Analysis: We ought to focus on a healthy old age, not just a long life

SINCE the 1860s, life expectancy in Scotland has been improving year on year. There have been a few dips, such as the pandemic at the end of the First World War, but by and large we’ve been seeing a constant improvement, and what the ONS data shows is the continuing fruit of that historical trend.

Human beings have always had the potential to live as long as this, it’s just that harsher environments, more infections and less conducive living circumstances over the centuries have never made it possible. It’s only now that we are achieving a potential that has always been there.

In terms of death rates for non-communicable or chronic diseases, these peaked in the 1960s and 1970s, so we now have, for example, half the age-specific rates of heart disease we had in the early 1970s

We have achieved these improvements by combating risk factors, like smoking, and treating these diseases more effectively.

Continuing improvement in life expectancy is, therefore, largely a function of our healthcare system’s ability to keep us alive.

Looking into the future, though life expectancy continues to improve, healthy life expectancy – the age at which the average person will get a major disease – has not. That is a concern.

There are reasons to question whether the optimistic scenario of continuing improvements in life expectancy will necessarily be fulfilled. Rising obesity levels and a growth in diabetes could reduce life expectancy.

There are also wider threats to health and prosperity that we can’t be complacent about – global warning, energy precariousness and financial meltdown, for example.

Will larger numbers of people live to be 110 or 120? On current trends, the answer is yes. However, we should be less focused on chronological age and more concerned about biological age – a healthy old age and not just a long life.

• Phil Hanlon is professor of public health at the University of Glasgow and honorary consultant in public health with NHS Greater Glasgow and Clyde.