Peer-reviewed article
Changes in life expectancy across selected countries in the Western Pacific Region and their underlying risk factors, 1990-2021.
Yan Zheng, Stefanos Tyrovolas, Paul S F Yip, Isaac Sasson ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This peer-reviewed study examines changes in life expectancy across five Western Pacific countries from 1990 to 2021 using Global Burden of Disease data. In lower-middle-income countries like Cambodia and Laos, life expectancy gains came mainly from reductions in child and maternal mortality and communicable diseases, while high-income countries saw gains from reduced cardiovascular disease and cancer. The COVID-19 pandemic had varying impacts, with some countries experiencing stagnation or slight decline in life expectancy after 2019. Despite progress, gaps between lower-middle-income and high-income countries have widened.
Key points
- Lower-middle-income countries in the Western Pacific remain substantially disadvantaged in life expectancy compared to high-income countries
- In Cambodia and Laos, life expectancy gains (1990-2019) were driven by reductions in under-5 mortality and communicable diseases
- High-income countries' life expectancy improvements were mainly from reduced cardiovascular disease and cancer mortality in middle and older ages
- COVID-19 caused different impacts: life expectancy decline in lower-middle-income countries and Malaysia, stagnation in Singapore, slight decline in South Korea
- The pandemic has enlarged the gap between lower-middle-income and high-income countries in the region
Limitations
This is an epidemiological analysis of aggregate life expectancy and mortality patterns, not a study of child-specific interventions or outcomes. It describes trends and causes of mortality changes but does not evaluate any specific intervention to improve child well-being.
Abstract
BACKGROUND: In accordance with the global trend, over the past decades, countries in the Western Pacific Region (WPR) have also experienced substantial improvement in life expectancy. However, this accomplishment was coupled with the differences between countries. METHODS: Using the latest data from the Global Burden of Disease study, we explored the underlying reasons for changes in life expectancy among observed WPR countries. RESULTS: Compared with observed high-income countries, lower-middle-income countries remain disadvantaged with respect to life expectancy, despite their substantial growth over time. The patterns of contribution varied considerably across countries. From 1990 to 2019, in lower-middle-income countries such as Cambodia and Laos, the gains in life expectancy could be mainly explained by reductions in under-5, 5-24, 25-44 mortality from communicable diseases and maternal-neonatal disorders, as well as reductions in mortality from communicable diseases and cardiovascular diseases at 45-84 years. In high-income countries, declines in middle and old-age mortality from cardiovascular diseases and neoplasms were mainly responsible for their life expectancy gains. After 2019, COVID-19 and related outcomes contributed to different magnitude of declines in life expectancy in lower-middle-income countries and Malaysia. In high-income countries, the impact of the pandemic resulted in a stagnation of life expectancy in Singapore and slight decline in life expectancy in South Korea. CONCLUSIONS: Despite the efforts from the government and WHO in the WPR, the gaps between lower-middle-income and high-income countries remain substantial and further enlarged because of the COVID-19 pandemic. Long-term reductions in mortality and gains in life expectancy in all observed countries in the Region require the further modification of the profile of the underlying risks.