The progress of modern medicine, improved hygiene, and rising living standards over recent decades have achieved something once thought impossible: a substantial increase in life expectancy worldwide. However, the added years of life have not automatically come with a matching increase in years lived in full health. Scientists capture this phenomenon through the concept of the “morbidity gap”: the emerging trend describing the growing distance between total life expectancy and the years people actually spend in genuine good health.
It is the medical and demographic term for the difference between life expectancy and healthy life expectancy, representing the number of years a person lives while suffering from poor health, chronic illness, or disability.
Life expectancy: A new global challenge
A recent, extensive study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, published in the international journal The Lancet Public Health, maps out this new global challenge in detail. The findings show that while the human population is gaining years, a large share of that additional time is being lived under the weight of chronic conditions, disabilities, and reduced functionality.
The gap widened worldwide from 8.8 years in 1990 to 10.7 years in 2023. In 2023, the average person spent 14.5% of their life in poor health, compared with 13.6% in 1990. This widening gap is not limited to the final years of old age, but extends across the whole of adult life.
The IHME study, which analyzed data from 1990 to 2023, revealed a clear and worrying trend: the morbidity gap is widening in almost every region of the planet.
Global life expectancy: Rose from 64.6 years in 1990 to 73.8 years in 2023.
Healthy life expectancy: Rose from 55.9 years in 1990 to 63.1 years in 2023.
Global morbidity gap: Increased by 21.9%, from 8.8 years to 10.7 years.
This increase is not confined to old age, but runs through the whole of adulthood, underscoring that chronic diseases now appear earlier and last longer.
The gap is largest in economically developed countries, where survival rates from acute events like strokes or heart attacks are high.
The data for Greece
Greece is one of the clearest examples of this demographic and health transition. The IHME research data for the country illustrates the scale of the challenge.
According to the study, Greeks spend an average of nearly 12 years of their lives dealing with serious health problems. While Greece’s overall life expectancy stands at close to 81.9 years, among the highest in the EU, healthy life expectancy is noticeably lower, at around 69 to 70 years.
One of the study’s most interesting findings concerns the significant gap between men and women:
Women: The morbidity gap stands at 12.1 years. Although women in Greece consistently have a higher overall life expectancy (reaching 84.3 years), they spend more years living with chronic illness or disability.
Men: The morbidity gap stands at 9.3 years. Men have a lower overall life expectancy (79.3 years) but maintain a proportionally slightly higher share of healthy living.
The main culprits behind lost good health
The IHME study doesn’t just track the years; it analyzes the specific conditions that rob people of quality of life. In Greece, the leading causes of lost good health are:
- Musculoskeletal disorders: The most significant factor in chronic disability. Conditions like lower back pain, neck syndromes, and osteoarthritis alone account for 1.8 years of lost healthy life per person.
- Mental health disorders: Depression and anxiety disorders are rising sharply, estimated to cost the population 1.6 years of good health.
- Cardiometabolic and chronic diseases: Ischemic heart disease, strokes, and type 2 diabetes cause multi-organ complications that turn patients into long-term users of health services.
- Neurodegenerative diseases: Due to the advanced aging of the population, dementia and Alzheimer’s disease place a dramatic burden on the final years of life, while also creating a huge caregiving gap.
IHME stresses that most of the chronic disease burden is not determined by heredity, but by the sum of environmental influences, habits, and living conditions.
In Greece’s case, the widening gap is fueled by specific behaviors:
- Obesity and metabolic syndrome: Greece has some of the highest rates of overweight and obese individuals in Europe, with especially worrying figures among children, predisposing people to early-onset diabetes and hypertension.
- Abandonment of the Mediterranean diet: Increased consumption of processed foods and sedentary living.
- High smoking rates: Despite a gradual decline, smoking remains a major driver of respiratory and cardiovascular disease.
- Environmental factors: Air pollution in urban centers and exposure to extreme heat further burden vulnerable populations.
Impact on the National Health System and the economy
The widening morbidity gap is not just a statistic; it’s a major challenge to the country’s sustainability:
- Pressure on health infrastructure: Rising multimorbidity among people over 65 means more hospital admissions, polypharmacy, and long-term hospitalization.
- Fiscal cost: Spending on managing chronic diseases absorbs the lion’s share of the health budget, limiting resources for prevention.
- Financial burden on families: In Greece, much of the long-term care for the elderly and disabled is informally covered by family members, which affects employment and workforce productivity.
- The challenge of the 21st century is shifting: the goal is no longer simply to add years to life, but to add real, healthy life to those years.
