By Prof. Raphael Nyarkotey OBU & Grace ANKUAH
The environment plays an important role in improving the quality of life of people. Hence, the issue of illegal mining or galamsey should concern every Ghanaian. We intend to map the life expectancy between Ghana and other countries based on 2023 and 2024 Global life expectancy rankings by two organisations.
In carrying out this study, we used secondary data to scope life expectancy estimates in 2023 and 2024 from Worldometer and the Central Intelligence Agency (CIA) and analysed them thematically. We further conducted literature review using Google search engines such as PubMed, Google Scholar, Webs of Science, Research Gate and other websites with keywords such as’ life expectancy’ and ‘longevity.’
We found from the two reports that African countries have the lowest life expectancy in the world. In the global space, Hong Kong, Macao and Japan, which featured in the top five countries in the 2023 and 2024 reports, have the highest life expectancy and have been consistent.
We also found that Algeria had the highest life expectancy at birth in Africa in both reports in 2023 and 2024, leading the African Continent. Ghana, on the other hand, was not featured in the top ten African countries in both reports. However, when we analysed the top five West African countries with the highest life expectancy, Ghana was featured in both reports.
We found that despite government expenditure in the health sector, it is not enough to increase the life expectancy of the people. The icing on the cake is that the major contributing factor to increasing the life expectancy of people is their eating habits, environment and lifestyles.
This can be inferred from the literature on why Japanese, Hong Kong and Macao people live longer.
The public health implications are that policies to improve the life expectancy of the Ghanaian people should advocate for the protection of the environment and reliance on traditional Ghanaian diets and herbal teas.
The keywords here are Ghana, life expectancy, Hong Kong, Macao, Japan
The empirical starting point for this commentary is the declining gap in the life expectancy of Ghanaians as compared to other countries in the world (WHO, 2024). What could account for this decline gap in the life expectancy of Ghanaians? Life Expectancy has been defined as the mean number of years of life that one has to live in a particular jurisdiction right from birth (The Centers for Disease Control and Prevention, 2023).
The average life expectancy of the Ghanaian has been pecked at 66.1 years, taking into account dates from 2000-2021(WHO, 2024). This notwithstanding, the oldest person in the world has been found to live up to over 122 years.
Hence, the maximum number of years for humans to live is 120 years (Dong X et al. 2016). Science, however, cannot hold the credit for this proposition as it was found in the Old Testament Bible: “My spirit will not contend in man forever, for he is mortal; his days will be a hundred and twenty years” (Genesis 6:3).
On the other hand, longevity has also been defined as the ability of a person to live a long life that is beyond the average age (De Benedictis & Franceschi, 2006) under some favourable conditions. Notwithstanding, Kaeberlein 2018 also highlights that one’s health span can be comparable to lifespan, as one can be ill but can live for many years.
In the case of Ghana, a recent statistical report released by the Births and Deaths Registry paints a gloomy picture as it revealed that 18,689 deaths, accounting for 36.7 percent of registered deaths (50,992), were attributed to the top 11 causes of mortality in the country (Graphic, 2024) in 2022.
The report further revealed that hypertension claims the lives of 2,573 people. This was accompanied by pneumonia (2,457), heart failure (2,225), acute respiratory failure (2,203), stroke (1,679), diabetes (1,578), severe sepsis (1,558), septic shock (1,401), chronic liver disease (1,103), cancer (1,036), and cerebrovascular diseases (876).
Another aspect of the report revealed that men died from all the diseases the most as compared to cancer dominated by women. The Daily Graphic reports further explained that the elderly in Ghana were more susceptible to these conditions: Pneumonia, severe sepsis, cerebrovascular diseases, heart failure and cancer with percentages ranging from 49 percent to 59 percent.
Fig 1 Top diseases that claimed the lives of Ghanaians in 2022. Source: Daily Graphic(2024)
The report called for urgent interventions to improve the quality of life (QOL) of the Ghanaian people to reduce the mortality rates, especially in the adult population.
The Komfo Ankoye Teaching Hospital also bemoaned the increasing cases of strokes to 500 percent annually at their facility (Myjoyonline, 2024; Myjoyonline 2021), mostly the youth being affected; and the Bono Region also recorded 800 stroke cases in nine months.
Another report also found that about 60 percent of Gamashi residents have hypertension and diabetes (Daily Graphic, 2024). This means six out of 10 residents in that area had either hypertension or diabetes. It also extends to obesity. Could these developments affect the life expectancy of the Ghanaian people?
We herein provide our commentary by analysing the life expectancy of the Ghanaian people by comparing them to other countries. We finally recommend public health strategies to address this development to fill the gap.
Objectives of the study
The objectives of this study are as follows:
- To examine the general overview of the life expectancy in the world based on two documents from 2023 to 2024.
- To examine how Ghana fared in life expectancy rate as compared to other countries
- To examine what factors account for the longevity of these countries with the highest life expectancy
- Finally, to recommend strategies for public health interventions to improve the longevity of the Ghanaian people to better enhance life expectancy on the global ranking.
Literature review
Achieving life expectancy in a particular jurisdiction goes beyond government investment in health infrastructure. One review by De Benedictis & Franceschi, 2006 found that genes have a role to play in longevity and an individual genetic predisposition is central to how we age and an individual’s life expectancy.
This was further explained by a recent review study by Melzer et al. 2020 that explored how identical twins’ genes can be influenced by 10-15 percent. Thus, one’s lifestyle and externalities are more significant in the process of ageing than genes. Despite 10-15 percent attributed to genes, in some model organisms, genes have been found to play a direct role in life expectancy (Max Planck Institute, 2024).
For instance, in some animal studies (Piper & Partridge 2018, Tissenbaum 2015) using the worm Caenorhabditis elegans and the fruit fly Drosophila melanogaster, the inactivation of certain genes extended the life expectancy.
Another factor that influences life expectancy is economic growth. Economic growth and life expectancy could be positive or negative depending on the jurisdiction in the individual lives ( Vu TV et al. 2023; Miladinov, G, 2020).
Another variable that affects life expectancy is the environment. The empirical study identified specific environmental factors such as atmospheric pressure, pollution, obesity, temperature, physical inactivity, smoking, drinking water, duration of sunshine and relative moisture, which affect the physical condition and immunologic state of humans; and this contributes to the life span ( Abo et al. 1997).
This means the issue of illegal mining in communities in Ghana could affect life expectancy in such areas (Abot et al. 1997; Annan et al. 2024).
Lifestyle and diets have also been researched and found to improve longevity. For instance, one empirical study found diet to increase lifespan by ten (10) years (Fadnes et al. 2023). Finally, the issue of government investment in healthcare and public health interventions has all been attributed to improving life expectancy (Onofrei M et al. 2023).
Theoretical framework
Tetz’s theory of longevity
A theoretical framework is a foundational review of existing theories that guide the pathway for the research to enhance the arguments (Luft et al. 2022). Hence, in this study that focuses on life expectancy, we have adopted Tetz’s theory of longevity and how it can contribute to longevity in the Ghanaian population.
Tetz’s theory of longevity is based on the assumption that the host organism is immortal when there is ideal cooperation with microbiota, and environmental factors and intrinsic alterations are absent ( Tetz G. and Tetz V. 2018).
Based on this theory, Tetz’s law was also promulgated to state that “longevity is limited by the accumulation of alterations in the Individual Pangenome to the limiting value that is not compatible with life”.
Thus, Tetz’s theory has a whole body of ideas and a mathematical model that can predict, estimate and enhance longevity by taking into context the host organism’s genetic subpopulations: host eukaryotic cells (including all materials in all ‘fluids’), representatives of commensal microbiota, and their NLGEs.
Thus, alternations in the DNA of the host organism are paramount to improve one’s quality of life(QOL). In a nutshell, one’s genes’ health is paramount to improving longevity.
Conceptual framework
The conceptual framework tells us about the relationships or variables of the research and how they relate to or influence it. It can be explained in a visual format, mathematical or narrative format. Based on our literature review, we present the conceptual framework that could affect life expectancy in a population or a jurisdiction.
Methodology
This commentary employed a documentary review approach to gather data. The study used secondary documentary data from 2023 and 2024 to map the current life expectancy. The 2023 and 2024 data were generated by Worldometer and the Central Intelligence Agency(CIA) and were analysed thematically. This period provides clear-cut selection criteria as far as literature is concerned for the present study. Hence, we did not include literature mapped outside this time-frame.
We also used African countries that have life expectancy in the fifties (50) years column to explain countries with the lowest life expectancy in the 2023 and 2024 reports.
We further conducted literature using Google search engines such as PubMed, Google Scholar, Research Gate and other websites with keywords such as’ life expectancy’ and ‘longevity’ to gather data to explain why the top three (3) countries such as Hong Kong, Macao, and Japan that featured in the top five(5) countries in the 2023 and 2024 reports have the highest life expectancy.
Results
What We Found
To examine the general overview of the life expectancy in the world
The first objective of this commentary examines the general overview of the life expectancy in the world based on two documents from 2023 to 2024.
We herein provide the following analysis:
Fig 3. Authors Construct
According to Worldometer (2023), Algeria had the highest life expectancy in Africa with 77.34 years, followed by Tunisia with 76.94 years, then Cape Verde with a life expectancy of 76.93 years. Mauritius had a life expectancy of 75.59 years followed by Morocco with 75.2 years, then Seychelles having a life expectancy of 75 years. Libya represented a life expectancy of 73.25 years, followed by Egypt with a life expectancy of 70.81 years, then Senegal with 69.31 years and finally Tanzania with 67.6 years life expectancy.
Fig 4. Authors Construct
According to the Central Intelligence Agency (CIA) 2024 report, Algeria had the highest life expectancy in Africa with 78 years, followed by Libya with 77.7 years, then Tunisia with a life expectancy of 77.3 years. Seychelles had a life expectancy of 76.6 years followed by Mauritius with 75.4 years, then Egypt having a life expectancy of 75 years. Cape Verde represented a life expectancy of 74.3 years followed by Morocco with a life expectancy of 74.2 years, then Malawi with 73 years and finally, DR Congo with 72.9 years life expectancy.
Fig 5 Authors Construct
Cape Verde, with 76.93 years, ranked first West African country with the highest life expectancy according to Worldometer (2023). Senegal, with 69.31 years, ranked the second West African country with the highest life expectancy, followed by Ghana with 64.53 years, Gambia with 64.12 years and finally, Niger representing 62.93 years of life expectancy.
Fig 6. Authors Construct
The Central Intelligence Agency (CIA) 2024 report ranked Cape Verde as the highest with 74.3 years, followed by Togo with 72.1 years, Senegal with 70.6 years, then Ghana with 70.1 years and finally Gambia with 68.4 years.
Fig 7. Authors Construct
According to Worldometer (2023) report, Guinea had the lowest life expectancy in Africa with 59.55 years, followed by Namibia with 59.53 years, then Eswatini with a life expectancy of 57.71 years. Somalia had a life expectancy of 57.35 years followed by South Sudan with 56.51 years; then Central African Republic, having a life expectancy of 55.48 years. Lesotho represented a life expectancy of 54.91 years, followed by Nigeria with a life expectancy of 53.87 years, then finally Chad represented 53.68 years with the least life expectancy.
Fig 8. Authors Construct
The Central Intelligence Agency (CIA) 2024 report ranked Sierra Leone as the lowest with 59.4 years, followed by Mozambique at 58.3 years, Somalia at 56.5 years, and finally the Central African Republic at 56.4 years representing the least life expectancy.
Fig 9. Authors Construct
According to the Central Intelligence Agency (CIA) 2024 report, Monaco had the highest life expectancy in the world with 89.8 years, followed by Singapore with 86.7 years, then Macao with a life expectancy of 85.3 years. Japan had a life expectancy of 85.2 years followed by Canada with 84.2 years, then San Marino having a life expectancy of 84.2 years. Hong Kong represented a life expectancy of 84 years followed by Iceland with a life expectancy of 84 years then Switzerland with 83.9 years and finally, Andorra with 83.8 years life expectancy.
Fig 10 Authors Construct
According to Worldometer (2023) report, Hong Kong had the highest life expectancy in the world with 85.83 years, followed by Macao with 85.51 years, then Japan with a life expectancy of 84.95 years. Switzerland had a life expectancy of 84.38 years followed by Singapore with 84.27 years, then Italy having a life expectancy of 84.2 years. South Korea represented a life expectancy of 84.14 years followed by Spain with a life expectancy of 84.05 years then Malta with 83.85 years and finally, Australia with 83.73 years life expectancy.
The second objective was to examine how Ghana fared in life expectancy rate as compared to other countries.
Life expectancy at birth is the average lifespan a newborn can be expected to live, assuming that age-specific mortality levels remain constant.
Worldometer Report(2023)
Worldometer(2023) reports used 201 countries to examine their life expectancy ranking. In this report, Hong Kong has the world’s highest life expectancy rate at 85. 83 years for both sexes. This was followed by Macao (85.51 years) and Japan (84.95 years), respectively.
The surprising thing was that in the G7 countries – consisting of Canada, France, Germany, Italy, Japan, the United Kingdom and the United States – only Japan was found in the first five countries with the highest life expectancy.
No African country falls in the world’s fiftys (50) ranking of life expectancy. Algeria was ranked 69th with a life expectancy of 77.34 years for both sexes. This was followed by Tunisia at the 73rd position with 76.94 years for both sexes.
The only West African country that performed better is Cape Verb at 74th position with 76.93 years, followed by Senegal at 145th position with a life expectancy of 69. 31 years for both sexes. Ghana was ranked at 166th position with a life expectancy of 64.53 years for both sexes.
The Gambia was ranked 169th with a life expectancy of 64.12 years for both sexes. The shocking thing was that Nigeria was ranked at 200th position with a life expectancy of 53.87 years for both sexes and Chad was the last at 201st with a life expectancy of 53.68 years for both sexes.
The Central Intelligence Agency (CIA) 2024 Report
In the case of the CIA report, Monaco was ranked the No.1 in the world with the highest life expectancy of 89.8 for both sexes. However, Monaco was absent in the Worldometer of 2023 in the top five countries with the highest life expectancy.
This was followed by Singapore with 86.7 years. Singapore, on the other hand, was found in the top five countries with the highest life expectancy in the Worldometer 2023 report at no. 5 with 84.27 years. Macao, in the CIA report, was found at No. 3 with 85.3 years for both sexes, and Japan at No. 4 with 85.2 years for both sexes. However, in the Worldometer report (2023) Macao was at No. 2 with a life expectancy of 85.51 years and Japan was found at No. 3 with a life expectancy of 84.95 years.
In Africa, the CIA reported that Algeria was ranked at No. 85 in the world with a life expectancy of 77.9 years, followed by Lybia at 87th position with a life expectancy of 77. 7 years for both sexes. Togo was ranked at No. 165th position with a life expectancy of 72.1 years. Senegal was ranked at No. 172 with a life expectancy of 70.6 years.
Ghana was ranked at No. 180th with a life expectancy of 70.1 years for both sexes, the Gambia at 189th with a life expectancy of 68.4 years and finally, Nigeria was ranked at No. 216 with a life expectancy of 62.2 years.
Ghana’s position was only cemented when we performed a West African regional analysis and was found in the top four (4) countries with the highest life expectancy. We were struck to see Togo beating Ghana on the CIA report with global rank at 165th position with a life expectancy of 72.1 years as against Ghana’s position at 189th with a life expectancy of 68.4 years.
The third objective of this commentary paper was to examine what factors account for the longevity of these countries with the highest life expectancy. This commentary found that Hong Kong, Macao and Japan are countries in the Asian region. They have been consistent on the global ranking of highest life expectancy countries in the top three (3) for both the 2023 and 2024 reports. We herein explore why these countries have the highest life expectancy in this objective.
Macao
In the case of Macao, it has been explained that they have stable lives and security (Macao News, 2021). Aged people do not have to worry about financial issues during their pension as they get financial support from the government. They also have effective public health intervention programmes. Natural disasters are rare as compared to other countries (Macao News, 2021). There are options in their healthcare system. Their lifestyle and diets are similar to those in the Japanese territory (Macao News, 2021).
Hong Kong
In the case of Hong Kong, reports presented indicate that it is one of the best environments in the world and this makes people live longer (Alea. Care, 2024). The indicators of the environment are accessible public transportation, social support and outreach with regards to health, activities and programmes to promote health and well-being, and security and independence such as appropriate employment opportunities and accessible and affordable housing.
Another indicator is their diet. Though experts claim Hong Kong is dirty, their reliance on diet plans such as the ‘Mediterranean diet’ has helped them to live longer. They eat fish, fruits, vegetables, rice, nut oils and a combination of meat and vegetables. (Alea. Care, 2024).
Hong Kong has good sanitation standards and clean water, which are also urban factors that promote long life.
The medical system in Hong Kong is affordable and also available in the private sector. Treatment for cancers is available in different forms. There is also care for the elderly to improve their mental health ( Alea. Care, 2024). There is easy access to greener city. The aged have families and live together. Hong Kong’s infant mortality rate is among the lowest in the world and the quality of the healthcare system has to be praised.
Fig 11 The environment plays a key role in life expectancy – Hong Kong Park is located in the central region of Hong Kong. Meera Senthilingam/CNN
Japan
In the case of Japan, studies have explained that though genes could be a factor, their reliance on a healthy diet is a major contributing factor. Furthermore, Japan has been able to lower disease rates. Heart diseases and other chronic illnesses have been decreasing drastically.
Japan has a low obesity rate, they consume low red meat. However, they consume fatty acids, specifically n-3 polyunsaturated fatty acids, as well as fish, plant foods such as soybeans, and non-sugar-sweetened beverages such as green tea ( Tsugane, S. 2021). This author has this to say:
“The decreasing mortality rates from cerebrovascular disease are thought to reflect the increases in animal foods, milk and dairy products, and consequently in saturated fatty acids and calcium, together with a decrease in salt intake which may have led to a decrease in blood pressure. This decrease in salt and highly salted foods also seems to account for the decrease in stomach cancer. The typical Japanese diet as characterised by plant food and fish, as well as modest Westernised diets such as meat, milk, and dairy products, might be associated with longevity in Japan.”
Recommendations and conclusion
Finally, the fourth objective was to recommend strategies for public health interventions to improve the longevity of the Ghanaian people to better enhance life expectancy on the global ranking.
From the literature and analysis on the higher life expectancy of the people of Macao, Hong Kong and Japan, we recommend that the government should take steps to address the rising cost of living in Ghana. This was evident as part of measures in the countries with the highest life expectancy.
The government should also take steps to provide a safe environment, access to transportation, and affordable healthcare in both private and public institutions. The government should also take steps to address the pollution in the country.
Government projects on tree-planting should be encouraged to provide a greener environment. Public health interventions should be encouraged. Access to preventive medicine programmes should be implemented to help improve the life expectancy of the people of Ghana.
Also, we know that Japanese people’s longevity is not cemented in their genes but in their lifestyle and diets. The public should be encouraged to consume lots of fresh vegetables, seasonal fruits and unprocessed foods.
The government should support farmers to grow more organic foods. Commercial farmers should be encouraged with subsidies to enable them to practise good farming methods; food is medicine.
We also found that when one explores further on Monaco and Singapore, there is one important variable that extends their lifespan and that has to do with eating a Mediterranean diet. They also spend plenty of time relaxing outdoors. Monaco is also a very family-centric and religious country, offering many positive, stress-free moments. The standard of living and the healthcare system is excellent in the Principality of Monaco.
In the case of Singapore, experts say the government’s policies and thoughtfully designed ‘ecosystem’ are responsible for the country’s higher life expectancy. Another explanation has to do with better chronic disease management. The policy of living together also accounts for their highest life expectancy. Another interesting thing has to do with their strict laws such as the ban on chewing gum and hefty fines on eating in public transportation.
All these countries with higher life expectancies have been designated as ‘blue zone’. Blue zones are places that have 10 times more centenarians compared to the U.S. on a per capita basis and most of these countries are in the Asian region apart from Monaco in Europe.
Another thing we found was that most countries around the Mediterranean region perform better on the life expectancy and they eat the Mediterranean diet. The countries surrounding the Mediterranean and its marginal seas in clockwise order are Spain, France, Monaco, Italy, Slovenia, Croatia, Bosnia and Herzegovina, Montenegro, Albania, Greece, Turkey, Syria, Lebanon, Israel, Palestine, Egypt, Libya, Tunisia, Algeria, Morocco, Malta and Cyprus.
It is not surprising that in Africa, North African countries have performed better in the life expectancy ranking. We believe it is due to their existence in the Mediterranean zone.
Also, the case of Algeria being an African country with the highest life expectancy has been attributed to the government’s heavy investment in healthcare, expanding the network of hospitals and clinics, giving resources to training and equipping a medical staff. As a result, the quality of care improved dramatically, and access to medical care became widely available.
Among other results, the national healthcare system helped reduce the infant mortality rate from over 10 percent at the time of independence to 2 percent by 2022, significantly impacting life expectancy ( Afrodemption, nd).
We also believe that the Gambia and Senegal life expectancy could be due to their regular consumption of attaya made from Chinese green tea.
In conclusion, the people of Macao, Hong Kong and Japan offer a framework that could be replicated through deliberate policies in developing and developed populations globally. Ghanaians should be encouraged to drink more hibiscus sabdariffa tea (sobolo) as studies proved hibiscus to be superior to green tea in enhancing longevity (Carlsen et al. 2010). This study compared the antioxidant content of 280 common beverages, but hibiscus tea ranked number one – even beating out the oft-lauded green tea.
Availability of data and materials
The datasets generated and/or analysed during the current study are available at https://www.worldometers.info/demographics/life-expectancy/ and https://www.cia.gov/the-world-factbook/field/life-expectancy-at-birth/country-comparison/
>>>Prof. Raphael Nyarkotey Obu is a Professor of Naturopathy and is currently in another MPhil/PhD program in Law & Development Studies at The Institute of Development and Technology Management (IDTM), Cape Coast. Whereas Grace Ankoah Ankuah is an MPhil Development Student at the same institution.
Email: [email protected] Tel: 0541090045
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