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Jaya Dantas, a professor of international health at Curtin University, points out that some countries, including Rwanda and Nigeria, saw the greatest increases in both healthspan and lifespan, in part due to reduced conflict across the region and advances in healthcare.
As far as the growing gap in western and developed countries goes, Dantas explains we are getting better at managing communicable and non-communicable diseases and are monitoring them more widely.
The data also showed women to have a mean healthspan-lifespan gap 2½ years higher than men.
Dantas says this is partly because women are living longer than men, but also because women are generally more resilient and better at managing diseases, particularly musculoskeletal diseases for which they bear a greater burden.
“They might have non-communicable diseases, but they are proactive in looking after their health.”
And, Dantas adds, “there are some things you can’t prevent – you can’t prevent ageing. You can’t prevent the effects that come from menopause, or osteoarthritis or the autoimmune conditions that some people get. But people can still manage these conditions and lead healthy, productive lives.”
Prevention, not intervention
In light of this growing gap, many researchers like Fontana are advocating for a focus on prevention, rather than medical intervention.
“The goal of medicine should be to minimise the unhealthy window,” he says.
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In 2020, The United Nations launched its Decade of Healthy Ageing resolution, which sought to shift societal focus from longevity to healthy longevity.
And Fontana says this gap does not need to be growing, as many of the diseases which contribute to poor ageing and burden the healthcare system are preventable.
According to the WHO, over 75 per cent of cardiovascular diseases and 40 per cent of cancers are preventable.
Fontana says the medical field is still focused on diagnosis and intervention, rather than prevention, and we should be looking at alternate models of care.
A novel Australian trial, conducted by Fontana and Kevin Chang in Sydney over three years, used a value-based preventative primary care model to propose an alternative to our current system. Strikingly, it found a 51 per cent reduction in hospital admissions and significant improvements across various markers of health. Scaled across Australia, its researchers estimate it could save $30 billion annually.
Fontana also believes prevention needs to start from a young age in homes and schools.
“We are not teaching our kids how nutrition, exercise and emotional health can be changed in a mechanistic way,” he says.
Healthy ageing
If we want to live healthier – not just longer – lives, our lifestyle is important. On an individual level, most of the advice for healthy ageing is simple and sensible: stay active, prioritise a whole food diet, don’t smoke, reduce alcohol consumption and maintain meaningful connections with friends and family.
But Dantas says this also needs to come with structural changes invested by governments that allow people to make these healthier choices. This includes things like building liveable cities that encourage walking and cycling, supporting the elderly in maintaining active and independent lives and improving access to healthcare and food security.
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