People are living longer than ever, but not every extra year comes with good health. That’s the picture emerging for San Marino from a study published in The Lancet Public Health, which compares life expectancy with the number of years spent free from major health problems.
In 2023, life expectancy on the Titano reached 85.1 years, the second-highest figure among all the countries and territories analyzed, behind only Singapore. The figure for healthy life expectancy is also remarkably high: 72.2 years, placing San Marino third in the world.
Between the two figures, however, lies a gap of 12.9 years — the so-called “morbidity gap,” meaning the average period of life spent dealing with illness, disability or less-than-optimal health. Back in 1990, that gap stood at around 10.2 years.
In just over three decades, San Marino’s overall life expectancy has grown by 6.7 years, while healthy life expectancy has increased by only 4.1 years. In other words, longevity has advanced faster than the ability to stay healthy into old age.
The gap is even more pronounced among women: in 2023, female life expectancy reached 87.2 years, compared with 83.2 for men. Years spent in good health, however, stood at 72.8 for women and 71.7 for men — pushing the gap to 14.3 years for women, against 11.5 for men.
San Marino’s figures reflect a broader global trend. Between 1990 and 2023, the average worldwide gap between total life expectancy and healthy life expectancy widened from 8.8 to 10.7 years. The study found an increase in 203 of the 204 countries and territories examined, confirming that the real challenge today is no longer simply living longer, but staying healthy for as many of those extra years as possible.
