**Singaporeans live longer and remain healthy longer than people anywhere else on Earth — yet they are also spending an increasing number of years with illness or disability, a new global study reveals.**
Published in The Lancet Public Health on July 27, the analysis by the Institute for Health Metrics and Evaluation (IHME) and the National University of Singapore tracked 204 countries and territories from 1990 through 2023. It found that the "morbidity gap" — the difference between total life expectancy and healthy life expectancy — widened in nearly every country.
Singapore ranked first globally in 2023 with a life expectancy of 85.4 years and a healthy life expectancy of 74.0 years. Yet the morbidity gap increased by approximately 2.35 years (26.6%) since 1990. Globally, the gap grew by 21.9%.
"Singapore's position as a global leader in life expectancy and healthy life expectancy is a major public health achievement," said Associate Professor Marie Ng of NUS Medicine, a co-author of the study. "However, the widening morbidity gap shows that living longer does not automatically mean that every additional year is lived in good health."
Worldwide, life expectancy rose from 64.6 years in 1990 to 73.8 years in 2023, while healthy life expectancy increased from 55.9 to 63.1 years. The average global morbidity gap climbed from 8.8 to 10.7 years — meaning people now spend 14.5% of their lives in poor health, up from 13.6% in 1990.
These findings challenge the long-held "compression of morbidity" hypothesis, which predicted that medical advances would compress illness into a shorter period near the end of life. Instead, the data shows that nonfatal health loss accumulates throughout adulthood.
The gender health paradox
A persistent divide emerged between women and men. Singaporean women had a life expectancy of 87.5 years in 2023, compared with 83.1 for men. Yet women were expected to spend 12.1 years in poor health, versus 10.4 years for men. Globally, the morbidity gap was 12.1 years for women and 9.3 years for men.
Five condition groups accounted for 57.4% of the global morbidity gap: musculoskeletal disorders (especially low back pain), mental disorders (depression and anxiety), sense organ diseases (hearing loss), unintentional injuries (particularly falls), and other noncommunicable diseases.
In Singapore, the top risk factors were high fasting plasma glucose, high body mass index, occupational risks, high systolic blood pressure, and dietary risks — pointing to the urgent need to address diabetes, obesity, and metabolic disease.
"Singapore has an opportunity to lead not only in how long people live, but in how long they live well," said Assoc Prof Ng. "The conditions contributing most to the morbidity gap are often non-fatal, but they can have a profound effect on people's independence, ability to work, and quality of life."
