Intended for healthcare professionals


Reversals in life expectancy in high income countries?

BMJ 2018; 362 doi: (Published 15 August 2018) Cite this as: BMJ 2018;362:k3399

Linked research

Recent trends in life expectancy across high income countries

  1. Domantas Jasilionis, research scientist
  1. Max Planck Institute for Demographic Research, DE-18057 Rostock, Germany
  1. jasilionis{at}

Warning signs must not be ignored

Two linked studies in The BMJ make important contributions to debates about the sustainability of improvements in life expectancy in high income countries.12

Ho and colleagues (doi:10.1136/bmj.k2562) report the significant decreases in life expectancy that occurred simultaneously in many high income countries, usually in 2015.1 This universal spike in mortality has often been attributed to the direct and indirect effects of severe flu epidemics, particularly among older people.34 The fact that modern healthcare systems in the most advanced high income countries were unable to cope with this unexpected challenge, resulting in the first reductions in longevity for decades, is striking and might signal more profound problems.

Despite a strong recovery observed in many countries in 2016, it is too early to conclude that similar fluctuations or more long lasting increases in mortality will not occur in the nearest future.1 Evidence suggests that discontinuities in secular trends can lead to prolonged health crises—they are warning signs of fundamental and longstanding societal and health problems. …

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