Longer Lives, Longer Illness: Europe’s Ageing Paradox

Europe is living longer. That part is clear.

Life expectancy across the EU is now over 81 years on average, according to recent Eurostat data. But what sits behind that number is less reassuring.

The increase in healthy life years, or “healthspan” has not kept pace.

In 2023, Europeans could expect to live around 63 years in good health, meaning a significant portion of life is now spent with illness or limitation. That gap—between how long people live and how long they stay healthy—is becoming a defining feature of ageing in Europe.

Research confirms this is not marginal. A recent study in JAMA Network Open shows that the difference between lifespan and healthspan has widened globally, with people living nearly a decade longer than they remain in good health. The driver is clear: chronic disease.

Cardiovascular disease, diabetes, cancer and neurodegenerative conditions now dominate later life. These are not short-term illnesses. They shape daily functioning, independence and long-term care needs.

As Francesco Sparaco, Chair of Threestones Foundation, puts it: “We are extending life, but too often without extending the quality of that life. The real challenge now is not longevity alone, but ensuring those extra years remain meaningful, active, and dignified.”

This is already visible in the data. Women live longer than men in Europe, but spend a greater proportion of those additional years in poorer health—a pattern highlighted in the OECD’s Health at a Glance report.

The implications are structural. Healthcare systems designed around acute intervention are now managing long-term, complex conditions at scale. At the same time, demand is rising as more people live into older age, often with multiple conditions requiring ongoing care rather than treatment.

The result is imbalance: more years lived with illness, and more pressure on systems not designed for it.

Some policymakers are making adjustments, shifting toward healthy life years, prevention, and maintaining independence for longer. But progress is uneven, and the underlying drivers—chronic disease, lifestyle factors, and unequal access to care—remain problematic.

Europe has been successful at extending life.

The next phase will pose new challenges about not just how long people live—but how well they live those extra years.