What has driven life expectancy gains in recent decades? A cross-country analysis of OECD member states

Countries with higher national income and health spending tend to have longer life expectancies. But these factors can only account for a part of life expectancy differences across countries. This chapter analyses the factors contributing to health status, including a closer assessment of the determinants of health that go beyond the health system. It shows that on average, a 10% increase in health spending per capita is associated with a gain of 3.5 months of life expectancy. The same rate of improvement in healthier lifestyles (10%) is associated with a gain of 2.6 months of life expectancy. Wider social determinants are also important: a 10% increase in income per capita is associated with a gain of 2.2 months of life expectancy, and a 10% increase in primary education coverage with 3.2 months. For income, minimum absolute levels are particularly critical to protecting people’s health.The main policy implication emerging from this analysis is the significant opportunities for health improvement from coordinated action across ministries responsible for education, the environment, income and social protection, alongside health ministries. This includes inter-sectoral action to address health-related behaviours. Collaboration with the private sector will also be important, especially with employers in relation to working conditions.