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Background <p>Longevity gains have not been matched by equivalent advances in healthy longevity, giving rise to the healthspan-lifespan gap. This study maps, by world region, the healthspan-lifespan gap; identifies gap-associated demographic, economic, and health indicators; and deciphers disease burden patterns contributing to gap profiles.</p> Methods <p>World Health Organization (WHO) Global Health Observatory, United Nations World Population Prospects and Global Health Expenditure Database were interrogated. The healthspan-lifespan gap was quantified from estimates of life expectancy and health-adjusted life expectancy. Regression analysis evaluated healthspan-lifespan gap correlates with a spatial error model used to adjust for confounders arising from geographic proximity. Dimensionality reduction by principal component analysis and clustering by machine learning discriminated disease burden patterns linked to healthspan-lifespan gap identity. Supervised machine learning enabled validation of disease burden pattern distinctness.</p> Results <p>Charted for six WHO-designated regions, comprising 183 member states, the healthspan-lifespan gap differs in size across regions. Life expectancy, gross domestic product, and noncommunicable disease burden most consistently correlate with the healthspan-lifespan gap. Unsupervised machine learning identifies three clusters delineating global morbidity patterns. Cluster-informed stratification discerns inter- and intra-regional gap heterogeneity. Africa, although exhibiting the narrowest healthspan-lifespan gap, is overrepresented in countries with larger than predicted healthspan-lifespan gaps and shows the greatest gap expansion and disease burden pattern restructuring. In contrast, Europe is overrepresented in countries with healthspan-lifespan gaps smaller than anticipated. Projections into 2100 forecast continuous widening of the healthspan-lifespan gap across regions.</p> Conclusions <p>The healthspan-lifespan gap is universal yet differs in magnitude and disease contribution among world regions. Gap identities imposed by distinct disease burden patterns caution against global generalization, necessitating region-informed solutions to maximize equitable healthy longevity.</p>

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Healthspan-lifespan gap differs in magnitude and disease contribution across world regions

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年9月1日

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  • Armin Garmany,
  • Andre Terzic

摘要

Background

Longevity gains have not been matched by equivalent advances in healthy longevity, giving rise to the healthspan-lifespan gap. This study maps, by world region, the healthspan-lifespan gap; identifies gap-associated demographic, economic, and health indicators; and deciphers disease burden patterns contributing to gap profiles.

Methods

World Health Organization (WHO) Global Health Observatory, United Nations World Population Prospects and Global Health Expenditure Database were interrogated. The healthspan-lifespan gap was quantified from estimates of life expectancy and health-adjusted life expectancy. Regression analysis evaluated healthspan-lifespan gap correlates with a spatial error model used to adjust for confounders arising from geographic proximity. Dimensionality reduction by principal component analysis and clustering by machine learning discriminated disease burden patterns linked to healthspan-lifespan gap identity. Supervised machine learning enabled validation of disease burden pattern distinctness.

Results

Charted for six WHO-designated regions, comprising 183 member states, the healthspan-lifespan gap differs in size across regions. Life expectancy, gross domestic product, and noncommunicable disease burden most consistently correlate with the healthspan-lifespan gap. Unsupervised machine learning identifies three clusters delineating global morbidity patterns. Cluster-informed stratification discerns inter- and intra-regional gap heterogeneity. Africa, although exhibiting the narrowest healthspan-lifespan gap, is overrepresented in countries with larger than predicted healthspan-lifespan gaps and shows the greatest gap expansion and disease burden pattern restructuring. In contrast, Europe is overrepresented in countries with healthspan-lifespan gaps smaller than anticipated. Projections into 2100 forecast continuous widening of the healthspan-lifespan gap across regions.

Conclusions

The healthspan-lifespan gap is universal yet differs in magnitude and disease contribution among world regions. Gap identities imposed by distinct disease burden patterns caution against global generalization, necessitating region-informed solutions to maximize equitable healthy longevity.