People who live in Japan can expect to remain in good health longer
than anybody else in the world, according to the World Health
Organization (WHO).
WHO scientists have developed a new way of calculating the number
of years that a person can be expected to live in full health.
It is known as the DALE (Disability-Adjusted Life Years) system,
and gives a truer picture of the health of a country than simply
studying death rates.
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Top ten countries
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Japan - 74.5 years
Australia - 73.2
France - 73.1
Sweden - 73.0
Italy - 72.7
Spain - 72.8
Greece - 72.5
Switzerland - 72.5
Monaco - 72.4
Andorra - 72.3
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Using the system to rank the world's 191 countries has uncovered
some surprise findings.
In Japan the average healthy life expectancy is 74.5 years.
Australia is second and France third on the list, but the US
ranks only number 24.
The UK is 14th, with an average of 71.7 years. For UK women the
average is 73.7 years, for men it is 69.7 years
For a full list of countries in ranking order click
here .
Sierra Leone comes last with an average life expectancy at birth
of only 25.9 years.
There is a notable gender gap in many countries. For instance, in
Russia women can expect 66.4 years of full health, compared to just
56.1 years for men.
The WHO estimates almost 56 million people died in 1999, 10.5
million of whom were children less than 5 years of age.
Previously, life expectancy estimates were based on the overall
length of life based on data about death rates.
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Bottom ten countries
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Sierra Leona - 25.9 years
Niger - 29.1
Malawi - 29.4
Zambia - 30.3
Botswana - 32.3
Uganda - 32.7
Rwanda - 32.8
Zimbabwe - 32.9
Mali - 33.1
Ethiopia - 33.5
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To calculate DALE, the years of ill-health are weighted according
to severity and subtracted from the expected overall life expectancy
to give the equivalent years of healthy life.
The WHO rankings show that years lost to disability are
substantially higher in poorer countries because some limitations -
blindness, paralysis and the debilitating effects of several
tropical diseases such as malaria - strike children and young
adults.
People in the healthiest regions lose 9% of their lives to
disability, compared to 14% in the worst-off countries.
Sierra Leone has the lowest healthy life
expectancy
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DALE is estimated to equal or exceed 70 years in 24 countries.
At the other extreme are 32 countries where disability-adjusted
life expectancy is estimated to be less than 40 years.
Many of these are countries with major epidemics of HIV/AIDS,
among other causes.
Dr Christopher Murray, director of WHO's Global Programme on
Evidence for Health Policy, said: "The position of the United States
is one of the major surprises of the new rating system.
"Basically, you die earlier and spend more time disabled if
you're an American rather than a member of most other advanced
countries."
The reasons why the US rates so low may be partly due to the very
poor standard of health among some ethnic minorities and people who
live in the inner cities.
Rates of coronary heart disease are also high.
All of the bottom 10 countries were in sub-Saharan Africa, where
the HIV-AIDS epidemic is rampant.
Alan Lopex, co-ordinator of the WHO Epidemiology and Burden of
Disease team, said: "Healthy life expectancy in some African
countries is dropping back to levels we haven't seen in advanced
countries since Medieval times."
