U n i v e r s a l h e a l t h c o v e r a g e a n d h e a l t h y a g e i n g approximately 30 years in India and around 27 years in Bangladesh, one of the world’s poorest countries. Progress in life expectancy in Kenya stagnated from the late 1980s and suffered a reversal in the later 1990s, attributed in part to deaths from HIV/AIDS. Life expectancy in South Africa declined even more severely between 1990–95 and 2005–10. It is currently predicted that life expectancy for Kenya and South Africa will increase by one to two years every five years until 2050. For the current period 2010–15 there is a 19-year difference in life expectancy at birth between Kenya and the UK. This is a sizeable gap to close. Figure 1 shows that considerable progress is possible in relatively short periods of time, not least because it has happened in other countries. Life expectancy increase rates Life expectancy has increased at a faster rate in many developing countries than in high-income countries. Figure 1, comparing the UK and Bangladesh, illustrates this point. The proportion of older people (for this purpose, 60 years and over) is growing in developed and developing countries. Indeed, the older population globally is currently growing at a faster rate (1.9 per cent per annum) than the total population (1.2 per cent per annum). The growth of the global older population is expected to accelerate to 2.8 per cent per annum by 2025–30 – 3.5 times faster than the total population growth rate (0.8 per cent; UNDESA, 2012). While the proportion of older people is higher in high-income countries, the actual numbers of older people are greater in lessdeveloped regions overall and their numbers will continue to rise, and rise faster than in more developed countries. In India, for example, while only 5.1 per cent of the population was over 65 years in 2010, this equates to around 61.5 million people. The total population of the UK was about 62 million in 2010, with 16.6 per cent, or 10.3 million people, aged over 65 years. Commonwealth countries already have sizable populations of older people and these figures are growing. The number of older people is higher in developing countries, which have less well-established and formalised social protection systems in place to support older populations than high-income countries. Instead, older people in developing countries depend to a much greater extent on informal social protection and support provided by families. Tackling health inequities Where data is available to reveal the distribution of health within countries we see inequalities in life expectancy. The WHO Commission on Social Determinants of Health (CSDH) reporting in 2008 cited a 28-year difference in life expectancy for men between Calton (54 years), a deprived area of Glasgow, and Lenzie (82 years), a wealthy suburb only eight miles away (CSDH, 2008). In Cape Town, South Africa, the poor and overcrowded township of Khayelitsha, whose residents are predominantly black, has the Figure 1 Life expectancy estimates and projections Life expectancy at birth (years) 90 70 50 30 1955–60 1960–65 1950–55 1965–70 1970–75 1975–80 1980–85 18 Commonwealth Health Partnerships 2015 1985–90 2000–05 1990–95 1995–2000 2010–15 2005–10 2020–25 2015–20 2030–35 2035–40 2025–30 2040–45 2045–50 Bangladesh India Kenya South Africa UK Source: UNDESA, 2012
Commonwealth Health Partnerships 2015
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