Wealthier, wiser, so why not healthier?

Our lives are longer though affluence has not helped cut sickness

The number of people living to the age of 100 is set to increase tenfold by 2031 with estimated figures putting the number of centenarians at 45,000.

While the trend suggests greater life expectancy, we are living longer in sickness, not in health, according to a report from the Office For National Statistics, which surveyed adult health from 1841-1994.

Life expectancy has almost doubled in 150 years, but healthy life expectancy has failed to rise significantly.

Medicine has contributed little to this improvement compared to changes in diet, housing and sanitation. Medical advances are estimated to have added five of the extra 30 years by which life expectancy has improved this century.

A large part of the improvement is due to better maternity care and reduced infant mortality. A child born in 1841 could expect to live to 41 if it were a boy and 43 if it were a girl. Its equivalent in 1991 could expect to live to 73 if male or 79 if female.

Between 1951 and 1991 the number of centenarians grew from 300 to 4,400, a rate of increase of 7 per cent a year, roughly doubling every 10 years.

At the same time, it is thought that maximum recorded ages for men and women in England and Wales [at present 115] will rise to at least 118 or 119 or even more.

In France, where life expectancy is higher, Jeanne Calment celebrated her 122nd birthday earlier this year.

Marriage is the best guarantee of good health, the study shows. Mike Murphy, of Oxford University and co-editor of the study, said: "It is almost an ironclad law the world around that married people do better. It has been true since statistics became available in the 1850s."

Contacts with relatives, neighbours, church, and through work appear to be important for good health. Death rates are higher for single, widowed and divorced people but marriage appears to protect men more than women.

Over the last century, the decline in deaths from tuberculosis and other infectious diseases has been the most important cause of improving life expectancy. In Victorian times, infections accounted for one in three deaths, compared with one in 200 today. Cancer deaths have risen from fewer than one in 10 in 1911 to more than one in four in 1991.

In the last 25 years, mortality has improved, but there has been no comparable increase in the number of years of healthy life. At 65, a man can look forward to seven years of healthy life, which has remained unchanged since the mid-1970s, despite an increase of almost three years in life expectancy over the period. "The extra years of life gained may be extra years of life with a disability," says the report.

In 1988, an ONS survey found 61 per cent of men over 75 and 71 per cent of women had a long-standing illness, disability or infirmity.

Recent studies found the population is becoming more overweight. Smoking has fallen since the 1970s, but there has been little change among women aged 16-24 in the last 10 years. Alcohol consumption has been stable amongst men, but is rising amongst women.