By Joy Portella
Minerva’s long-time client the Institute for Health Metrics and Evaluation (IHME) cranks out comprehensive, almost real-time data to help people make better decisions about health policies, investments, and everyday choices. IHME has had a big month. Minerva’s Global Team partnered with them to roll out findings from two groundbreaking studies published in the international medical journal The Lancet.
Both studies were exciting new endeavors for IHME. The first, published in late September, was the first of its kind to measure and compare the strength of countries’ “human capital,” which means the health and education of their workforces. Researchers looked at both the quantity and quality of health and education in 195 nations and territories. The study, conducted at the request of World Bank President Jim Yong Kim, underscored that when a country’s human capital score increases, its economy grows.
The second study, published just this past week, is IHME’s first attempt to look into the future of health. The study uses data from IHME’s famed Global Burden of Disease Study to forecast life expectancy and major causes of death for people around the world. Researchers examined “reference scenarios,” if current health trends hold, as well as alternative health scenarios, if countries do a good job addressing future drivers of health like obesity, and tobacco and alcohol use – or not.
The studies include an enormous amount of data, and there are more findings than I could ever attempt to recount here. But there were a few findings that stuck with me:
Mediterranean lifestyle is the way to go. I’m completely biased because I’m sitting in southern Italy as I write this, but the data prove that people in this part of the world are onto something. IHME’s forecasting paper predicts that Spain will have the longest average lifespan in 2040; Spaniards will live 85.8 years. Portugal is not far behind at #5 with 84.5 years, and Italy is #6 with 84.6 years.
I can see how this happens: a diet of fresh vegetables, lean protein, lots of olive oil, and a healthy dose of pasta and wine; an exercise regime that’s build around natural movement (watch Italians stroll sometime); and a tight community of family and friends to provide health support. Oh yeah, and all of these countries have universal health coverage, which provides amazing access to quality care.
PS: The United States, with a projected life expectancy of 79.8 years, will be ranked #64 in the world in 2040.
It’s quality and quantity. One of the interesting aspects of the human capital study is that it looks at both quality and quantity of education and health. For education, the study calculates how long people spend in school and the quality of their learning based on internationally comparable test scores. For health, researchers measured how many years between the ages of 20 and 65 – when people are most active in the workforce – they can expect to live, as well as how much they struggle with sickness and disability that impact their work productivity. This inclusion of both quality and quantity provides stark contrasts.
Let’s look at Lebanon. Lebanese spend more time in school than anywhere else in the world – 14.6 years out of 18 years measured in the study. But the quality of that education is poor; Lebanese rank only #105 out of 195 countries. The quantity of education –years spent in school – provides an incomplete picture of how much Lebanese students are learning. Here’s a great article from The Economist about how these measurements work.
Don’t lose focus. IHME’s forecasting study predicts vastly different life expectancy outcomes under the reference, best-, and worst-case scenarios. Much of the wide variation will be determined by how we handle “independent drivers” of health like diet and alcohol and tobacco consumption. But there’s one huge variable that could determine the fate of tens of millions of people: the HIV/AIDS epidemic.
The world has spent hundreds of billions of dollars to combat the epidemic but if we lose focus and HIV/AIDS resurges, as many as 26.3 million people could die of the disease in 2040 – close to the nearly 30 million people who died annually at the height of the global epidemic in the early 2000s. If focus on HIV/AIDS continues, that number is expected to be only 8.5 million, and if we redouble efforts to combat the disease, deaths could sink below 6 million.
Countries in sub-Saharan Africa are in the most precarious position. For example, if current health trends continue, people in Zambia could expect to have an average life expectancy of 67.3 years in 2040 – an increase of nearly 9 years from 2016. But this masks widely varying outcomes under different scenarios with divergent HIV/AIDS outcomes. In the best scenario, Zambia’s life expectancy could increase by as much as 13.4 years, or it could decrease by .7 years in a worse health scenario. If you are as intrigued by this forecasting data as I am, you can play with IHME’s data visualization here.
We’ll have more exciting IHME news to share with you in the coming months. You can also follow IHME’s efforts to measure what matters on their website.
