Singapore has the world’s longest, healthiest lives — but also more years in poor health

National University of Singapore, Yong Loo Lin School of Medicine

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Singaporeans have the world’s highest life expectancy and healthy life expectancy, but a growing number of years are spent in poor health, according to a new global study led by the Institute for Health Metrics and Evaluation (IHME), in collaboration with the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine). Analysing 204 countries from 1990 to 2023, the study finds that the morbidity gap, which refers to the gap between how long people live and how long they live in good health, has widened in almost all countries, including Singapore, which has the world’s longest and healthiest lives. This represents an increase of approximately 2.35 years, or 26.6%, in the morbidity gap, based on the study’s unrounded estimates, compared with a global increase of 21.9%.

 

Published in The Lancet Public Health, the findings suggest that while Singapore has made substantial progress in preventing early deaths and extending life, improvements in the number of years spent in good health have not kept pace with its gains in longevity.

 

Associate Professor Marie Ng, Director, NUS-IHME Global Burden of Disease Research Centre, NUS Medicine, and a co-author of the study, said, “Singapore’s position as a global leader in life expectancy and healthy life expectancy is a major public health achievement. However, the widening morbidity gap shows that living longer does not automatically mean that every additional year is lived in good health. The next frontier for Singapore is therefore not simply to add more years to life, but to reduce the burden of chronic illness, disability, and functional decline across the life course. This will require stronger prevention, earlier intervention, rehabilitation, and sustained support to help people remain healthy and independent as they age.”

 

A trend observed globally

Estimates indicated that the morbidity gap widened in 203 of the 204 countries and territories studied. Globally, life expectancy increased from 64.6 years in 1990 to 73.8 years in 2023. Healthy life expectancy also improved, rising from 55.9 to 63.1 years. However, as total life expectancy increased more quickly, the global morbidity gap widened from 8.8 to 10.7 years, which is an increase of 1.9 years, or 21.9%. In 2023, people worldwide spent an average of 14.5% of their lives in poor health, compared with 13.6% in 1990.

 

The results challenge the “compression of morbidity” hypothesis, which proposes that advances in prevention and healthcare would delay illness and disability, concentrating them into a shorter period near the end of life. Instead, the study found that non-fatal health loss has generally accumulated across adulthood, rather than being confined to the final years of life.

 

Women live longer but spend more years in poor health

The study also highlighted a persistent difference between women and men. In Singapore, women had an estimated life expectancy of 87.5 years in 2023, compared with 83.1 years for men. However, women spent an estimated 12.1 years in poor health, compared with 10.4 years among men. This mirrors the global “gender health paradox”, in which women generally live longer than men but experience more years with illness and disability. Globally, the morbidity gap reached 12.1 years for women and 9.3 years for men in 2023.

 

Professor Simon Hay, first author of the study and Director of Research Strategy at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, said, “Over the past three decades, the world has achieved remarkable gains in survival, but gains in healthspan have not kept pace. For most populations, the additional years of life gained are accompanied by more years lived with illness or disability. This does not diminish the importance of preventing deaths, but highlights that the definition of public health progress must broaden. Health systems should be assessed not only by how many deaths they prevent, but also by whether people are able to live longer with good health, mobility, and independence.”

 

Leading causes and risk factors

Globally, five predominantly non-fatal groups of conditions accounted for 57.4% of the morbidity gap in 2023: musculoskeletal disorders, particularly low back pain; mental disorders, including depression and anxiety; sense organ diseases such as age-related hearing loss; unintentional injuries, especially falls; and other non-communicable diseases. The leading global risk factors included high fasting plasma glucose, high body-mass index, child and maternal malnutrition, tobacco use, and air pollution. The relative importance of these risks differed according to countries’ income and socio-demographic development.

 

In Singapore, the causes contributing most to its morbidity gap were musculoskeletal disorders, mental disorders, unintentional injuries, sense organ diseases and cardiovascular diseases. The five leading risk factors were high fasting plasma glucose, high body-mass index, occupational risks, high systolic blood pressure and dietary risks.  These findings highlight the importance of preventing and managing diabetes and metabolic disease, obesity, hypertension, unhealthy diets, workplace-related health risks, mental health conditions, falls, hearing loss, and musculoskeletal problems.

 

Assoc Prof Ng added, “Singapore has an opportunity to lead not only in how long people live, but in how long they live well. The conditions contributing most to the morbidity gap are often non-fatal, but they can have a profound effect on people’s independence, ability to work, and quality of life. Tracking healthy life expectancy and the morbidity gap can help policymakers identify where additional attention and resources are needed, and whether programmes are successfully turning added years of life into added years of good health.”

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Journal

The Lancet Public Health

DOI

10.1016/S2468-2667(26)00098-8 

Article Title

Global, regional, and national trends in the morbidity gap and contributing diseases, injuries, and risk factors, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Article Publication Date

22-Jul-2026

 

Young people and aging populations shape dietary emissions

University of Groningen

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image: 

This figure breaks down changes in global dietary GHG emissions by age group during 2000–2010 and 2010–2019. The coloured bars show the contributions of six driving factors: population size, per-capita food intake, diet structure, energy density, nutritional density, and emission intensity of nutrients. The dots show the total change in emissions for each age group. Source: Li et al. (2026)

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Credit: Li et al / Nature Food

A new international study published in Nature Food reveals that age plays an important but often overlooked role in shaping global food-related greenhouse gas emissions. The study shows that dietary emissions can vary substantially across people’s life stages, reflecting differences in nutritional needs, demographic change, and evolving dietary patterns. Effective mitigation of dietary emissions therefore requires age-sensitive approaches.

The study, published by an international team of researchers led by scientists from the Energy and Sustainability Research Institute Groningen (ESRIG), University of Groningen, examined dietary emissions and nutritional quality across 149 countries, 22 age groups, and five time periods between 2000 and 2019. The research found that adolescents and young adults consistently have the highest per-capita dietary greenhouse gas emissions globally, while population aging has become an increasingly important driver of total dietary emissions.

Who contributes to dietary emissions?

'Older people are often seen as having a higher contribution to carbon emissions. We found a more nuanced pattern: the increasing contribution of seniors to dietary emissions is driven largely by population aging (a rising share of seniors in the population), rather than more carbon-intensive diets among seniors,' says Yanxian Li, an ESRIG PhD student at the time the research was conducted and now with Chongqing University. 

'Understanding who contributes to dietary emissions is essential for designing effective climate solutions. Sustainable diets, therefore, need to account for differences across life stages, nutritional requirements, and regional contexts,' emphasizes Yuli Shan, professor at the University of Birmingham and a co-author of the study.

Meat, Dairy, and Changing Diets Influence Emissions

The study found that meat and dairy products remain major sources of dietary emissions, particularly in high-income countries. In emerging economies, changing consumption patterns also played an important role. For example, increases in dietary emissions in China were largely associated with increased meat consumption, while a shift to more dairy products contributed significantly to food-related emission growth in India.

The researchers emphasize that reducing emissions must be balanced with improving nutrition. 'In many low- and middle-income countries, dietary shifts towards certain nutrient-rich foods have improved nutritional quality, but have also contributed to rising emissions. This means that simply reducing certain types of food may have unintended health effects', highlights Klaus Hubacek, professor at the University of Groningen and a co-author of the study.

Moving Beyond One-Size-Fits-All Climate Solutions

The study identifies several pathways for reducing dietary emissions, including improving food production systems, supporting sustainable dietary transitions, and tailoring interventions to local conditions. The researchers conclude that climate mitigation strategies should move beyond universal approaches and account for demographic shifts, dietary patterns, nutritional needs, and differences between countries and regions.

The authors emphasize that effective mitigation of dietary emissions requires age-sensitive approaches. 'For younger populations, this highlights the importance of education and sustainable food environments, including approaches that encourage schoolchildren to switch to healthier meals with lower carbon emissions', adds Prajal Pradhan, an associate professor at the University of Groningen and a co-author.

About the Study

The research assessed emissions from 141 food products, combining global food consumption data, dietary surveys, population statistics, and consumption-based greenhouse gas emission inventories. The study was conducted by researchers from institutions including the University of Groningen, Chongqing University, Fudan University, the University of Hong Kong, Cardiff University, the University of Birmingham, and the Potsdam Institute for Climate Impact Research.

Reference: Yanxian Li, Jin Yan, Pan He, Prajal Pradhan, Shuai Fang, Yuli Shan, Franco Ruzzenenti, Klaus Hubacek (2026): Youth lead current dietary emissions while seniors increasingly drive total emission growth. Nature Food, 22 July 2026.

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Journal

Nature Food

DOI

10.1038/s43016-026-01383-4 

Method of Research

Data/statistical analysis

Subject of Research

Not applicable

Article Title

Youth lead current dietary emissions while seniors increasingly drive total emission growth

Article Publication Date

22-Jul-2026

 

Healthy plants – healthy people: New approaches against hidden hunger

Leibniz Instiute of Plant Biochemistry

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Over 700 million people worldwide suffer from hunger. Additionally, over two billion people are affected by micronutrient deficiencies. "Hidden hunger" refers to an inadequate intake of essential vitamins and minerals. Using estimates of daily nutrient intake, the authors illustrate the epidemic scale of hidden hunger worldwide. Their global assessment reveals that more than half of the world’s population lacks an adequate supply of vitamins B2, B9, C, and E, as well as minerals such as calcium, iron, and iodine. Hidden hunger affects all nations, regardless of income level.

The Green Revolution, a period of agricultural development that peaked in the 1960s, spurred the creation of high-yielding, disease-resistant dwarf varieties of wheat, rice, and corn. These varieties doubled crop yields in Asia and saved more than one billion people worldwide from starvation. For decades, increasing yields was the sole goal of breeders and agricultural decision-makers. However, this approach resulted in bountiful harvests with declining nutritional value. The authors demonstrate that cooked rice contains the fewest micronutrients of all staple foods, including corn and wheat. Consequently, by 2050, an additional 239 million people may face a vitamin B9 (folic acid) deficiency, on top of the 2.5 billion people already affected today.

However, vitamins are essential not only for humans, but also for plants, as they play an important role in stress resistance. For instance, studies have shown that treating plants with thiamine (vitamin B1) increases their tolerance to drought. Generally, B vitamins, as well as vitamins C and E, protect plants from stress caused by drought, salt, and flooding. Therefore, focusing plant breeding efforts on the micronutrient content of crops could lead to healthier people and more resilient plants.

Comparing Current Breeding Methods
Biofortification, or the breeding of crops with enriched nutrient levels, became a focus of nutritional science in the 1990s. Since then, over 400 nutrient-enriched varieties have been developed using conventional breeding methods. These include wheat, corn, and beans with increased levels of zinc, provitamin A, or iron. However, enriching other vitamins has not yet been achieved through traditional crossbreeding. The authors conclude that, while conventional breeding is socially accepted, it faces natural limitations because it can only work with existing genetic traits and takes 8–15 years for new varieties to be introduced.

Mutational breeding accelerates the creation of new plant varieties by inducing random mutations in a plant’s genome through radiation or chemicals. This method has been used to produce iron-enriched rice and provitamin A-containing wheat. While it generates new variants quickly and inexpensively, it is highly dependent on chance because it does not allow for the targeted modification of individual genes. Market-ready varieties can be developed within 8–15 years.

The greatest successes in biofortification to date have been achieved through genetic engineering. The best-known example is Golden Rice, a transgenic variety that accumulates provitamin A in its grains, giving them their yellowish color. Golden Rice was developed to combat widespread blindness caused by vitamin A deficiency in Far Eastern countries. Due to strict approval procedures for genetically modified plants, it takes 12–16 years for new varieties to become established.

The authors state that new genomic techniques based on the CRISPR/Cas gene-editing system are the most precise and hold great potential for the future. Unlike earlier methods, CRISPR/Cas enables the targeted modification of specific genes. This emerging technology has produced a rice variety with increased zinc and iron content, among other applications. It takes approximately 2–6 years to develop new varieties. The strictness of the approval process and public acceptance of new CRISPR varieties varies by region.

In June 2026, the European Parliament adopted the amended regulation on New Genomic Techniques, paving the way for the liberalization of modern breeding methods, such as CRISPR/Cas. Under this regulation, CRISPR-edited plants, whose genetic changes could have theoretically occurred through natural mutation or conventional breeding, will be treated like conventionally bred varieties. "This is a great opportunity to accelerate the development of biofortified crops and effectively combat hidden hunger," said co-author Mustafa Bulut from the IPB.

The authors' conclusion is nuanced. None of the available technologies can solve the global micronutrient deficiency alone. To address this challenge, a combination of traditional and modern breeding methods is necessary. The authors emphasize that new varieties must first be developed in a laboratory setting. Therefore, long-term funding for this research is essential for successfully biofortifying staple foods.

Original Publication:
Van Der Straeten, D., Bulut, M., Cao, D. et al. Genetic technologies to enhance crop nutritional value under climate change. Nature 654, 877–891 (2026). https://doi.org/10.1038/s41586-026-10593-6

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Journal

Nature

DOI

10.1038/s41586-026-10593-6 

Method of Research

Systematic review

Subject of Research

People

Article Title

Genetic technologies to enhance crop nutritional value under climate change

 

Children become 'climate detectives' to help cool overheating schools 

University of Surrey

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Children with thermal cameras as part of the Heat-Cool Programme

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Credit: University of Surrey

Primary school children equipped with thermal cameras are helping redesign their schools to cope with hotter summers, thanks to a University of Surrey programme that gives pupils the tools to spot dangerous heat hotspots and develop their own cooling solutions. 

With heatwaves becoming more frequent across the UK, reaching highs of 36°C in parts of London, the 'Heat-Cool' programme designed by Professor Prashant Kumar has shown that children as young as nine can use thermal imaging technology to investigate how heat builds up around their schools, using evidence they gathered themselves to design greener, cooler spaces. 

In a study published in Environmental Research Communications, researchers led by Surrey’s Global Centre for Clean Air Research (GCARE) rolled the programme out to more than 500 children at seven schools across the South East. During two-hour workshops, pupils measured differences in surface temperatures across school grounds using handheld thermal cameras. They then worked out which nature-based solutions would work best for specific areas, such as green roofs, ponds, rain gardens and shaded outdoor spaces to reduce overheating. 

After taking part in the programme, more than eight in ten pupils either maintained or improved their understanding of climate change, while students overwhelmingly rated the experience as enjoyable and engaging.  

Professor Prashant Kumar, Founding Director of GCARE and corresponding author of the study, said: 

"As the UK experiences hotter summers, we need to think differently about how we prepare schools for a changing climate. Children are among those most affected by extreme heat, yet they're rarely involved in designing solutions. 

"Our Heat-Cool programme turns pupils into climate detectives. Give them thermal cameras and the right knowledge, and they can quickly see which parts of their school are heating up and which natural features help keep spaces cool. They then use that evidence to develop practical ideas for making their schools more resilient." 

The research team analysed more than 1,700 thermal images captured by pupils, covering over 4,300 objects around school grounds. The findings consistently showed that natural, water-based and engineered green infrastructure was typically between one and three degrees cooler than surrounding areas without it, although students favoured infrastructure-integrated solutions such as green roofs.  

Dr Jeetendra Sahani, Research Fellow at GCARE, said: 

"It was a proud moment watching children discover that some of the coolest places around their school were also the greenest. They weren't just learning about climate change in a classroom – they were gathering real evidence, interpreting it and using it to design practical solutions for their own environment. I think this is such a special way to help young people understand both the challenges we face and the role they can play in tackling them.” 

Combining classroom learning with citizen science and technology, the programme encourages pupils to investigate their own school environment and develop effective solutions to help make buildings and playgrounds more bearable in the warming climate. 

Researchers believe the approach could be adopted more widely to help schools prepare for rising temperatures while improving climate literacy and encouraging young people to play an active role in shaping more resilient communities. 

This work, part of the Heat-Cool programme, was supported by the NERC-FAPESP GreenCities project and builds on Professor Kumar’s GCARE team’s extensive research through UKRI-funded initiatives, including RECLAIM Network Plus, GREENIN Micro Network Plus, and GP4Streets. 

Reference 

Sahani, J., Ayvaz, C., & Kumar, P. (2026). Building climate resilience of schools through thermal-imaging and GBGI consultation: Advancing climate literacy via the ‘Heat-Cool’programme. Environmental Research Communications 8, 065065. Online link: https://doi.org/10.1088/2515-7620/ae7d9c 

[ENDS] 

Notes to editors 

• The full paper can be found here: https://doi.org/10.1088/2515-7620/ae7d9c 

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Journal

Environmental Research Communications

DOI

10.1088/2515-7620/ae7d9c 

Article Title

Building climate resilience of schools through thermal imaging and GBGI consultation: advancing climate literacy via the ‘Heat-Cool’ programme

 

Local policies drive global emissions: The unintended carbon cost of "livestock-free zones"

New research finds local environmental regulations in China paradoxically amplify carbon emissions through regional displacement

Peer-Reviewed Publication

Biochar Editorial Office, Shenyang Agricultural University

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Spatial transfer and policy leakage of livestock carbon emissions driven by local livestock-free zone policies

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Credit: Zhiyi Ye, Xunan Yang & Yadong Cao

As nations worldwide confront the urgent challenge of climate change, China's "Dual Carbon" goals prioritize significant decarbonization across all economic sectors. While industrial and energy sectors often receive primary attention, the agricultural sector, particularly livestock farming, represents a substantial source of potent greenhouse gases like methane (CH₄) and nitrous oxide (N₂O). Local governments in China have implemented stringent environmental regulations, such as "Livestock-Free Zones," to curb agricultural pollution. However, the overall effectiveness of these spatially targeted policies, especially regarding their potential to displace environmental burdens, remains a subject of considerable debate.

A recent study investigated the impacts of the "Livestock-Free Zone" policy in Guangdong Province, China's largest provincial economy. Researchers utilized county-level panel data from 2014 to 2023, employing a sophisticated combination of spatial Durbin models, continuous difference-in-differences models, and network analysis. This approach allowed for a precise quantification of the policy's local effects and any subsequent spatial spillover, addressing gaps in understanding policy-induced pollution transfers within land-intensive agricultural sectors and at subnational scales.

Local Success, Regional Burden: The Carbon Leakage Paradox

The analysis revealed a striking paradox: while the "Livestock-Free Zone" policy successfully reduced local carbon emissions in regulated areas, this achievement was overshadowed by a significantly larger "policy leakage" effect. The study found that for every unit of carbon reduced locally, approximately 3.14 units of carbon emissions were displaced to neighboring regions. This spatial transfer indicates that the environmental burden was not eliminated but rather shifted, potentially undermining overall regional mitigation efforts and confirming the Pollution Haven Hypothesis within the agricultural sector at a subnational scale.

Further investigation into the emission transfer patterns demonstrated a clear hierarchical structure. Core cities within the highly developed Pearl River Delta region, with their stringent environmental regulations, emerged as primary sources of emission spillovers. Less developed northern and western Guangdong regions became major absorption zones. While western Guangdong, with its established large-scale farming, maintained high total emissions yet low carbon-emission intensity, northern Guangdong faced an "efficiency dilemma." This region absorbed production capacity without sufficient technological upgrades, leading to amplified environmental risks and a development trap where capacity absorption resulted in deteriorating low-carbon efficiency.

Beyond Borders: Advocating for Coordinated Governance

The findings underscore the limitations of fragmented environmental policies that do not account for broader spatial scales and feedback mechanisms. Such localized regulations, when lacking regional coordination, disproportionately shift costs to peripheral regions with weaker environmental governance and technological foundations. The study advocates for a policy shift from a simple "spatial squeeze" approach to a regionally coordinated development strategy centered on "efficiency improvement." This requires establishing top-level coordination mechanisms, implementing measures like ecological compensation, encouraging joint technology investment, and developing shared industrial parks to guide synchronized capital and advanced technology flows into spillover regions.

The research provides critical micro-level evidence for policymakers to refine environmental governance. Despite its robust findings, the study acknowledges limitations, including potential measurement error in policy intensity derived from image recognition, the use of IPCC Tier 1 emission factors that might not capture specific technological upgrades, and the representation of statistical correlations rather than direct physical livestock flows in the spatial network. Future research could track individual farm migration decisions and assess the co-transfer effects of multiple pollutants for more comprehensive regional sustainability pathways.

Suggested author quote for approval:

"Our findings demonstrate that fragmented local environmental regulations, while achieving immediate local benefits, can inadvertently create a 'carbon leakage' effect that moves the problem rather than solving it," states Xunan Yang, a corresponding author on the study. "To genuinely advance sustainable development, future environmental policies must embrace a regional, coordinated approach that pairs industrial relocation with synchronized technological transfers, transforming environmental challenges into opportunities for green upgrading across all regions."

Corresponding Author: Xunan Yang

Original Source: https://doi.org/10.1007/s44246-026-00283-3

Contributions: All authors contributed to the study conception and design. Conceptualization, funding acquisition, and project administration were led by Xunan Yang. Methodology design, investigation, and visualization were conducted by Zhiyi Ye and Xunan Yang. Data curation and formal analysis were performed by Zhiyi Ye, Xunan Yang, Yadong Cao, and Qihua Liang. The first draft of the manuscript was written by Zhiyi Ye and Xunan Yang. Xunan Yang, Ai-Jun Ma, and Meiying Xu critically reviewed and edited the manuscript. All authors read and approved the final manuscript.

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Journal

Carbon Research

DOI

10.1007/s44246-026-00283-3 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Spatial transfer and policy leakage of livestock carbon emissions driven by local livestock-free zone policies

Article Publication Date

22-Jul-2026

 

Drinking water contaminant exposures and risk of uterine cancer

JAMA Network Open

About The Study: 

In this cohort study of female California educators, associations between drinking water trihalomethanes and uterine cancer overall and with endometrioid tumors specifically were consistent with findings from the only prior study, conducted in the midwestern U.S. Further investigation of drinking water contaminants as modifiable risk factors for this common gynecologic cancer is warranted.

Corresponding Author: To contact the corresponding author, Rena R. Jones, PhD, MS, email rena.jones@nih.gov.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2026.24391)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

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Journal

JAMA Network Open