Born to Live (Longer?): Why Geography is Destiny

Imagine this: two babies are born on the same day in 2025. One in Monaco, the other in a lower-income nation like Chad or Nigeria. By sheer accident of geography, the child in Monaco is expected to live more than 30 years longer than the other.

This isn’t an exaggeration. According to the latest UN World Population Prospects, life expectancy remains wildly uneven across the globe. Despite advances in medicine, public health, and technology, where you’re born remains one of the strongest predictors of how long you’ll live.

The visualisation by Visual Capitalist helps put this into sharp relief, ranking countries with the highest life expectancy in 2025. Monaco tops the list with an average lifespan of 86.5 years, followed closely by San Marino, Hong Kong, Japan, and South Korea.

Notably, Asia punches well above its weight, with Hong Kong, Japan, South Korea, and Singapore all within the top 10. This reflects decades of focused investments in universal healthcare, education, and public hygiene.

Where Does the UK Stand?

As of 2025, life expectancy in the UK is around 81.7 years overall — approximately 80.1 years for men and 83.3 years for women, according to the Office for National Statistics (ONS).

This places the UK below the top 25 countries in global life expectancy rankings, and well behind longevity leaders like Monaco (86.5 years), Japan (84.8 years), and Switzerland (84.1 years).

In fact, the UK is now ranked around 30th globally, behind countries like Malta, Ireland, and Portugal.

More concerning is the growing regional inequality within the UK. A man in Blackpool, for instance, may have a life expectancy 8–10 years lower than one in Kensington. Factors like income, education, employment, diet, and housing play massive roles in shaping these outcomes. Why Is the UK Falling Behind?

Despite being one of the world’s wealthiest economies and home to the National Health Service (NHS), the UK’s progress on life expectancy has stalled since 2010. According to research from the Health Foundation and King’s Fund, the UK has experienced the slowest improvement in life expectancy among comparable high-income countries.

A 2023 report from The Lancet described the UK’s life expectancy gains as “flatlining” due to multiple systemic issues:

1. Widening Health Inequalities

   The life expectancy gap between the richest and poorest areas of the UK is stark. A man living in Kensington and Chelsea can expect to live nearly 10 years longer than one in Blackpool or Glasgow. For women, the gap is around 7 to 8 years.

   
   

2. Economic Austerity and Funding Cuts

   Following the 2008 financial crisis, public health budgets were slashed. Between 2015 and 2020, local authority public health spending per head fell by 23%, disproportionately affecting deprived areas that rely on state support the most.

   
   

3. Lifestyle and Chronic Illness

   The UK has high rates of obesity, alcohol-related illness, and diabetes compared to its European peers. According to the NHS, around 28% of UK adults are obese, and nearly 5 million live with diabetes, mostly type 2.

   
   

4. Delayed Access to Healthcare

   With ongoing NHS backlogs and GP shortages, many Britons experience long waits for diagnosis and treatment. Delays in cancer diagnosis and elective surgeries have directly impacted survival rates.

Regional Life Expectancy Gaps in the UK (2023–2024 data)

Region	Male Life Expectancy	Female Life Expectancy
Kensington & Chelsea	84.8 years	87.5 years
Surrey	83.7 years	86.4 years
Greater Manchester	78.5 years	81.9 years
Blackpool	74.1 years	79.3 years
Glasgow (City)	73.6 years	79.0 years
UK National Average	80.1 years	83.3 years

(Source: ONS, 2024; Health Foundation)

The Retirement Challenge

With an average retirement age of 66 in the UK, and rising, the average British pensioner can expect to live around 15–20 years in retirement. But not all years are healthy.

A key measure is Healthy Life Expectancy (HLE) — the years lived without chronic illness or disability. In the UK:

• Men have a healthy life expectancy of just 63.1 years

• Women have a healthy life expectancy of 63.8 years

That means many Britons are spending nearly two decades in poor health — a major challenge for families, the NHS, and social care systems.

UK vs. Peer Countries: A Quick Comparison (2025)

Country	Life Expectancy	Healthcare Access Ranking*	Obesity Rate
Japan	84.8 years	Top 3	4%
Switzerland	84.1 years	Top 5	11%
France	83.5 years	Top 10	17%
UK	81.7 years	Ranked 18th	28%
United States	79.9 years	Ranked 22nd	36%

*Source: Commonwealth Fund’s International Health Care Performance Rankings, 2024

What Needs to Change?

To improve life expectancy and close the gaps, the UK must address not just medical care, but the social determinants of health:

• Invest in prevention — early intervention for diabetes, heart disease, mental health

• Level up deprived communities with better housing, clean air, and job opportunities

• Support healthy ageing with elder-friendly policies, accessible infrastructure, and digital inclusion

• Modernise the NHS to reduce backlogs, integrate tech, and focus on personalised care

The UK's standing in global life expectancy rankings is more than a number — it’s a reflection of national priorities. The fact that Monaco or Japan can offer 5–7 years more life on average is not just about money — it’s about strategic investment, equality, and a long-term vision for public well-being.

Why Do Women Live Longer Than Men?

This is one of the most enduring demographic trends worldwide — and one of the most complex.

Biological Explanations

• Hormonal Protection: Eostrogen has been shown to protect against heart disease by improving cholesterol profiles and arterial function.

• Stronger Immune Systems: Women generally mount more robust immune responses, giving them an edge against infections.

• Genetic Backup: With two X chromosomes, women are less likely to suffer from X-linked genetic disorders.
  

Behavioural & Social Factors

• Riskier Male Behaviour: Men are more likely to smoke, drink heavily, engage in violent behaviour, and take physical risks.

• Occupational Exposure: Men dominate dangerous professions — from construction to military roles — leading to higher injury and death rates.

• Healthcare Habits: Women are more likely to seek preventive care, follow medical advice, and attend regular check-ups.
  

The Gap is Narrowing in Some Regions

As gender roles shift and health awareness increases, the gap between male and female life expectancy has narrowed in parts of Europe and North America. However, the global trend still holds strong — with women outliving men by an average of 4 to 6 years in most developed nations.

What Drives a Country’s Life Expectancy?

1. Healthcare Access

Nations with universal healthcare and high physician density (doctors per 1,000 residents) consistently rank higher in life expectancy.

2. Education & Public Health

Higher literacy rates and public health campaigns (like anti-smoking or vaccination drives) improve long-term outcomes dramatically.

3. Economic Stability

Wealthier countries can afford better infrastructure, nutrition, elder care, and sanitation — key pillars of longer life.

4. Lifestyle & Culture

Diets rich in fruits, vegetables, and fish (as in Japan or the Mediterranean) lead to lower rates of chronic illness. Social cohesion and family support also correlate with longevity. What This Means for the Future

With longer lives come new challenges — and opportunities:

• Retirement Planning: In countries like the UK, many individuals will spend 20+ years in retirement. That requires robust pension systems, savings strategies, and perhaps most importantly, investment education.

  
  

• Healthcare Systems: An aging population means higher demand for long-term care, geriatric medicine, and innovations like AI in diagnostics or robotic eldercare.

  
  

• Wealth Inequality: As life expectancy becomes more tied to wealth and education, it could widen social divides unless addressed through policy.

Life expectancy is not just a health statistic — it's a mirror of national priorities. Countries like Monaco, Japan, and Singapore didn’t end up with long-lived citizens by chance. They made conscious, strategic investments in public health, education, and infrastructure — and the payoff is generational.

If the UK and other nations want to climb higher on this list, the answer lies not only in hospitals but in housing, education, job security, and early-life nutrition. And as always, individuals can make powerful choices — but systems matter just as much.

Sources:

• UN World Population Prospects (2025): https://population.un.org/wpp/

• Visual Capitalist Life Expectancy Chart: https://www.visualcapitalist.com/

• World Health Organization (WHO): https://www.who.int/

• Harvard Medical School – "Why Do Women Live Longer?": https://www.health.harvard.edu/

• ONS – UK Life Expectancy Trends: https://www.ons.gov.uk/

• OECD Health Statistics: https://www.oecd.org/health/health-data.htm

Alpesh Patel OBE

www.campaignforamillion.com 

Visit www.alpeshpatel.com/shares for more and see www.alpeshpatel.com/links