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Monday 11 May 1998

How the world feels today: Never better

The Ottawa Citizen

The World Health Organization looks ahead to 2025, and sees a far healthier planet, as Juliet O'Neill discovers.

The World Health Organization has taken the planet's pulse and finds an "unmistakable trend" toward healthier and longer life, with clear evidence that disability is not inevitable in old age.

And according to the report, Canada's "clear approach" to health care makes this country a model for the world.

Experts from the United Nations organization looked back to the 1950s to show how far the state of the world's health has come and projected ahead through the first quarter of the next century to show how far we're expected to go.

"As the new millennium approaches, the global population has never had a healthier outlook," says the fourth world health report.

By 2025, WHO projects worldwide life expectancy to average 73 years, compared with 66 now and 48 in 1955. It cites studies proving how good health can be secured for old age: calmness and exercise, no smoking, low-fat diets, and safe sex.

Canadians can expect to live well above the average -- to a ripe 81 years, compared with 79 now. That'll put Canada on par with Finland, Spain, the Netherlands and Switzerland. The only countries with higher life expectancy of 82 years in 2025 will be Italy, Sweden and Japan.

The global trend to longer, healthier lives is thanks to decades of social, economic and technological progress that provides "hope in the future" of a world we're often told is going to hell in a handbasket.

WHO calls the revolution in global technology, especially telecommunications, a stunning advance that is contributing to international prosperity and shrinking the information gap, allowing more societies than ever to learn, plan and practise the secrets of good health and disease prevention. The secrets range from clean drinking water to vaccinations.

Dr. David Brandling-Bennett, deputy director of the Pan American Health Organization and an adviser on the report, said this one is a bit more optimistic than the previous three annual reports. The first one dwelled on poverty, the second on infectious diseases, the third on non-communicable diseases. "The reason for optimism is we have good examples from countries like Canada and Finland, where significant advances in health have taken place over the last 50 years," he said.

Heart disease and cancer mortality have declined in Canada and the country's "clear approach" to health care -- from anti-smoking measures to food labelling practices -- is a model for the world.

Studies in Finland and elsewhere had shown not only that healthy old age is not a random or genetic phenomenon "but that people can contribute to it" through lifestyle habits.

The picture is far from evenly bright around the world. The hefty report details the cruel fate awaiting millions of people. Poverty plagues many communities. The overall gap between rich and poor is widening. Millions are undernourished. Tuberculosis is far from eradicated. HIV is a growing scourge. And huge, in some places expanding, swaths of people still live without sanitation.

"The report's most disturbing find is that, despite increasing life expectancy, two-fifths of all deaths in the world this year can be considered premature, in that more than 20 million people a year are dying before the age of 50," WHO says. Almost half those deaths are children under five.

However, WHO's experts also focussed on a long view, finding so many more people with access to food, clean water, literacy and medical treatment that it concluded "humanity has many good reasons for hope.

"Such an optimistic view must be tempered by recognition of some harsh realities," the report said. "Nevertheless, unprecedented advances in health during the 20th century have laid the foundations for further dramatic progress in the years ahead."

Sources of optimism are such facts as the world's food supply has more than doubled in the past 40 years, a pace faster than population growth. Per-capita gross domestic product has risen by at least 2.5 times in the past 50 years. Adult literacy rates have increased by more than 50 per cent since 1970. The number of chronically undernourished people has fallen.

These factors are contributing to population trends that will make the 1950s face of humanity almost unrecognizable in 2025. The world will be much more crowded; there will be eight billion of us on the planet by then, compared to 2.8 billion in 1955.

And there will never have been so many older people (10 per cent of the population, compared with five per cent in 1955) and so relatively few young ones (32 per cent in 2025 compared to 45 per cent in 1955).

By 2015, the number of people living in urban areas will exceed rural residents for the first time in history, adding to the burden of social, economic and environmental challenges facing the world.