Reacción a "Improvements in life expectancy slowed down in many European countries between 2011 and 2021"

The international collaboration that has made the GBD (Global Burden of Disease) studies possible is well known and appreciated, not only for the breadth of countries covered, but also for the use of an appropriate methodology, which has required prior homogenisation of data.

This article highlights the slowdown in the progress that had been made in improving life expectancy in most of the countries included in the study. Although a quick first reading may make it seem that the cause of this phenomenon can be explained in a simple way, due to changes in the population's exposure to common risk factors, the authors obviously emphasise the complexity of the phenomenon. They reel off, quite rightly in my opinion, the factors that may be behind all this. They draw attention to the importance of political interventions which, if they include tackling the commercial determinants of health, reducing food risks, improving levels of physical activity and guaranteeing access to effective medical care for prevention and treatment, can achieve improvements in life expectancy. They also emphasise that there is an urgent need to develop more intersectoral strategies to reverse the slowdown in improvements in life expectancy, with a health-in-all-policies approach being necessary to address these determinants and reduce health inequalities.

The authors also emphasise that the countries that experienced the greatest slowdown in improvements in life expectancy before the COVID-19 pandemic were generally the ones that were most severely affected by COVID-19. It was in these countries that some of the greatest decreases in life expectancy occurred in 2019-2021. This indicates that the situation in these countries was not good before the Covid-19 pandemic and that an impact, such as that which has occurred since 2020, had greater consequences due to the previous situation. This is an important warning for decision-makers and policy-makers, especially since in times of crisis there has been a general tendency to reduce spending on public services, including health spending. When this line is applied more, the impact on the social determinants of health has a greater impact on health and social well-being and ends up contributing to the slowdown in the improvement of mortality.