Life expectancy at age 60 summarises expected remaining years of life after age 60 based on period life tables, while healthy life expectancy (HALE) at age 60 adjusts these years for time spent in less than full health. Taken together, they provide a more complete picture of ageing than life expectancy alone, distinguishing gains in survival from gains in health. WHO estimates are produced using standardised methods to enhance comparability across countries and provide final age‑sex mortality estimates through 2021, capturing the mortality shock during the COVID‑19 pandemic.
Remaining life expectancy at age 60 is lower in LAC than in the OECD, and many LAC countries experienced a marked drop in 2021, coinciding with the COVID‑19 mortality shock. On average in LAC31, a 60‑year‑old in 2021 could expect to live a further 20.7 years if female and 17.5 years if male (Figure 9.3) – about 4.6 and 4.0 years fewer than the OECD average, respectively. Between 2000 and 2021, life expectancy at age 60 in LAC31 declined overall (women: 21.6 to 20.7; men: 18.7 to 17.5), whereas the OECD average was broadly stable over the period, with slower gains in many countries even before the pandemic. Country patterns are heterogeneous: several countries recorded sizeable reductions by 2021 (especially among men), while others continued to post modest gains. In 2021, remaining life expectancy at age 60 was highest in Costa Rica and Chile and lowest in Bolivia for both women and men. These differences reflect a mix of long-term drivers (such as cardio-metabolic risk, health system performance and socio‑economic conditions) and short-term shocks; updated Global Burden of Disease (GBD) 2021 estimates provide a consistent lens on cause‑specific mortality changes and their impact on life expectancy during 2020‑2021 (Naghavi et al., 2024[1]).
Longer life does not necessarily mean more years in good health. HALE at age 60 – from WHO GHO – captures expected years lived in full health, adjusting for disease and disability (see “Definition and comparability”). In the OECD, HALE at 60 is 18.3 years for women and 16.2 for men; in LAC31 it is about 2.8‑2.9 years lower (15.5 and 13.4, respectively; Figure 9.4). Country estimates range from 11.5 healthy years for women in Haiti and 9.3 for men in Bolivia to 18.5 for women and 16.6 for men in Costa Rica, with similarly high values in Chile (17.8; 16.4) and Panama (18.1; 15.9). This gap translates into more years with functional limitations and higher demand for community-based and residential long-term care. While HALE is model-based, its value lies in integrating fatal and non-fatal health loss into a single, comparable metric; GBD 2021 results reinforce that HALE gains often lag life expectancy gains when morbidity is not reduced as much as mortality (Ferrari et al., 2024[2]).
The divergence between life expectancy and HALE at older ages has direct implications for health system design and long-term care. Lower HALE often reflects greater prevalence and severity of functional impairment and multimorbidity, which interact to accelerate declines in physical and cognitive function. This strengthens the case for integrated, person‑centred primary care with prevention, medication review, rehabilitation and maintenance of function at its core (Calderón‐Larrañaga et al., 2018[3]). Gender gaps also narrow when focussing on healthy years: in LAC31, women live about 3.2 more years than men at age 60 in total life expectancy (20.7 vs. 17.5) but only 2.1 more healthy years (15.5 vs. 13.4), with very small HALE gaps in some countries (e.g. Haiti) and larger ones in others (e.g. Uruguay). Consistent with evidence of partial decoupling between longevity and healthy longevity in LAC (Robledo, Cano-GutiéRrez and Garcia, 2022[4]), HALE series typically lag life expectancy updates and may not fully capture the COVID‑19 period depending on the latest WHO GHO year used in this publication.
