Introduction

While rising life expectancy is a sign of societal progress, it presents a challenge if those added years are dominated by illness, disability, and dependence. The real objective must be to reduce the gap between lifespan (total years lived) and healthspan (years lived in good health), ensuring that longer lives remain active, independent, and fulfilling.

Historical Gains in Longevity

• Improvements in life expectancy worldwide have been the result of:

o   Public health advancements: Safer drinking water, sanitation, better nutrition, and medical innovations lowered deaths from infectious diseases.

o   Social progress: Better education, economic development, and women’s empowerment improved population health.

o   Post-independence development in former colonies enhanced healthcare access and infrastructure.

• However, a new challenge emerged:

o   Survivors of childhood diseases often faced long-term disabilities.

o   As populations aged, chronic conditions led to growing health dependency.

The Rise of Non-Communicable Diseases (NCDs)

·       Today, the leading contributors to death and disability are: Cardiovascular diseases, cancers, diabetes, and chronic respiratory disorders.

·       Rising risk factors include: Obesity, poor diets, smoking, excessive consumption of processed food and sugary beverages, and increasingly sedentary lifestyles.

·       Other contributing factors: Mental health issues driven by emotional disconnect in a digitally connected world. Increasing incidents of road traffic injuries, suicide, and violence. Climate change and pollution introducing new public health threats.

The Global Healthspan–Lifespan Divide: A 2024 study (Garmany & Terzic) shows:

·       Globally, the average difference between life expectancy and healthy life expectancy (HALE) from 2000–2019 was 9.6 years.

·       Women experienced a wider gap—2.4 years more than men—due to longer life spans but extended periods in poor health.

·       In developed countries: USA had a gap of 12.4 years, and the UK 11.3 years, largely due to lifestyle-related conditions and aging populations.

·       Low-income countries showed narrower gaps, though they require balanced improvements in both life and health expectancy.

India’s Healthspan Challenge

• Between 2000 and 2019: Life expectancy increased by 0.43 years per year. Healthy life expectancy improved slightly slower—0.37 years per year.
• By 2022, the healthspan-lifespan gap was 10.49 years: Men: 9.22 years | Women: 11.77 years.
• Notably, 56.4% of India’s total disease burden is linked to poor diets (Economic Survey 2024).
• This health crisis threatens India’s demographic dividend, as poor health among youth could reduce productivity and long-term growth.

Policy Priorities to Bridge the Gap

1. Lifelong Health-Oriented Approach

• For children and mothers: Tackle undernutrition, stunting, and improve access to healthcare.
• For adolescents and young adults: Reduce tobacco, alcohol, and drug use; combat physical inactivity; promote mental wellbeing.
• For the elderly: Develop geriatric care, manage chronic conditions, and expand palliative care services.

2. Risk Factor Mitigation

• Dietary interventions: Encourage consumption of fresh fruits, vegetables, and whole foods. Curb marketing of junk food and sugary beverages.
• Physical activity: Design walkable cities, build cycle lanes, and public recreational spaces.
• Environmental health: Strengthen pollution control measures and climate adaptation strategies.

3. Universal, Affordable Healthcare Access

• Enhance primary healthcare systems to integrate preventive, diagnostic, and treatment services.
• Expand reach using digital health tools, telemedicine, and AI-driven solutions to serve remote and underserved communities.

4. Behavioural and Policy Interventions

• Use regulatory levers: Taxation of tobacco, alcohol, and sugary drinks. Incentivise healthy consumption choices.
• Promote health literacy: Integrate health education into school curricula. Launch national campaigns on lifestyle diseases and preventive care.

Conclusion

As the most populous nation, India faces the pressing challenge of ensuring that longer lives are also healthier and more productive. The solution lies in a comprehensive strategy encompassing nutrition, lifestyle, healthcare delivery, and environmental safeguards. Without proactive action, gains in lifespan risk being undermined by poor health. India must now move from adding years to life toward adding life to years—ensuring each year lived is healthy, empowered, and dignified.