Countries With the Most Years in Poor Health

Many people are living longer—but not necessarily healthier—lives.

This visualization ranks countries by the number of years their citizens can expect to live in poor health, calculated as the gap between average life expectancy and health-adjusted life expectancy.

Skip to the second-last section for a full explanation of what health-adjusted life expectancy (HALE) is, and why it matters.

HALE data (for the year 2021) is sourced from the World Bank, via Our World in Data. Average life expectancy is from 2025 estimates UN World Population Prospects.

Together they reveal how disease, disability, and chronic conditions shape the quality—not just the quantity—of our lives.

The Difference Between Living Longer and Living Healthier

Oil wealth appears genuinely toxic to health outcomes.

Nearly every Middle Eastern petrostate (Bahrain, Oman, Qatar, UAE, Kuwait) appears in this worst-performers list.

Bahrain (17.4 years), Oman (17.3), Qatar (16.5), and the UAE (15.9) all post sizable gaps despite having robust health-care budgets.

The lifestyle changes that come with sudden wealth, like sedentary living, processed foods, air conditioning replacing physical activity, seem to create a specific pattern of prolonged morbidity.

The U.S. makes the top 10 as well, the only G7 economy to do. Americans are projected to spend 15.7 of 79.6 expected years in poor health.

Also worth noting is the average life expectancy at birth for all of these aforementioned countries is fairly high. Which means these countries are good at keeping people alive with advanced medical technology.

But they may be failing at keeping them healthy, as if they’ve optimized for extending life rather than living well.

Life Expectancies in Low-Income Countries

s everal sub-Saharan African nations, including Eswatini, Botswana, and Namibia, also record gaps above 14 years.

Unlike the richer Gulf countries, they face this burden alongside much shorter life expectancies, meaning fewer total healthy years.

Latin American countries such as Peru and Brazil post similar gaps, reflecting both higher infant mortalities and higher disease burdens.

These patterns highlight a central challenge for global health: boosting not only how long people live, but how long they live well.

What is HALE (Health-Adjusted Life Expectancy)?

HALE measures how many years a person can expect to live in good health, defined as free from disabling illness or injury.

HALE matters because it fundamentally reframes what we mean by a “successful” life and healthcare system.

Traditional life expectancy tells us how long people live, but HALE tells us how long they live well.

Those “unhealthy years” are extraordinarily expensive. The U.S. healthcare system’s poor HALE performance means they’re essentially running a massive, costly life-support operation for millions of people.

Countries with better HALE ratios spend less on healthcare while achieving better outcomes because they’re preventing problems rather than managing chronic decline.

Source: Ranked