Do you really want to live to be 100?

I am one of life’s optimists. When I think about living to be 100, I envision a birthday party surrounded by my devoted descendants, perhaps followed by a commercial space flight as a celebratory treat.

But I’m in the minority here. Many people would rather be dead. In a recent British poll by Ipsos, only 35 percent of people said they wanted to be centenarians.

Men were more keen on the idea than women (43 per cent to 28 per cent) – a shame really, as women are more likely than men to achieve it. Age is also a factor: Older people are less likely to want to live to 100 than younger people, perhaps because they have already experienced poor health, or have experienced caring for elderly parents who suffered in their later years. In the poll, fewer than one in five people thought they would have a good quality of life if they reached 100.

We all know that life expectancy has increased globally over the last century thanks to advances in healthcare and medicine as well as improvements in education and living standards. In the UK in 2020, the number of centenarians reached more than 15,000, up almost a fifth from the previous year. But – as is clear from how many people don’t want to live to be 100 – “healthy life expectancy” is probably a better measure of what people actually wishes.

Healthy life expectancy – a measure of the number of years someone is expected to live in good health – is not a perfect calculation, as it is based on health and mortality now rather than projections of how they might change. But it’s still useful. What can it tell us?

First, while it has increased globally, it has not kept pace with improvements in life expectancy, according to a study of 195 countries between 1995 and 2017.

Second, women may outlive men, but the number of years they can expect to live in good health is very similar. In the EU, for example, life expectancy for women in 2020 was 5.7 years longer on average than for men, but the healthy life expectancy gap was only one year.

Third, as with general life expectancy, the correlation between healthy life expectancy and gross domestic product per head becomes quite loose once countries have passed a certain level of development. Greece and Germany, for example, have very similar healthy life expectancies, even though Germany is considerably richer.

There are some big differences between neighbors too. In 2020, a man born in Finland or Denmark could expect to live between 73 and 74 percent of his life free from health restrictions, a commodity compared to the 90 percent offered in Sweden. Cultural factors play a role, from the Mediterranean diet in Greece to alcohol use in Finland.

In the UK, which ranked in the middle of the EU countries before Brexit, things do not look good. In the years before the pandemic, healthy life expectancy had stagnated for men at 62.9 years and had begun to fall slightly for women to 63.3 years.

The differences between the rich and the poor are also large. In England, women living in the most deprived areas have a healthy life expectancy at birth of 51.4 years compared to 71.2 years for women living in the least deprived areas.

David Finch, associate director at the Health Foundation, says UK policymakers should be “very concerned” about the trend, given the country was barely at the top of the league table to begin with. “When you can see the clear room for improvement and we stop improving, that’s particularly concerning.”

There are many possible reasons why health has deteriorated, from rising obesity and alcohol abuse to the impact of government spending cuts after 2010 and the wider impact of a decade without any real wage growth.

Britain’s frail health has now become a problem for the labor market, with an increasing proportion of people too ill to work. That’s a reason to be aware, of course. But we should have been paying attention anyway. Health matters not only because it has an impact on the economy; it matters because that’s what people want.

The government has set an ambitious target of increasing life expectancy by five years by 2035. Such rapid improvements are possible: it increased by four years in the first decade of the millennium. But it was a time of sustained economic growth and higher social spending. It’s hard to imagine that’s what the next decade will look like, even for an optimist like me.


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