Life Expectancy in Asian Countries 1990–2021: A Subanalysis of Causes and Risk Factors from the Global Burden of Disease Study 2021

Abstract

Although global Life expectancy (LE) has been increasing for a long period of time, the post-2019 COVID-19 pandemic has led to a reversal of life expectancy trends in most regions. Asia is an ideal region to analyze health drivers due to its population diversity and significant health disparities. Based on the data from Global Burden of Disease Study 2021 (GBD 2021), this study analyzes the changes in LE, health-adjusted life expectancy (HALE), and life expectancy with disability (LED), and risk factor contributions in 34 countries in Asia from 1990-2021, aiming to reveal regional health trajectories and risk factors, and provide a foundation for the development of precise public health strategies. LE and HALE were calculated by standard life tables and Sullivan's method, combining age-specific mortality rates and disability-adjusted life years (YLDs). LED is the difference between LE and HALE. The contribution of 21 categories of causes of death to the change in LE was quantified by the age-cause-of-death decomposition method. Risk factor analyses encompassed the summary exposure values (SEVs) of 88 risk categories and their theoretical minimum exposure levels, with a focus on assessing the spatial and temporal trends of key upstream risks for cardiovascular diseases, respiratory infections and tuberculosis. LE and HALE in Asia showed growth from 1990 to 2021, but there were significant regional differences. Dietary improvement, cholesterol and blood pressure management contributed significantly to most Asian countries, while the negative impacts of air pollution and tobacco were relatively small. Additionally, there was significant regional heterogeneity in the burden of mortality and the effects of risk interventions in the Asian health transition. This study fills this gap by integrating life expectancy trajectories for 34 Asian countries from 1990-2021 and incorporating COVID-19 pandemic impacts, showing significant regional health differentiation in Asia.