Living long and living well are different goals

By Neil Solomon · 3 min read

Suppose someone offers you two more years at 60. Before you answer, you might ask what shape those years would be in.

Researchers ask that question with healthy life expectancy. The World Health Organization defines it as the average number of years a person can expect to live in full health. The count leaves out years lived with disease or injury.

We compared 2000 with 2019 for people who have reached 60, both sexes, using the World Health Organization tables. The question was whether the added years came in full health.

More years at 60, 2000 and 2019 (World Health Organization, both sexes)

Country	Total years	Years in full health	Years with illness or injury	Share of added years in full health
Japan	24.6 to 26.7	18.4 to 19.9	6.2 to 6.8	75%
South Korea	20.3 to 26.1	15.1 to 19.4	5.2 to 6.7	74%
Spain	22.7 to 25.4	17.2 to 19.2	5.5 to 6.2	74%
United Kingdom	21.3 to 24.1	16.1 to 17.9	5.2 to 6.2	64%
France	23.0 to 25.7	17.3 to 18.8	5.7 to 6.9	56%
United States	21.3 to 23.2	15.1 to 15.8	6.2 to 7.4	37%
Mexico	21.4 to 22.2	15.1 to 15.2	6.3 to 7.0	13%
Thailand	20.7 to 23.4	15.8 to 18.6	4.9 to 4.8	104%

The last column is our calculation from unrounded figures. It is above 100% in Thailand because years with illness fell slightly.

In most of these countries, years with illness or injury grew. In the United States they rose from 6.2 to 7.4. In France they rose from 5.7 to 6.9, and in South Korea from 5.2 to 6.7.

The share of added years spent in full health varied widely. In Japan, South Korea and Spain it was about three in four. In the United States it was about three in eight. In Mexico, total years at 60 rose by 0.8 and healthy years by 0.1.

Two countries went the other way. Thailand's years with illness went from 4.9 to 4.8. Brazil's went from 5.7 to 5.5.

These are modeled estimates. A difference of a few tenths of a year is best read as roughly equal.

The Organisation for Economic Co-operation and Development reports a similar pattern. Most of its member countries gained life expectancy at 65 between 2013 and 2023. The organization notes that not all of the added years are lived in good health.

Habits connect to healthy years. In the Harvard studies, women at 50 with four or five low-risk habits could expect 34.4 years free of cancer, heart disease and diabetes. With none, they could expect 23.7. For men the figures were 31.1 and 23.5.

That is a gain of 10.7 disease-free years for women and 7.6 for men. These are observational findings, and the participants were health professionals.

So the two goals can come apart. A country or a person can add years of life without adding years in full health. The tables suggest the gap between them has been widening in many places.

If you compare countries, you could look at both numbers. Our life expectancy calculator shows total years. The healthy years figure shows up in the other articles in this series.

In the United States since 2000, a little more than one added year in three has been a healthy one. In Japan it has been about three in four.

What would a good year look like for you at 80? Tell us in the comments. Someone may be defining it for the first time.

Sources we read

World Health Organization, Global Health Observatory, healthy life expectancy at age 60 (2000 and 2019) and life expectancy at age 60. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/life-expectancy-at-age-60-(years)

Organisation for Economic Co-operation and Development, Health at a Glance 2025, life expectancy and healthy life expectancy at older ages. https://www.oecd.org/en/publications/health-at-a-glance-2025_8f9e3f98-en/full-report/life-expectancy-and-healthy-life-expectancy-at-older-ages_599cf359.html

Li and others, Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes. https://pure.psu.edu/en/publications/healthy-lifestyle-and-life-expectancy-free-of-cancer-cardiovascul/