Who wants to live forever?

In the midst of pre-election positioning, there were two interesting health stories last week: life expectancy predictions for the UK and the rise of non-alcoholic fatty liver.

As might be expected, each paper presented its own interpretation of the life expectancy story. The Telegraph warned of the perils of older age without better health, and The Guardian highlighted the discrepancy between North and South, or rich and poor.

The UK does show wide regional variation. Men in Blackpool can currently expect to live to 75.2 years, the lowest life expectancy in the country, while those in the City of London - where life expectancy is highest - live an average of 83.4 years. The longest life expectancy for women is also in the City where they live to 87.3 years on average.

Wide variation also exists across the globe; Japan and Switzerland have some of the highest life expectancy at 83 years. Sierra Leone has one of the lowest - just 46 years.

Looking to the future, forecasts for 2030 in the UK are 85.7 years for men and 87.6 years for women. The gap between the sexes has narrowed, possibly because more women are smoking. Smoking plays a significant role in four of the leading five causes of premature death: cancer, heart disease, stroke and respiratory disease. The other is liver disease. The headline news was that most liver transplants are expected to be linked to overeating rather than alcohol abuse by 2020. Figures from a Lancet paper last year estimated that one in three of the UK population have non-alcoholic fatty liver and liver specialists fear this is a bit of a ticking time bomb.

These predictions will have an impact on government spending as pensions will have to pay out longer than planned, and health and social services will have to serve an even older and sicker population than is currently planned for.

The major limitation of any study that predicts life expectancy is that it is always based on trends from death rates in the past. It assumes that past trends will continue into the future, so these types of studies cannot account for unexpected events or major social changes that could have a huge effect on life expectancy. For example, unlikely events such as a natural disaster or a scary epidemic, changes within the healthcare system, or even a major health breakthrough, such as a cure for heart disease or cancer.

GP care will play a bigger part in keeping people alive and (more importantly) well for a longer time. Increased longevity has historically been ascribed mainly to improvements in social conditions, education, nutrition and better vaccinations and vaccination rates. It remains to be seen if further improvements in these areas will bring corresponding gains. People might have longer lives, but they will experience more sickness. This will need managing. However, from what we already know, by stopping smoking, drinking alcohol sensibly and not overeating, we could expect life expectancy to rise even further.

Should (and can) we make people change their lifestyle behaviours?

Where does 'free will' sit when faced with billions of pounds of funding deficit?

Read 17 responses to this question from medical professionals.