Xi Jun-Yan, Zhao Jian-Guang, Li Xue-Qi, Yan Bo, Bai Jian-Jun, Xiang Yi-Ning, Hu Wei, Hu Jie, Liao Yu, Gu Jing, Lin Xiao, Hao Yuan-Tao
Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China.
BMJ Glob Health. 2025 May 7;10(5):e018194. doi: 10.1136/bmjgh-2024-018194.
Investing in health to improve healthy life expectancy (HLE) is fundamental to create a demographic dividend. However, how dramatic population ageing affects HLE remains unknown. This study aims to quantify and project the major diseases and injuries attributed to changes in population size and age structure that contributed to substantial losses in HLE.
Using data from 188 countries in the Global Burden of Disease Study 2021 and World Population Prospects 2024, we assessed the correlation between HLE and total dependency ratios. Furthermore, we decomposed the mortality and disability burden attributable to changes in population size as well as age structure for 22 disease and injury categories and then quantified the loss of HLE due to the attributable burden. Additionally, we projected the loss of HLE due to priority diseases in 2030, while considering the impact of population ageing.
From 2010 to 2019, globally, the mortality and disability burden attributable to age structure caused 0.40 years and 0.71 years of HLE loss, while for population size, these two estimates were 1.18 years and 1.00 years. By 2030, the mortality and disability burden attributable to age structure may lead to 0.76 years and 0.89 years of HLE loss, while for population size, these two predictions will be 1.21 years and 1.17 years.
Population size growth is a consistent and crucial contributor to HLE losses. Reaping the second demographic dividend requires eliminating the double burden of premature death caused by infectious and chronic diseases, whereas gaining the sustainable third demographic dividend requires investments in healthy and successful ageing.
投资于健康以提高健康预期寿命(HLE)是创造人口红利的根本。然而,人口老龄化如何显著影响健康预期寿命仍不明确。本研究旨在量化并预测由于人口规模和年龄结构变化导致的主要疾病和伤害,这些变化导致了健康预期寿命的大幅损失。
利用全球疾病负担研究2021中的188个国家的数据以及《世界人口展望2024》,我们评估了健康预期寿命与总抚养比之间的相关性。此外,我们分解了22种疾病和伤害类别的人口规模变化以及年龄结构变化所导致的死亡率和残疾负担,然后量化了归因负担导致的健康预期寿命损失。此外,我们预测了2030年优先疾病导致的健康预期寿命损失,同时考虑了人口老龄化的影响。
2010年至2019年期间,全球范围内,年龄结构导致的死亡率和残疾负担分别造成了0.40年和0.71年的健康预期寿命损失,而对于人口规模,这两个估计值分别为1.18年和1.00年。到2030年,年龄结构导致的死亡率和残疾负担可能导致0.76年和0.89年的健康预期寿命损失,而对于人口规模,这两个预测值将分别为1.21年和1.17年。
人口规模增长是健康预期寿命损失的一个持续且关键的因素。收获第二次人口红利需要消除传染病和慢性病导致的过早死亡的双重负担,而获得可持续的第三次人口红利需要投资于健康和成功老龄化。