The New Zealand Institute
| Grade | NZ Rank | Trend | Latest Value | 2015 Target | |
|---|---|---|---|---|---|
| B | 11th of 34 | Good | 80.8 years | 82.4 | Living longer every year |
Life expectancy at birth is an estimate of the average number of years people are expected to live. The measure is a high level summary of the health and physical well-being of residents in a country. Figure 1 shows that life expectancy varies a lot even within the OECD peer group.
Life expectancy is driven by many factors. About one third of life expectancy is explained by genetics, with the longevity of parents being closely related to age of death of their children. One third can be attributed to health habits including good nutrition, regular exercise and not smoking or drinking excessively. The remaining third is related to income, societal and health system factors including health service availability.
Figure 1 shows New Zealand’s life expectancy for 2009 was 80.8 years, ranking 11th of the 34 OECD countries. Over the last three decades New Zealand’s life expectancy has been steadily increasing and New Zealand is ranked consistently in the top half of the OECD, as shown in Figure 2. However the rate of increase varies. New Zealand’s annual growth rate in life expectancy increased at a faster rate (0.65%) than the OECD average (0.32%) from 1990 to 2002 but since then has increased in line with the OECD average.
More developed countries with more expenditure on health per capita tend to have longer life expectancy although the relationship between the two measures can vary greatly. For example the USA is an outlier in terms of its health spending per capita. The USA has very similar life expectancy to Chile but it spends over six times as much per capita on health.
Better life expectancy for less health spending per capita may result from an inexpensive or relatively efficient healthcare system, or from having a healthy population that has made better lifestyle choices than other populations. New Zealand’s position in Figure 3 indicates that New Zealanders’ life expectancy is better than many countries that spend much more on health care. However, recent increases in the incidence of obesity and diabetes and persistently high levels of smoking means that New Zealanders may not enjoy their above average performance for long.
The latest survey of New Zealand’s health showed some positive trends with increased access to GPs and a decrease in the daily smoking rate. However, there are still many people who do not follow healthy behaviour recommendations and there is increased prevalence of some common health conditions such as high blood pressure and high cholesterol. One of the most concerning issues identified was, “the persistence of large disparities across a range of risk factors and health outcomes for Māori and Pacific peoples compared to the total population, and also for children and adults living in neighbourhoods of high socioeconomic deprivation compared to those living in neighbourhoods of low deprivation.”(Ministry of Health, 2008).
Figure 4 shows differences in life expectancy for some segments of the New Zealand population. Women live longer than men in New Zealand and in other countries. On average people who live in the most deprived 10th of areas in New Zealand live 6-7 years less than those who are in the least deprived 10th of areas. Māori, on average, have life expectancies 8-9 years less than non-Māori. The differences are even greater for men. Life expectancy for a male Māori is only about one year above the global average life expectancy and is nine years below the OECD 2008 average.
Some researchers argue that slowing improvements in life expectancy are inevitable based on inherent limits for humans. Others argue that real life expectancy gains tracked over many years do not show evidence of such assumed slowing. The life expectancy achieved by the lowest-mortality population in the world has increased by more than two years per decade for over 160 years and shows no sign of slowing down.
Knowing about health risks can help people make choices that will lead to better health outcomes and longer lives. Policies designed to improve life expectancy involve increasing public awareness about the consequences of such choices and ensuring medical care is provided to address illness and injury.
Educational programmes and regulations to reduce lifestyle risks have been a feature of the health improvement efforts of successive governments. Driving behaviour, smoking, exercise, sunburn, drinking and obesity have been targeted in various ways with some positive results in the first four.
On 29 April 2010 the Government introduced the first of three progressive 10% increases in the tax on tobacco. Following the tax increase success rates of those who attempted to quit smoking improved. Many smokers commented that although they had been meaning to quit for a number of other reasons the increase in cost gave them the incentive they needed to act.
In March 2011 the Government agreed to develop targets for reducing smoking rates with the goal of becoming a smoke-free nation by 2025.
Adverse trends continue in obesity and binge drinking. Almost two thirds of adults are overweight or obese and adult obesity is higher than the average for OECD countries. The New Zealand Institute’s discussion paper, More ladders, fewer snakes: Two proposals to reduce youth disadvantage, reports that one third of 15 to 19 year olds and almost half of 20 to 24 year olds are overweight or obese, and one third of New Zealand youth aged 15 to 24 years have hazardous drinking behaviour. One in seven adults have potentially hazardous drinking patterns.
People in disadvantaged groups have higher exposure to many lifestyle risk factors so efforts to improve lifestyles, if successful, may help reduce life expectancy disparities. The B4 School Check is a nationwide programme offering a free health and development check to identify and reduce future health problems for four year olds. The Ministry of Health is implementing Whānau Ora to improve outcomes among Māori which are demonstrably poorer than those of non-Māori.
The Ministry of Health’s 2007-2010 Statement of Intent identified the Better Health For All strategy would focus on targeting chronic disease, child and youth services, elective services, primary health care, the health of older people, infrastructure, continuing to ensure value for money is achieved, improving Māori health and reducing inequalities.
The performance of health services has been an important concern of governments in New Zealand for some time, with substantial efforts going into ensuring national health targets are met and high quality outcomes are delivered cost-effectively.
Higher incomes promote longer lives and the average New Zealander’s income has been increasing. However the disparity between incomes also affects average health outcomes and is discussed in the NZahead income inequality measure.
New Zealand’s overall life expectancy at birth is 11th of 34 in the OECD, resulting in a grade of B.
New Zealand’s good average performance masks significant disparities and poor life expectancy for sub-populations. New Zealand has not yet remedied the large life expectancy disparities for Māori and the most deprived groups, and has worsening trends in obesity and binge drinking.
The target of 82.4 is based on New Zealand lifting the annual growth rate in life expectancy to the OECD average of 0.33% for the six years from 2003 to 2009. Achieving the target growth rate could lift New Zealand to be within the top 10 OECD countries.
The estimate of life expectancy at birth is calculated based on gender and age-specific mortality tables. The 2010 age-specific mortality for 53, for instance, would be calculated based on the number of the population who died during 2009, aged 53 and those aged 53 who did not die. Life expectancy is then based on combining the age-specific mortality for each year of life to develop a projection of the distribution of ages at which those born now might die, then taking an average of those ages of death.
Life expectancy is based on the recent but historical experience of the population. Assuming ongoing improvements in health care, someone born today could therefore reasonably expect to live to an even greater age, based on the treatments for a 53 year old being better and therefore more successful 53 years from now than they were last year.
The data is rigorously collected, highly standardised, and has limited errors or skews across countries or recent history, so comparisons can be reliably made. Changes in life expectancy are generally small and slow to respond to policy and changed circumstances, particularly in larger populations. At the last NZahead update in September 2010, the World Bank Millennium Development Goal data set was used, which reported an incorrect figure for New Zealand’s 2008 life expectancy. As the World Bank cannot provide an explanation for the incorrect data, the Institute has returned to the OECD data set. The OECD data set also shows a slowing growth rate, but not to the same degree. OECD updates the data at the end of June each year, and their data on New Zealand is collected through the New Zealand Ministry of Health. More information is available at http://www.oecd.org/health/healthdata or http://www.moh.govt.nz or http://www.socialreport.msd.govt.nz.
Figure 1: OECD (2011). Health Data, Life expectancy, Total population at birth, retrieved 28 July 2011 from http://stats.oecd.org/index.aspx. All data is 2009 except: 2007 - Canada; 2008 - Italy; 2010 - Chile, France, Mexico, Sweden. OECD average is an unweighted average of the 34 countries data.
Figure 2: As for Figure 1. Chile and Slovenia excluded as life expectancy records do not go back to 1980.
Figure 3: Life expectancy data as per Figure 1. OECD (2011). Health Data, Health Expenditure, Total expenditure on health, / capita, US$ purchasing power parity retrieved 28 July 2011 from http://stats.oecd.org/index.aspx, converted to NZD with exchange rates: 0.736 for 2007, 0.715 for 2008, 0.634 for 2009 and 0.722 for 2010, retrieved 28 July 2011 from the Reserve Bank of New Zealand historical series at http://www.rbnz.govt.nz. Deflators from Statistics New Zealand (2011). Gross Domestic Product: March 2011 quarter, Table 5.1, retrieved 28 July 2011 from http://www.stats.govt.nz/browse_for_stats/economic_indicators/GDP/GrossDomesticProduct_HOTPMar11qtr.aspx. Health expenditure data is 2009 except: 2007 - Greece; 2008 - Australia, Japan, Portugal, Turkey; 2010 - Canada, Finland, Iceland, Italy, Mexico, South Korea.
Figure 4: Ministry of Social Development (2010, November). The Social Report 2010, retrieved 14 April 2011 from http://www.socialreport.msd.govt.nz/health/life-expectancy.html. OECD average life expectancy value of 79.2 years for 2008 from Figure 1 data source. Global life expectancy value of 68.9 years for 2008 retrieved 28 April 2011 from the World Bank, Health Indicators, Life expectancy at birth, total (years), http://data.worldbank.org/indicator/SP.DYN.LE00.IN/countries/1W?display=graph.
Further information links for life expectancy
Use the Gapminder data available at http://www.gapminder.org/news/life_expectancy_updated/
to compare life expectancy for 155 countries back to 1800, although in most cases, the early estimates are based on a very rough model.
If you are interested in more individualised information on life expectancy, you can use this calculator http://moneycentral.msn.com/investor/calcs/n_expect/main.asp.
Ministry of Health (2008, June). A Portrait of Health: Key results of the 2006/07 New Zealand Health Survey. Wellington: Ministry of Health. http://www.moh.govt.nz/moh.nsf/indexmh/portrait-of-health#info.
Ministry of Health (2010). Tatau Kahukura: Māori Health Chart Book 2010, 2nd Edition. Wellington: Ministry of Health. http://www.maorihealth.govt.nz/moh.nsf/pagesmh/10136/$File/maori-hth-cbk-2010.pdf.
OECD (2009). Society at a Glance 2009 - OECD Social Indicators, Chapter 7 Health Indicators, Version 1-last updated 29 April 2009. Table HE4.1 High obesity rates in many OECD countries, at http://www.oecd.org/document/40/0,3746,en_2649_37419_47507368_1_1_1_37419,00.html.
New Zealand Treasury (2003). The Ageing of the New Zealand Population, 1881-2051. http://www.treasury.govt.nz/publications/research-policy/wp/2003/03-27/08.htm.
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