected: that simply living longer doesn’t automatically mean living better. Previous studies have shown that heart disease is becoming the leading cause of death worldwide, but this review provides a comprehensive picture of how this shift has affected the gap between total lifespan and healthy lifespan across all regions and income levels.
This review analyzes existing data rather than conducting new research, so the findings are only as good as the original data sources. Some low-income countries have less reliable health statistics, which may make their trends less accurate. The review also focuses primarily on heart disease and metabolic conditions, so other chronic diseases that affect quality of life may not be fully captured. Additionally, the review doesn’t provide detailed recommendations for specific interventions, since it’s focused on describing global patterns rather than testing solutions.
The Bottom Line
High confidence: Governments and health systems should prioritize prevention of heart disease and metabolic problems through improved nutrition education, increased physical activity opportunities, and better access to primary healthcare. Medium confidence: Countries should implement targeted interventions based on their specific situation, with developing countries focusing on preventing rapid increases in heart disease as they urbanize, and high-income countries focusing on helping people manage chronic diseases better to improve quality of life in older age.
Everyone should care about this research, but it’s especially important for policymakers and public health officials in developing countries experiencing rapid urbanization and dietary changes. People in high-income countries should also pay attention, since the research shows that living longer doesn’t automatically mean living better without active disease prevention. Healthcare providers should use this information to shift focus from just extending life to improving the quality of those extra years.
Changes in life expectancy and healthy life expectancy happen over decades, not months or years. However, individual prevention efforts like improving diet, increasing exercise, and managing stress can reduce heart disease risk within months to a few years. Population-level improvements in healthy life expectancy would likely take 10 to 20 years to become visible.
Frequently Asked Questions
Why are people living longer but getting sicker with heart disease?
Better medicine and sanitation have eliminated many infectious diseases that used to kill people young, allowing people to live longer and develop age-related conditions like heart disease. Additionally, urbanization and processed food diets in developing countries are accelerating heart disease rates faster than healthcare systems can prevent them.
What is the difference between life expectancy and healthy life expectancy?
Life expectancy is the average age people live to, while healthy life expectancy measures years lived without serious disease or disability. Between 1990 and 2019, life expectancy increased 8.1 years globally but healthy life expectancy only increased 6.6 years, meaning the extra 1.5 years were spent managing chronic conditions.
Are developing countries facing different health problems than wealthy countries?
Yes. Developing countries face a double burden: they still deal with infectious diseases while simultaneously experiencing rapid increases in heart disease and metabolic problems due to urbanization and dietary changes. High-income countries have mostly controlled infectious diseases but struggle with managing chronic diseases in aging populations.
Can we prevent the gap between lifespan and healthy lifespan from getting worse?
Research suggests that targeting heart disease and metabolic disease prevention through better nutrition, physical activity, and primary healthcare access can help. Individual actions like regular exercise, eating more vegetables, and managing stress can reduce personal heart disease risk within months to years.
What should governments do about this health gap problem?
Governments should prioritize heart disease prevention through nutrition education and healthcare access, with developing countries focusing on preventing rapid disease increases during urbanization, and high-income countries improving quality of life for people managing chronic diseases in older age.
Want to Apply This Research?
- Track weekly cardiovascular health markers including minutes of moderate exercise, servings of vegetables consumed daily, resting heart rate, and blood pressure readings if available. Set a goal of 150 minutes of moderate activity per week and 5 servings of vegetables daily.
- Use the app to log daily meals and identify processed foods to reduce, set reminders for regular physical activity, and track progress toward heart-healthy habits. Create a personalized plan based on your age and current health status to prevent metabolic diseases.
- Review your cardiovascular health trends monthly, comparing your exercise consistency and dietary choices to previous months. Share quarterly reports with your healthcare provider to identify patterns and adjust prevention strategies based on your individual risk factors.
This review summarizes global health trends and is not a substitute for personalized medical advice. Individual heart disease risk depends on many factors including genetics, age, lifestyle, and existing health conditions. Consult with your healthcare provider before making significant changes to diet, exercise, or health management, especially if you have existing heart disease or metabolic conditions. The findings in this review apply to population-level trends and may not reflect individual circumstances in specific countries or communities.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.