Slowing of life expectancy in the UK: Global Burden of Disease Study 2016

Abstract

BackgroundLife expectancy in the UK stopped increasing in 2010. To identify possible causes, we explored changes in life expectancy by age, sex, and condition. MethodsUsing the Global Burden of Disease (GBD) study 2016, we determined estimates of life expectancy, death rates, and premature mortality (years of life lost [YLL]) from 1990 to 2016 in the UK by sex and age. Annual change in YLL and death rates were calculated for the following leading causes of premature death in 2016: ischaemic heart disease, lung cancer, stroke, chronic obstructive pulmonary disease, dementia, lower respiratory tract infections, colorectal and breast cancers, self-harm, and diseases due to alcohol use and related diseases. FindingsCombined mean improvements in life expectancy were 0·26% per year (75·72–80·99) and death rates were 0·98% (195427·59–154351·73) from 1990 to 2010; improvements stalled after 2010. The slowdown was seen across all age groups and in both sexes, with a slightly more marked slowdown in men (0·04%, 72·85–78·92) than in women (0·03%, 78·47–82·86). The conditions that showed the greatest changes in YLL since 2010 were ischaemic heart disease, stroke, lower respiratory tract infections, and lung and colon cancer. YLL reduction rates from ischaemic heart disease fell from 2·94% (205098·90–84411·42) to 1·77% (84411·42–75449·83) per year and stroke 2·03% (78921·56–46918·77) to 1·17% (46918·77–43638·12). YLL rates from lung and colon cancer increased in the over 85 year age group with lung cancer at 1·03% (5718·47–6072·65) per year and colon cancer 0·44% (5423·75–5568·14). YLL rates from lower respiratory tract infections increased 1·25% (27984·06–30086·93) per year after 2010 following yearly reductions for the previous 16 years. The YLL rate for lower respiratory tract infections increased more in England than in the other three UK countries. InterpretationThe slowdown in UK life expectancy since 2010 appears to have been driven largely by declining improvements in YLL from ischaemic heart disease and stroke, with increasing YLL from lower respiratory tract infections and cancer also contributing. Further research is needed into the causes of these condition-specific changes, including the effects of austerity and international comparisons to explore the extent to which further improvements in life expectancy are biologically possible. FundingNone.