July 27, 2026, 11:07 am | Read time: 4 minutes
Living longer doesn’t automatically mean living healthier. In fact, a new study concludes that more years of life also mean more “sick time.” This is especially true for wealthy countries like Germany. FITBOOK explains the background.
One of the greatest achievements of modern medicine is that we live significantly longer on average than we did 100 years ago. Today, much of humanity enjoys increased life expectancy. Or do they? The question of whether a longer life also means a longer healthy phase of life was not conclusively answered. An international research team addressed this question with the “Global Burden of Disease Study 2023” (GBD 2023). Their findings were recently published in the journal “The Lancet Public Health.”1
The Issue with the Morbidity Gap
The focus of the study was the so-called morbidity gap. If a person lives to be 80 years old, with 70 of those years being healthy and the remaining years being sick, the morbidity gap is ten years. This refers to the years people live with health limitations. Examples include back pain, depression, hearing loss, diabetes, chronic diseases, or frailty. Back pain and age-related hearing loss are the biggest drivers of unhealthy years worldwide.
How has this gap changed since 1990? Which diseases and injuries contribute most to these “unhealthy years”? Are there differences between genders or countries? And are we actually living longer and healthier than our great-grandmothers?
How the Study Was Conducted
The study is a global, population-based analysis. Researchers evaluated health data from 204 countries and regions between 1990 and 2023. These data were found in sources such as death registers, health surveys, medical records, and other population statistics. From this, they determined global life expectancy, healthy life expectancy, the absolute morbidity gap, and the time spent in a health-impaired state. Finally, the researchers broke down the data by regions and countries, socioeconomic development, and examined men and women separately. Risk factors such as smoking, alcohol consumption, obesity, and air pollution were also considered.
Life Expectancy Has Increased by Almost Ten Years Since 1990
The good news first: Thanks to significant declines in infectious diseases, maternal and child mortality, and advances in the prevention and treatment of chronic diseases, global life expectancy at birth has increased from 64.6 to 73.8 years since 1990. However, a closer look reveals that healthy life expectancy in the same period only increased from 55.9 to 63.1 years. On average, people spend 10.7 years of their lives sick, which is about two years more than in 1990. Specifically, they spend 14.5 percent of their lives in a poor health state. In other words, those who live longer are sick longer. In Germany, the morbidity gap also increased from 10.1 years in 1990 to 11.9 years in 2023.
Sick Only at the End of Life?
An important finding of the study concerns when these health limitations occur. Many ailments actually begin in the “prime” of adulthood. Chronic, non-immediately fatal, and mental illnesses such as depression and anxiety disorders significantly contribute to health-impaired years in many wealthy countries.
Women Live Longer but with More Health Limitations
The study also highlights the so-called “Gender Health Paradox.” Women live longer on average than men but also spend more years with health limitations. They now spend 12.1 years with health problems instead of ten, an increase of 21.3 percent. Men today endure “only” 9.3 unhealthy years.
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Living with Illnesses Has Become the Norm
The notion that a longer life automatically brings more healthy years is significantly challenged by the study. According to the researchers involved, modern medicine can treat once-fatal injuries or diseases like cancer, but life afterward often continues with lasting limitations. The same applies to chronic diseases. Living with them has long become the norm.
Also interesting: These factors determine healthy aging
What the Study Can and Cannot Show
The researchers did not follow the same individuals from 1990 to 2023. Individual fates did not play a role in the assessment. The results are based solely on population-based data and statistical models, which vary significantly in quality and quantity from country to country.
However, the study sends an important signal to health policy. Its success should not be measured solely by how many people survive, but by how many additional healthy years each person can enjoy. Living longer but suffering longer is not a gain. Particularly concerning: The biggest drivers of this development are factors we could theoretically influence–chief among them high blood sugar, a high body mass index (overweight), and tobacco use. Combating the main risk factors and investing in prevention are crucial for healthy aging.