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Elderly South Koreans lounging at Tapgol Park in Seoul’s Jongno District. (Shin So-young, staff photographer)
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Halt partially explained by increased pneumonia deaths and aging population
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Elderly South Koreans lounging at Tapgol Park in Seoul’s Jongno District. (Shin So-young, staff photographer)
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“82.7 years.”
The rise in South Korea’s average life expectancy has come to a halt for the first time since the National Bureau of Statistics (now Statistics Korea) first began collecting data on it in 1970 (62.3 years). According to 2018 mortality table data published by Statistics Korea, the predicted life expectancy for a child born last year was 82.7 years -- unchanged from the 82.7-year life expectancy projected for a child born in 2017. By sex, male children were predicted to live for 79.7 years and female children for 85.7 years.
Cold temperatures associated with tripling of pneumonia mortality rate
“Winter of last year brought severely cold temperatures to their lowest level since 1973. In addition to a trend of higher mortality rates due to an aging population, the effects of the cold weather appear to have been particularly large last year.”
Statistics Korea pointed to the cold weather in 2018 as a factor in average life expectancy remaining frozen in place, with the number of deaths in January and February respectively up by 21.8% and 9.3% from the same months the year before. Another factor cited was an increase in the percentage of deaths from pneumonia. In 2018, pneumonia was found to account for 10% among major causes of death -- meaning that one in 10 people passed away from the disease. The rate was over three times higher than the 3.2% recorded in 2008. This stood in contrast with the probability of dying from cancer or cerebrovascular disease, which declined over the same period.
The halt in the life expectancy increase last year did not receive major media attention. According to Statistics Korea, South Korea’s life expectancy is expected to rise again as long as this winter does not bring a severe cold snap. Residual life expectancy, which refers to the average length of time members of certain age group in the population are expected to remain alive, is calculated based on the number of deaths in the population for that age group, the number of survivors, and the mortality rate. For a newborn child whose age is “zero years,” residual life expectancy is equivalent to life expectancy.
South Koreans believe that life expectancy will only continue to grow. Scholars and the government have also predicted an ongoing increase in life expectancy. An analysis of life expectancy among OECD countries by Imperial College London and the World Health Organization (WHO) predicted that a Korean female born in 2030 will have a life expectancy of 90.82 years, passing the 90-year mark for the first time. South Korea was seen as experiencing the world’s fastest trend toward longer life spans.
But that increase in life expectancy has now come to an abrupt halt. While government authorities described the development as a one-off instance of stagnation due to cold weather conditions, scholars referred to it as “shocking.”
“South Korea had been experiencing the fastest rise in life expectancy among OECD countries,” explained Khang Young-ho, a professor with the Seoul National University College of Medicine Department of Health Policy & Management and an expert in domestic life expectancy and inequality issues.
“Recent decreases in US and UK life expectancies drew some attention, but the rates of change in those countries were not large. For South Korea’s life expectancy to halt its increase after recording growth of 0.2 to 0.4 years at a time for decades is a major issue,” he said.
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S. Korea's life expectancy and "healthy life expectancy"
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UK also viewing stagnation as “serious public health crisis”
Khang explained that while deaths from pneumonia were indeed an important factor in the halt to the life expectancy increase, the matter is tied not only to harsh winter weather and other climate issues but also to issues of social inequality. Increases in pneumonia deaths have been found primarily in the population aged 75 and over, and many senior citizens reside in nursing hospitals and other long-term care institutions. Infections occur as patients are brought into proximity with one another, and a large number of deaths were reported from aspiration pneumonia, in which substances enter a patient’s bronchial tubes and lungs while they are bedridden with a stroke or similar condition. In other words, the pneumonia mortality rate is high among patients who are failing to receive adequate care at facilities with a shortage of nursing staff.
“If we look at the socioeconomic elements together with the life expectancy, we see that a lot of the deaths from pneumonia occurred at higher ages and lower income levels,” Khang said. “Not only does pneumonia contribute to lowering life expectancy, but it also contributed to life expectancy inequality.”
Some questions remain. Is the steady rise in the pneumonia mortality rate over the past decade enough to account for the halt in life expectancy growth?
While no precise research findings have yet been published, a few factors are worthy of note. First among them are record heat waves. In addition to cold snaps, 2018 also included 31.5 days classified as “heat wave conditions” -- the highest number since 1973. (See Vol. 1288, “2018 Heat Wave Death Toll 160, Not 48.”) High temperatures are known to have a negative impact on cardiovascular and respiratory disease.
The year 2018 also saw the suicide rate reversing its decline. Since reaching a rate of 31.7 persons for every 100,000 in 2011 -- its peak since the foreign exchange crisis in the late 1990s -- the suicide rate had been steadily declining following an expansion of suicide prevention efforts in 2012. The level in 2017 stood at 24.3; in 2018, it rose again to 26.6, an increase of 2.3 persons. A notable development in the 2018 suicide statistics was the increase in suicides among the younger population. By age group, increases were observed for all categories apart from people aged 80 and over. Among teens in particular, suicides increased by 22.1% from the year before. Other large increases were observed among those in their 30s (12.2%) and 40s (13.1%).
An increase in suicide rates was also noted in the US, which has experienced a decline in life expectancy for three consecutive years from 78.9 years in 2014 to 78.6 in 2017. Information published by the American Academy of Family Physicians (AAFP) in 2018 pointed to drug misuse and abuse and suicide as factors in the life expectancy decline, noting that the 70,237 drug overdose deaths in 2017 represented a 9.6% increase from the year before, while a rise in the suicide rate from 13.5 to 14 persons per 100,000 contributed to the drop in life expectancy.
In the United Kingdom, life expectancy has been a focus of attention in the public health and medical communities after their sharp increase over the century since industrialization came to a halt in 2011. Between 2000 and 2015, life expectancies for newborns rose sharply by one year every five years for females and one year and 3.5 years for males. In 2015, that rate slowed down. According to the UK Statistics Authority, the increase in life expectancy between 2016 and 2018 amounted to just 4.7 weeks for males and 3.1 weeks for females. One British scholar referred to this as the “worst public health crisis since the Second World War.”
Socioeconomic factors have drawn attention as factors in the rise in UK life expectancy stagnating. Lucinda Hiam, a research fellow at the London School of Hygience and Tropical Medicine, told the Guardian in an interview that “life expectancies started to stall just after the austerity cuts were introduced [in 2010],” suggesting that a decline in the public health and welfare budget in the wake of the 2008 global financial crisis may have been responsible for the stalling life expectancies. In response to these arguments, the British government is looking into differences in life expectancy based on regional health and income disparities and working toward a solution.
Continued decline in “healthy life expectancy”
While the halt to life expectancy growth is an issue in South Korea, another major one is a continued decline in the “healthy life expectancy,” or the average amount of time a person lives a life without disease. Healthy life expectancy has been estimated every other year since 2012.
From its level of 65.7 years in 2012, healthy life expectancy has been in continuous decline, reaching 64.4 years in 2018. A comparison with general life expectancy statistics indicates that a female born in 2018 who lives to an age of 85.7 years can expect to spend 20.8 of those years suffering from some form of disease.
Under these circumstances, the stagnation in the rise in life expectancy cannot be explained solely in terms of record low temperatures or an increase in pneumonia deaths. It’s essential to understand the issues that are getting in the way of rising life expectancy and the root causes behind the decline in healthy life expectancy.
By Lee Jae-ho, staff reporter
Please direct comments or questions to [english@hani.co.kr]
