Life expectancy at birth had continued to increase remarkably in Asia-Pacific over the past two decades, reflecting sharp reductions in mortality rates at all ages, particularly amongst infants and children (see indicators “Infant mortality” and “Under age 5 mortality” in Chapter 3). These gains in longevity can be attributed to several factors, including rising living standards, better nutrition and improved drinking water and sanitation facilities (see indicator “Water and sanitation” in Chapter 4). Improved lifestyles, better education, and enhanced access to healthcare also play an important role (NIA/NIH/WHO, 2011[1]). The large decline in under age 5 mortality, which reflects important commitment and investment at local, national, and global levels over several decades, is another major drive of the increase of life expectancy (Dicker et al., 2018[2]).
Life expectancy at birth across low- and lower-middle‑income Asia-Pacific countries reached 71 years on average in 2023, a gain of 3 years since 2010, whereas it reached 74 years in upper-middle-income Asia-Pacific countries and territories, a gain of almost 2 years since 2010, similar to the trend observed across OECD countries (Figure 3.1). Nonetheless, a very large regional divide persists as, on average, a newborn in Hong Kong (China) is expected to live over 20 years more than a newborn in Papua New Guinea. The countries or economies that surpass a life expectancy of 80 years in 2023 tend to be in the high-income group (e.g. New Zealand, Macao (China), Singapore, Australia, Korea, Japan and Hong Kong (China)). In contrast, Papua New Guinea, Myanmar, Fiji, Pakistan and Lao PDR had an estimated life expectancy at birth of less than 70 years.
Although during the COVID‑19 pandemic, from 2019 to 2021 life expectancy had decreased in most upper-middle, lower-middle- and low-income Asia-Pacific countries, recent years have shown only slight changes for most countries. Countries, such as, Bangladesh, India, Mongolia, Indonesia, Solomon Islands and Pakistan experienced an increase of more than 1 year in life‑expectancy between 2020 and 2023.
Consistently, across upper-middle-income countries, women have greater percentage of cohort surviving to age 65 (Figure 3.2). On average, 69% and 88% of a cohort of female newborns would survive to age 65 in low- and lower-middle-, and upper-middle-income Asia-Pacific countries and territories, respectively, while only 69% and 72% of male newborns will survive to age 65 in low- and lower-middle-, and upper-middle-income Asia-Pacific countries and territories, respectively. In Korea, Japan, and Hong Kong (China) more than 94% of female newborns will survive to age 65, whereas in Myanmar, Papua New Guinea, and Fiji, less than 65% of male newborns will survive to age 65. Many reasons contribute to this gender difference, such as biological differences resulting in slower ageing of immune systems and the later onset of cardiovascular diseases such as heart attacks and strokes amongst females (UNESCAP, 2017[3]).
Besides life expectancy, another indicator of the population health status is the healthy life expectancy. Higher healthy life expectancy is generally associated with higher life expectancy, and therefore it is longer – on average – for females. On one side, females born in 2021 in Japan and Singapore are expected to live around 75 years of good health, whereas on the other side, males from the same cohort in Fiji, Solomon Islands, India, Papua New Guinea and Pakistan have a healthy life expectancy of less than 60 years (Figure 3.3).
The difference of healthy life years for females born in 2021 between low- and lower-middle-, and upper-middle-income countries and territories across Asia-Pacific is three years, with 62 and 65 healthy life years, respectively. This difference increased to seven years when comparing upper-middle-income to high-income countries and territories, which exhibit an average of 72 healthy life years for females. Gender gaps amount to 2, 3, and 2 healthy life years for low- and lower-middle-, upper-middle-, and high-income countries and territories across Asia-Pacific, respectively. Men born in 2021 in high-income countries and territories across Asia-Pacific are expected to have 10 more years of healthy life than those born in low- and lower-middle-income countries and territories, with an average of 70 and 60 healthy life years, respectively.
