New Global Study: Americans Now Spend an Average of 14 Years in Poor Health Before Death

A new analysis from the Global Burden of Disease (GBD) Study 2023, published in The Lancet Public Health and widely reported starting July 21, 2026, finds that while global life expectancy climbed from 64.6 years in 1990 to 73.8 years in 2023, “healthy life expectancy” — years lived without significant illness or disability — rose more slowly, from 55.9 to 63.1 years.

The widening “morbidity gap”

The difference between those two numbers is what researchers call the morbidity gap: the average number of years a person spends in poor health before death. Globally, that gap grew from 8.8 years in 1990 to 10.7 years in 2023, with people now spending roughly 14.5% of their lives in poor health, up from 13.6% in 1990. In plain terms, medicine and public health are keeping people alive longer, but not necessarily keeping them well for those extra years.

“Healthy life expectancy” is a standard public-health measure that estimates how many years a person can expect to live without a significant illness or disability weighing on their day-to-day function. It isn’t the same as simply being alive; a person can live many additional years past that marker while managing a chronic condition, reduced mobility, or a disability that requires ongoing care. The GBD researchers say the trend reflects survival gains — better trauma care, cancer treatment, and chronic-disease management keeping people alive longer — outpacing progress on preventing or slowing the conditions that erode quality of life in those later years.

The U.S. has the widest gap of any country studied

The United States had the largest national morbidity gap of any country in the study, at 14 years — ahead of Australia (13.9 years) and Canada (13.7 years). Women face a notably larger gap than men across the study, 12.1 years versus 9.3 years, despite generally longer life expectancy.

NoteThese are the study’s modeled national estimates, presented as reported. They describe population averages, not a forecast for any individual person’s health or lifespan.

What this means for you

Longer lifespans get the headlines, but this study is a reminder that more years of life increasingly means more years of managing a chronic illness, a disability, or caregiving needs before death — and that has real financial consequences for a family. It strengthens the case for locking in permanent, fixed coverage while you’re healthy: once a whole life or final expense policy is issued, the death benefit and premium generally can’t be revoked or repriced later if health declines during those additional years. It’s also a useful data point for anyone tempted to wait — the years you’re weighing whether to apply are exactly the years this study says are most likely to still be healthy ones. Our whole life coverage page explains how permanent protection works, the free calculator estimates how much a family might need, and final expense coverage is built specifically to cover end-of-life costs. Who we serve covers the households we work with most.

Sources

• News-Medical: Global Study Reveals Widening Gap Between Lifespan and Healthspan
• Institute for Health Metrics and Evaluation: People Are Living Longer But Spending More Years in Poor Health

Frequently Asked Questions

What is the “morbidity gap” in this study?

It is the average number of years a person spends in poor health before death — the gap between overall life expectancy and “healthy life expectancy.” Globally it grew from 8.8 years in 1990 to 10.7 years in 2023.

Why does the U.S. have the largest morbidity gap?

The Global Burden of Disease Study 2023 found the U.S. has the largest national morbidity gap of any country studied, at 14 years, ahead of Australia (13.9) and Canada (13.7). The study attributes the trend to survival gains outpacing improvements in healthy years lived; it does not assign a single cause.

What does this mean for planning ahead?

More years spent managing declining health can mean more years of medical and caregiving costs. Securing permanent life insurance coverage while healthy locks in a fixed death benefit that is not affected by a later health decline.