title: Are global and regional improvements in life expectancy and in child, adult and senior survival slowing?
abstract: Improvements in life expectancy have been considerable over the past hundred years. Forecasters have taken to applying historical trends under an assumption of continuing improvements in life expectancy in the future. A linear mixed effects model was used to estimate the trends in global and regional rates of improvements in life expectancy, child, adult, and senior survival, in 166 countries between 1950 and 2010. Global improvements in life expectancy, including both child and adult survival rates, decelerated significantly over the study period. Overall life expectancy gains were estimated to have declined from 5.9 to 4.0 months per year for a mean deceleration of -0.07 months/year2; annual child survival gains declined from 4.4 to 1.6 deaths averted per 1000 for a mean deceleration of -0.06 deaths/1000/year2; adult survival gains were estimated to decline from 4.8 to 3.7 deaths averted per 1000 per year for a mean deceleration of -0.08 deaths/1000/year2. Senior survival gains however increased from 2.4 to 4.2 deaths averted per 1000 per year for an acceleration of 0.03 deaths/1000/year2. Regional variation in the four measures was substantial. The rates of global improvements in life expectancy, child survival, and adult survival have declined since 1950 despite an increase in the rate of improvements among seniors. We postulate that low-cost innovation, related to the last half-century progress in health-primarily devoted to children and middle age, is reaping diminishing returns on its investments. Trends are uneven across regions and measures, which may be due in part to the state of epidemiological transition between countries and regions and disparities in the diffusion of innovation, accessible only in high-income countries where life expectancy is already highest.
authors.affiliation: Center for Global Engineering and Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Hum
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Verguet
authors.affiliation: Center for Global Engineering and Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Cheng
authors.affiliation: Rotman School of Management and Munk School of Global Affairs, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Anita M
authors.initials: AM
authors.lastname: McGahan
authors.affiliation: Center for Global Health Research, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Prabhat
authors.initials: P
authors.lastname: Jha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056808:Biostatistics; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy / Q000639:trends*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D055815:Young Adult