Changes in life expectancy

Over the last century there has been a marked decline in premature death throughout the developed world. In 1888, a newborn baby girl in England and Wales had an average life expectancy of just over 40 years. By 1930, this had risen to just over 60 years, and by 1999 it had reached 80 years (Fig. 1). However, if a child survived into middle age, life expectancy even in 1888 was quite high. A 45-year-old woman in 1888 could, on average, expect to live to nearly 70 years of age, and in 1999 she had an average life expectancy of over 80 years.

Fig. 1 Average life expectancy for a woman at different ages in 1888, 1930 and 1999 (England and Wales)

(from Registrar General’s Mortality Statistics, 1999, with permission).

The major cause of increase in life expectancy is a dramatic fall in the death rate for infants during their first year of life. In 1888 in England and Wales, out of every 1000 infants under the age of 1 year, 145 died. By 1930 this figure had been more than halved to 68 infant deaths and the rapid decline continued until the present-day rate of 5–6 infant deaths per 1000. At the beginning of the 21st century almost all newborn babies in the UK can expect to live through childhood. In many developing countries in the world, life

If you were going to practise medicine in a developing country today, what sorts of ill health would you expect to encounter and what sorts of intervention would you become involved in?

expectancy at birth remains below 50 years of age because of high rates of infant mortality. According to McKeown (1979), the most important factor leading to changes in infant and child mortality has been a dramatic improvement in child and maternal nutrition over the past century.