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"Something to do with lifestyle and certainly diet and excercise"
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Monday, 5 June, 2000, 13:33 GMT 14:33 UK
Japan 'the most healthy country'
Japanese children
Japanese children can look forward to a long and healthy life
People who live in Japan can expect to remain in good health longer than anybody else in the world, according to the World Health Organisation (WHO).

WHO scientists have developed a new way of calculating the number of years that a person can be expected to live in full health.

It is known as the DALE (Disability-Adjusted Life Years) system, and gives a truer picture of the health of a country than simply studying death rates.

Top ten countries
Japan - 74.5 years
Australia - 73.2
France - 73.1
Sweden - 73.0
Italy - 72.7
Spain - 72.8
Greece - 72.5
Switzerland - 72.5
Monaco - 72.4
Andorra - 72.3

Using the system to rank the world's 191 countries has uncovered some surprise findings.

In Japan the average healthy life expectancy is 74.5 years.

Australia is second and France third on the list, but the US ranks only number 24.

The UK is 14th, with an average of 71.7 years. For UK women the average is 73.7 years, for men it is 69.7 years

For a full list of countries in ranking order click here .

Sierra Leone comes last with an average life expectancy at birth of only 25.9 years.

There is a notable gender gap in many countries. For instance, in Russia women can expect 66.4 years of full health, compared to just 56.1 years for men.

The WHO estimates almost 56 million people died in 1999, 10.5 million of whom were children less than 5 years of age.

Previously, life expectancy estimates were based on the overall length of life based on data about death rates.

Bottom ten countries
Sierra Leona - 25.9 years
Niger - 29.1
Malawi - 29.4
Zambia - 30.3
Botswana - 32.3
Uganda - 32.7
Rwanda - 32.8
Zimbabwe - 32.9
Mali - 33.1
Ethiopia - 33.5

To calculate DALE, the years of ill-health are weighted according to severity and subtracted from the expected overall life expectancy to give the equivalent years of healthy life.

The WHO rankings show that years lost to disability are substantially higher in poorer countries because some limitations - blindness, paralysis and the debilitating effects of several tropical diseases such as malaria - strike children and young adults.

People in the healthiest regions lose 9% of their lives to disability, compared to 14% in the worst-off countries.

Sierra Leone
Sierra Leone has the lowest healthy life expectancy

DALE is estimated to equal or exceed 70 years in 24 countries.

At the other extreme are 32 countries where disability-adjusted life expectancy is estimated to be less than 40 years.

Many of these are countries with major epidemics of HIV/AIDS, among other causes.

Dr Christopher Murray, director of WHO's Global Programme on Evidence for Health Policy, said: "The position of the United States is one of the major surprises of the new rating system.

"Basically, you die earlier and spend more time disabled if you're an American rather than a member of most other advanced countries."

The reasons why the US rates so low may be partly due to the very poor standard of health among some ethnic minorities and people who live in the inner cities.

Rates of coronary heart disease are also high.

All of the bottom 10 countries were in sub-Saharan Africa, where the HIV-AIDS epidemic is rampant.

Alan Lopex, co-ordinator of the WHO Epidemiology and Burden of Disease team, said: "Healthy life expectancy in some African countries is dropping back to levels we haven't seen in advanced countries since Medieval times."

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