The slowing pace of life expectancy gains since 1950

From Carolina Cardona and David Bishai:


New technological breakthroughs in biomedicine should have made it easier for countries to improve life expectancy at birth (LEB). This paper measures the pace of improvement in the decadal gains of LEB, for the last 60-years adjusting for each country’s starting point of LEB.


LEB increases over the next 10-years for 139 countries between 1950 and 2009 were regressed on LEB, GDP, total fertility rate, population density, CO2 emissions, and HIV prevalence using country-specific fixed effects and time-dummies. Analysis grouped countries into one-of-four strata: LEB < 51, 51 ≤ LEB < 61, 61 ≤ LEB < 71, and LEB ≥ 71.


The rate of increase of LEB has fallen consistently since 1950 across all strata. Results hold in unadjusted analysis and in the regression-adjusted analysis. LEB decadal gains fell from 4.80 (IQR: 2.98–6.20) years in the 1950s to 2.39 (IQR:1.80–2.80) years in the 2000s for the healthiest countries (LEB ≥ 71). For countries with the lowest LEB (LEB < 51),

decadal gains fell from 7.38 (IQR:4.83–9.25) years in the 1950s to negative 6.82 (IQR: -12.95–1.05) years in the 2000s. Multivariate analysis controlling for HIV prevalence, GDP, and other covariates shows a negative effect of time on LEB decadal gains among all strata.


Contrary to the expectation that advances in health technology and spending would hasten improvements in LEB, we found that the pace-of-growth of LEB has slowed around the world.

Of course in many United States counties, life expectancy is moving backwards these days.

For the pointer I thank the eternal Kevin Lewis.


Considering we can't make the maximum lifespan budge yet ( ~120 years), why wouldn't we expect LEB increases to slow down sooner or later.

Yeah, but only in retrospect do we find that we have not been able to increase maximum lifespan. That wasn't necessarily what people expected 50 years ago.

Also, progress against many major diseases like cancer has been much slower than predicted in the past.

'but only in retrospect do we find that we have not been able to increase maximum lifespan' - A retrospective supported by fairly accurate documentation for the last 200 or so years in places where the extreme limit of lifespan seems to be about 120 years.

'That wasn’t necessarily what people expected 50 years ago.' - Which people? 50 years ago, living to 100 was considered a major milestone and noteworthy. And to a certain extent, it still is.

'Also, progress against many major diseases like cancer has been much slower than predicted in the past.' - Yet we have done phenomenally well against dropsy, that being a way to point out that in a century or two, our current understanding of 'cancer' is likely to be seen as impenetrable ignorance.

The article is intentionally dishonest. They have an agenda and have no problem with dishonesty to achieve their objectives. A simple and obvious example of this is the last sentence; "Of course in many United States counties, life expectancy is moving backwards these days." Of course the author refers to the latest trend where drug use and in particular the misuse of Fentynal has caused premature deaths which tends to distort the statistics. The author is gleeful of this because it supports their bias. A proper approach would be to ignore these outlier stats and if they did they LEB would in fact continue to rise. What the author is doing is comparing apples with oranges and serving up pap.

Why is it “dishonest” to include the impact of opiates on life expectancy? Right now we are facing an influenza epidemic which will shorten lives as flu outbreaks usually do. We certainly should include flu deaths in our public health picture. The opiate epidemic costs lives; people dying young affect life expectancy numbers. Whether the people making these observations are “gleeful” does not matter to the accuracy of the observation. If we compare health in Utah with health in North Carolina, we would acknowledge the differential in tobacco use, but we would not exclude smokers from population studies.

I always bowel perfect games once you understand anything that isn't a strike is just an 'outlier' which, of course, you would disregard unless you were biased against me!

It's Obesity. We should tax people by their body fat percentage.

Please lookup the obesity paradox and try to understand it. Based on your core belief it would seem that we should tax thin people instead.

Found the fatty!

But the fatty is right. Or so the observations say.

From the Wikipedia article on the obesity paradox, criticisms section.
"Anotherconcern is reverse causation due to illness-induced weight loss. That is, it may not be low BMI that is causing death (and thereby making obesity seem protective) but rather imminent death causing low BMI. Indeed, unintentional weight loss is an extremely significant predictor of mortality.[24] Sick individuals often undergo weight loss before death, and classifying those individuals as lean greatly inflates the mortality rate in the normal and underweight categories of BMI, while lowering the risk in the higher BMI categories."

Fat people are ugly. Hence they generate negative externalities hence there should be a tax on fat. I think that 10 dollars per kilo of fat sold in groceries (i.e. 1 pound of cheese with 200 grams of fat would cost 2 dollars fat tax) would correct this externality. The 10 dollar figure has been estimated by my gut.

Come now, some of us could live to 200, if we ate better - '“I told the president if he'd had better diet over the last 20 years he could have lived to 200 years old. The answer is he has incredibly good genes, it’s just the way God made him.'

And the eternal Kevin Lewis will clearly live longer than even Donald Trump, it appears.

everyone involved in the Trump Russia stuff is either a Faulknerian idiot manchild like Don Jr or Carter Page or a detestable spy inchworm like Christopher Steele. every single one who ruined our Gen Xers impressionable brains with this crap should be sent to a prison colony

So, it seems like the bot writers have changed the experiment a bit. Shame that the text generator doesn't seem to include sentence capitalization. That the 'reply' has absolutely no contextual relationship to the preceding comment apart from an apparently poorly defined key word selection seems fairly clear.

Look, having nuclear—my uncle was a great professor and scientist and engineer, Dr. John Trump at MIT; good genes, very good genes, OK, very smart, the Wharton School of Finance, very good, very smart—you know, if you’re a conservative Republican, if I were a liberal, if, like, OK, if I ran as a liberal Democrat, they would say I'm one of the smartest people anywhere in the world—it’s true!—but when you're a conservative Republican they try—oh, do they do a number—that’s why I always start off: Went to Wharton, was a good student, went there, went there, did this, built a fortune—you know I have to give my like credentials all the time, because we’re a little disadvantaged—but you look at the nuclear deal, the thing that really bothers me—it would have been so easy, and it’s not as important as these lives are (nuclear is powerful; my uncle explained that to me many, many years ago, the power and that was 35 years ago; he would explain the power of what's going to happen and he was right—who would have thought?), but when you look at what's going on with the four prisoners—now it used to be three, now it’s four—but when it was three and even now, I would have said it's all in the messenger; fellas, and it is fellas because, you know, they don't, they haven’t figured that the women are smarter right now than the men, so, you know, it’s gonna take them about another 150 years—but the Persians are great negotiators, the Iranians are great negotiators, so, and they, they just killed, they just killed us.

Sorry, that is just a direct quote from our current president, who is not a bot.

And it seems as if someone is not doing much in the way of experimentation, but is just hiding behind a name.

Donald Trump's blood work

Let's not forget that even a tiny increase in life expectancy can profoundly improve the lives of millions of families. I'm concerned that we could invest less in medical research if we get discouraged.

Sadly, as Tyler Cowen notes, America is moving in the wrong direction, though that is the result of narcotics, which can be avoided.

The US had peak tobacco smoking around 1950 and high smoking rates until the 1980s.

In emerging economies smoking is still an aspirational issue. Tobbaco demand is still growing. Population preferences take a lot of time to change. Smoking rate took 50 years to halve in the US.

But tobbaco demand per capita has been falling globally from at least 1980. In 1980, 26% of the world smoked and this fell to 23% by 1996 and to 20% by 2006.

Smoking in China was 30% in 1980 and in 1996 then dropped to 25% by 2012.

Fun fact: The number of cigarettes smoked per person over 15 is now the same in Japan and the U.S. at about 1700 a year.

That's not a fact.

It's an opinion?

Ooooh, excuse me, your numbers were obtained from wikipedia, ergo they are infallible facts! Unfortunately, facts are different than statistics. Someone might say that 15% of Americans are nitwits. That's not a fact, which differs from a statistic, in one sense since it can be proven. For instance, one might say "Todd K is a nitwit." That's a fact rather than a statistic, since it's easily proven.

In which chuck argues against numbers.

Nearly all lifespan improvement is driven by lifestyle improvement, not medicine.

The human population explosion was driven firstly by nutrition, secondly by reduction of water and food pathogens, Medical tech comes in third, with childhood immunisations.

Somewhere, you seemed to forget about mortality for the extremely young and mothers, where it is not unfair to put medical knowledge on a higher footing.

That's reasonable; but falling childhood and maternal mortality is mostly a function of 2 and 3 in my list above rather than medical tech; more deaths occurred after delivery and before 5th birthday rather than during birth.

Well, 'medical tech' would seem to include medical techniques. And regardless of what one thinks about C-sections in a broader sense, there is no question that a significant number of infants and mothers have benefited from that procedure becoming safely available in the last 150 years.

Of course a healthy woman will more likely have a healthy outcome after becoming pregnant, yet the entire 'preemie' survival framework is fairly modern also. Here is a bit of information from wikipedia - 'Complications from preterm births resulted in 0.74 million deaths in 2013 down from 1.57 million in 1990.'

And here is some U.S. centric information - 'In the early 20th century, premature birth was one of the highest causes of infant mortality – in 1925, 36% of all infant deaths were due to premature birth.' (A fascinating article, detailing how preterm babies were basically sideshow attractions - 'Couney's baby incubator attractions were featured at prominent expos and amusement parks. The babies were also featured at Coney Island's Luna Park, and at a number of the World's Fair expositions including New York City's World Fair, the Omaha Trans-Mississippi Exposition, the Buffalo Exposition and the Chicago World's Fair.

In Atlantic City, the permanent infant incubator exhibit was located on the Boardwalk at Arkansas Avenue, across from Million Dollar Pier. The exhibit was in place as early as 1902. Admission at first was one dollar to see the infants and hear a lecture on their care. Later, the price was changed to whatever donation the visitor wished to make.

As more hospitals began to develop methods for treating premature infants, and as the field of neonatology became more accepted, Dr. Couney declared success and closed the exhibits in the 1940s. The Atlantic City exhibit closed in 1943. Dr. Couney died in March of 1950 at his home in Coney Island.')

You've omitted medical hygiene and antibiotics.

One lifestyle improvement would be to include broccoli sprouts in one's diet.

Alternatively medicine has little to do with how long we live. It is nice if we get sick but it is fiddling at the edges.

What matters is clean water and to a lesser extent, the decline of physically punishing manual labor. We are all eating better - or at least with a lot less human feces distributed around the place. So there just isn't much room for improvement.

Yes having clean food and water is probably the biggest advance you can have in improving health. Then personal hygiene, fleas and ticks were very common until relatively recently, removing those significantly reduces the chance of spreading of diseases. Now we are trying to deal with the significantly greater problem that for some reason people are programmed to age. Ageing is not just an accumulation of wear and tear, if that were the case it would be easy to see people who have had easy lives living longer. It seems to be an process with the intent to ensure we die by not too late a date. Cancer, heart disease, muscle wasting, senility, gradually decreasing vision and hearing, white hair, wrinkles, brittle bones and so on all start to ramp up pretty much the same age. It must have been pretty lethal for anyone in a dangerous environment like our ancestors were in. There are many insects who live as pupae for a number of years, and then become a fly to mate for a very short period of time, and then die, their purpose done. Maybe we are the same, deliberately programmed to die once we have raised our children, to leave the resources for them. So can we defeat this genetic program? It may be that it is so inherent in our genes, that we defeat (or slow) one aspect of it, then another aspect kicks in. So we won't see any significant progress against programmed ageing until we understand the entire mechanism.

Reincarnation. There is really not much purpose on living longer than 80.

That's looking at it the wrong way.

Evolution doesn't "intend" (in an instrumental sense) that we die. It's certainly not a "resource" constraint involving kids; that makes no sense from a phylogenetic POV. However, evolution may prefer a shorter-lived but stronger/more active organism to one with great longevity.

Well I didn't say evolution "intended" anything, I proposed that we have a genetic program (like say the one that runs the process of puberty) that is actively making us "old". i.e. physical changes in our bodies to make us weaker and more and more prone to things like cancer or heart disease. And as to this being anti-survival - in other words why don't organisms that somehow don't have this trait outbreed ones that do - I mentioned the example of the mayfly. Why don't mutant mayflys who live longer and thus breed longer than normal mayflys? It is definitely possible for flys in general to live more than a day or so. It must be something to do with resource constraints, and the associated benefits perhaps of escaping predators and parasites. Think of it this way, a mayfly (or human) that lives a long time will gradually accumulate parasites so eventually they are living not for the survival of their genes but of the parasites, consuming resources that could feed its young. Now of course we don't have to worry too much about parasites but the genetic mechanism endures.

From a gene's eye view, immortality through reproduction has been deemed a better strategy than immortality via an organism living forever.

As their part in the drama, organisms develop and decay and propagate along the way. Life is an ongoing battle against relentless entropy. At some point, genes 'want' resources shifted from parent to offspring. Often, this happens at birth and the parent moves on to more eating, fucking, and reproduction until death. In more complex creatures (mammals,birds), parents aid in the development of offspring, often for years.

Anyway, long development periods for offspring of complex creatures means genes have to devote more resources to the maintenance of parents for longer periods of time, often for decades after the parents are reproductively useful.

The organisms get credit for figuring out ways to continue to make themselves relevant to the genes' larger project beyond the organisms own reproductively useful lives. so the genes are willing to devote entropy-fighting resources to keeping the organisms around for a while. But natural selection, like apocryphal Henry Ford, goes about its business efficiently, producing a "general failure" age.

Yes but the question is, is this process whereby the older gene container grows old and dies just an accident or is it the case it is an organized process, programmed if you like. If it is a program then treating various symptoms of the program won't help the container much, the program still is running.

That is why women live longer than men. Grandmothers are very useful tending the kids while the younger mother is out gathering food. There is not a comparable role for old men.


This is interesting:

spencer, sounds sexist

If it's sexist then it has a chance of being true.


Old men are available to teach young men manly arts. and more generally to transmit the knowledge of the clan to the younger generation.

If almost everyone in the past died before their 60th birthday, there was not much selection for genes that helped you live past 60.

How many people produce children after 60? There has never been any selection for extreme old age since people at those ages do not leave offspring. The closest you can com to that is the likely fact that societies which include grandparents may be stronger than those where everyone dies as soon as their fertility ends.

the decline of physically punishing manual labor

No, the opposite, in fact. Physically active people, even in the work place as well as at LA Fitness, are in better health than those that spend their employed hours on their buttocks.

There' such a thing as good exercise and then there's punishing physical labor which wrecks the skeleto-muscular system and can also damage the circulatory system. Also, people who are physically exhausted are easier prey for pathogens.

Japan is getting crushed under the burden of caring for old people.

No country will survive until it can lower life expectancy to 70-75 at most. The medical lobby must be reined with or they'll be the end of us all.

Have you been to Japan? It doesn't seem to me to an economy labouring under the weight of supporting old people.

Trust me, for most people there is really no purpose in living beyond age 80.

That's an entirely orthogonal claim.

For a lot of people, I think that 16 is quite enough.

Well, no-- 18. People who peak in high school and spend the rest of their lives befuddled are not rare. But generally their senior year is their best year.

I've lived many years there and speak the language perfectly.

The labor force is shrinking but disposable income isn't growing because all the extra money workers are supposed to get is going to payroll taxes, to pay for old people healthcare and nursing.

Where do you think all those trillions in public debt are going? It's not like Japan is paying for refugees.

Japan's net public debt, the important measurement, not gross debt, which the press reports, has not increased since 2007. Real wages have been growing but slowly. Japan's per capita growth has been at almost the same rate as the U.S. and U.K. so at least relatively, Japan isn't being crushed by eldery care.

The Japanese now live lives of quiet desparation.

While many wealthy philanthropists continue to fund projects that improve the health of the poor and thus increase life expectancy, more recently wealthy individuals are investing in projects designed to increase longevity, in particular their own. This blog has a rather unfavorable view of philanthropy in the former category, not because the contributors to the blog are opposed to philanthropy per se, but because much of giving is actually counterproductive. I'm not trying to express Cowen's view for him, as one may read or listen to the many blog posts and talks by Cowen on this subject by simply googling Tyler Cowen and philanthropy. I'd be interested in knowing Cowen's view of the more recent efforts to increase longevity, in particular his friend Peter Thiel's efforts to increase his own longevity. I suspect that, as an economist, Cowen would approve Thiel's efforts: selfishness is the gold standard when it comes to efficiency and productivity. If philanthropists aren't moving the needle for increased life expectancy, then doesn't it make economic sense to devote more resources to the alternative, namely longevity?

Truth is, we lost our way. When I was young, there were no drugs, there was no pornography, no delinquence. There was patriotism, there was dignity, there was honor. Our leaders had gravitas and pathos. We worked hard, we built things. But now America exchanges its firstborn right for a mess of cheap trinkets and its soul for opioids.

Such stylish sarcasm implies that you are not American. Or, at least, not USian.

Wars, accidents, murders/beatings are all down, but the rates of decrease have also decreased.
The 120 max is for women, 115 or so for men. Not much change in Life Expectancy at age 50 for the last 50 years (for non-smokers).

Medicine keeps the sick & dying people alive for a limited time - think of the thousands spent on Ted Kennedy in his last 2 years of life.
Dick Van Dyke, at 90, has great genes (& jeans):

Longevity ain't gonna happen soon, most folk over 90. Getting most folks over 50 is already happening. The rate of increase to 50 is slowing down, inevitably.

Not much change in Life Expectancy at age 50 for the last 50 years (for non-smokers).

The life expectancy of a 65 year old person in this country has increased by 4 years since 1970.

I wonder how much of that is due to the decline in smoking?

The current life expectancy at 50 is 80 for males and 83 for females. In 1960, it was 73 for males and 78 for females, a a gain of 7 years for males and 5 years for females.

Tyler said in 2010 during his The Great Stagnation book tour that he didn't expect that there would be any medical breakthroughs before the year 2030. Now that major advances have been made in stem cell trials, immunotherapy for cancer as well as CRISPER becoming a household name, I wonder if he would like to update his 2030 prediction.

The increase in longevity is economically important in that it increases the numbers of those that speak English as a second language employed in changing the diapers and switching the channels of TVs in the human warehouses where the benefactors of increased longevity are stored.

The west did what it could in terms of theory and IT for health. The west developed gene sequencing, inexpensive gene sequencing, powerful computers to help understand that data, and mechanisms to program genetics.

However, as expected as the world of 0-1s moved to the physical the (“liberal/progressive”) government destroyed all that it could find, the most blatant example being 23andme.

China will take the torch from here, they may not share their successes with the decadent west, but humanity will benefit.

23andMe is still going strong.

Don't forget Ketamine for mood disorders, if you haven't heard about it yet you will very soon

Are any of those breakthroughs on the shelf for purchase yet? It may well be 2030 before they are.

I'm always amazed that so many can't see that we are in the long tail of a dramatic improvement in the human condition. It is only logical that improvement gains would slow down. Consider what came to the fore in the first half of the 20th century. Sanitation spread, disease control spread, emergency (life-saving) medical care improved dramatically, and we got antibiotics. Economically, we got electric power, conditioned environments, rapid transport, etc.

Consider this from Nassim Taleb's 'Anti-Fragile'

"Life expectancy has increased (conditional on no nuclear war) because of the combination of many factors: sanitation, penicillin, a drop in crime, life-saving surgery, and of course, some medical practitioners operating in severe life-threatening situations. If we live longer, it is thanks to medicine’s benefits in cases that are lethal, in which the condition is severe— hence low iatrogenics, as we saw, the convex cases. So it is a serious error to infer that if we live longer because of medicine, that all medical treatments make us live longer."

Taleb, Nassim Nicholas. Antifragile: Things That Gain from Disorder (Incerto) (Kindle Locations 6283-6287). Random House Publishing Group. Kindle Edition.

"It is only logical that improvement gains would slow down."


The greatest increases per decade since 1900 were through 1950: 3 years, 4 years, 6 years, 3 years, 5 years. From 1960 to 2020, the increases per decade were 2 years, 1 year, 3 years, 1 year, 2 years, 3 years, 0 years. So 28 years and 12 years, respectively, and the second group is a decade longer.

But wait! The 2020s and 2030s are coming, and we haven't seen anything yet! Rejuvination therapies, synthetic organs, Alzhiemer's disease cures, CRISPR.

'Alzheimer's disease cures:

Heh heh

We'll believe it when we see it, not your hyperventilating naivety.

I know it must be tough but don't worry, you'll be OK. The smart pills are coming too.

The way we’ve increased life expectancy in the last couple centuries have reached diminishing returns—we already have most people living to the point where their bodies are wearing out on multiple levels. Future gains will have to work differently—perhaps stopping or slowing various aspects of the aging process. And eventually, we will probably engineer people who won’t die of old age and will almost never get cancer or heart/artery disease.

The slowing pace of life expectancy gains since 1950

File another for the Law of Diminishing returns? The biggest success in medicine were from 1850 - 1950 that made enormous improvements and as the age is higher it gets harder to improve at 78 versus 56.

And make it past 80 it take good lifestyle choices.

Life span is about to take a jump into the centuries... but we'll only be catching up to the Bowhead Whale, Greenland Shark, etc.

The statistic here is "life expectancy at birth." Something which enables someone who might have died before age ten to survive to 70+ is just going to have a much larger effect on this statistic than a medical procedure that extends the life of those who might have died at age 78 all the way to age 85. Life expectancy at birth is an average and, as with any average, a few low scores have a big effect on the number.

Thus, the big gains in life expectancy at birth come from things like vaccines for common childhood illnesses and improved life-support for those born prematurely and/or those born with life-threatening birth defects.

Vaccines are cheap but treatments for the degenerative diseases of old age are costly. Why would anyone be surprised to see diminishing returns to efforts to increase life expectancy [at birth]?

(And, yes, opiate OD deaths skew toward youth, especially as a death hastened by efforts to keep a dying patient comfortable won't be counted as an "opiate death" anyway.)

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