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Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death

The Lancet has published a study on moddeling life expectancy, all-cause mortality and cause of death forecasts. The authors' reference forecast predicted continued declines in global mortality and improvements in life expectancy, though at a slower rate than achieved in the past. Because of faster progress among many lower-SDI countries, absolute disparities between countries are currently projected to narrow by 2040. Nonetheless, the differences between better health and worse health scenarios for 2040 remain substantial, emphasising that the reference forecast is not inevitable and thus policy choices made today can profoundly affect each country’s future health trajectories.

Understanding potential trajectories in health and drivers of health is crucial to guiding long-term investments and policy implementation. Past work on forecasting has provided an incomplete landscape of future health scenarios, highlighting a need for a more robust modelling platform from which policy options and potential health trajectories can be assessed. This study provides a novel approach to modelling life expectancy, all-cause mortality and cause of death forecasts —and alternative future scenarios—for 250 causes of death from 2016 to 2040 in 195 countries and territories.

Globally, most independent drivers of health were forecast to improve by 2040, but 36 were forecast to worsen. As shown by the better health scenarios, greater progress might be possible, yet for some drivers such as high body-mass index (BMI), their toll will rise in the absence of intervention.

We developed a three-component model of cause-specific mortality: a component due to changes in risk factors and select interventions; the underlying mortality rate for each cause that is a function of income per capita, educational attainment, and total fertility rate under 25 years and time; and an autoregressive integrated moving average model for unexplained changes correlated with time.