A new global study reveals a striking reality: Your chances of living past age 70 still depend heavily on where you live.
Even with modern medicine, vaccines, and artificial intelligence helping to diagnose diseases early, the risk of dying before age 70—known as probability of premature death (PPD)—still varies widely around the world.
In 2019, just 12% of people in the world’s healthiest countries died before age 70. But in sub-Saharan Africa, that number was 52%, India’s rate was 37%, the United States stood at 22% and Western Europe and Canada fared better at 15%, according to the study in JAMA Health Forum.
Researchers at Duke University School of Medicine pulled data from the United Nations and the Human Mortality Database to examine how well countries are doing relative to their wealth. Instead of comparing death rates alone, they measured the world’s 30 most populous countries against the “global frontier”—the best case scenario for preventing early deaths.
“We expected disparities,” says the study’s lead author Omar Karlsson, a scholar with the Center for Policy Impact in Global Health at the Duke Global Health Institute. “What was surprising was just how extremely uneven mortality decline has been across the world.”
When it comes to longevity, Japan remains the place to be. As global PPD fell to 12%—a dramatic improvement from 57% in 1900—Japan stood out, setting the benchmark among the world’s healthiest countries. But progress has not been universal.
Many parts of the world are still facing health risks that others left behind generations ago.
Sub-Saharan Africa, while still facing a 52% premature death rate in 2019, has improved remarkably from 65% in 2000, a level the world last saw in 1916. China has progressed even faster, closing much of the gap with the world’s healthiest countries: once nearly a century behind the frontier in 1970, it has now narrowed that difference to just a few decades.
How did China do it? China’s success came from sweeping public health campaigns, nearly universal access to primary care, pollution reduction, and major gains in education and poverty alleviation.
The United States, on the other hand, is losing ground. Despite having the highest health care spending in the world, the US is doing worse than expected when it comes to preventing early deaths.
In 1970, the US lagged 29 years behind the global frontier. By 2019, that gap had grown to 38 years.
That means other countries are catching up and even passing the US when it comes to helping people live longer lives.
The researchers cite deep inequalities in the US health care system, high costs, and wasteful medical spending. Rising deaths from drug overdoses, gun violence, and suicide are also contributing to the US backslide.
Other countries face their own challenges. In parts of Africa, deaths from infectious diseases, childbirth complications, and lack of clean water remain leading causes of preventable deaths.
Central and Eastern Europe struggle with alcohol-related deaths and suicide, while India and Central Asia are seeing more deaths from chronic conditions like heart disease and stroke.
As medicine advances with high-tech treatments like precision cancer treatments and genetic therapies, the study’s authors warn that technology alone won’t close the gap.
“The tools to prevent early death are out there,” says the study’s co-senior author and Duke global health researcher Osondu Ogbuoji, an assistant professor in population health sciences and commissioner on the Lancet Commission on Investing in Health. “But how quickly and fairly they’re shared is the real challenge.”
Source: Duke University
