I'm one of life's optimists. When I think about living to be 100 years old, I picture a birthday party where I am surrounded by my devoted descendants, perhaps followed by a commercial space flight as a celebratory treat. But I'm in the minority here. A lot of people would rather be dead. In a recent UK poll by Ipsos, only 35 per cent of people said they wanted to become centenarians.
我是對生活抱著樂觀主義看法的人之一。每當我設想自己活到一百歲的光景，我就想像會有一場生日宴會，孝順的子孫們圍在我身邊為我慶祝，沒準還能來一場商業太空飛行。但在英國我屬於少數派。很多人寧可死。益普索(Ipsos)最近在英國做了一個調查，只有35%的人表示希望活到一百歲。
Men were keener on the idea than women (43 per cent to 28 per cent) — a shame really, since women are more likely than men to achieve it. Age is a factor too: older people are less likely to want to live to 100 than younger ones, perhaps because they have already had a taste of poor health, or have gone through the experience of caring for elderly parents who suffered in their later years. In the poll, fewer than one in five people thought they would have a good quality of life if they reached 100.
男性的這種願望比女性強烈（43%對28%）——這委實令人唏噓，因為女性比男性更有可能活到一百歲。年齡也是一個因素：和年輕人相比，年紀比較大的人更加不會期待自己能活到一百歲，這可能是因為他們已經吃到了身體不好的苦頭，或者是他們曾經照顧過年邁體弱的父母。在這項調查中，認為自己活到一百歲也能活得好好的人不到五分之一。
We all know that life expectancy has risen globally over the last century thanks to advances in healthcare and medicine as well as improvements in education and living standards. In the UK in 2020, the number of centenarians reached more than 15,000, up almost a fifth on the year before. But — as is clear by how many don't want to live to be 100 — 「healthy life expectancy」 is probably a better measure of what people actually want.
我們都知道，在上個世紀裡，全球範圍內的「預期壽命」(life expectancy)都有所上升，這得益於醫療醫藥領域的進步以及教育和生活水平的提高。2020年，英國百歲老人的數量超過1.5萬人，比上一年增加近五分之一。然而，正如很多人並不想活到一百歲這一點所昭示的，「健康預期壽命」(healthy life expectancy)或許更能反映人們實際上想要什麼。
Healthy life expectancy — a measure of the number of years someone is expected to live in good health — is not a perfect metric, since it's based on health and mortality rates now rather than projections of how they might change. But it's still useful. What can it tell us?
健康預期壽命是指人們能健康地活著的預期歲數。它不是一個完美的指標，因為它依據的是人們當前的健康狀況和死亡率，而不是對這些數據可能會發生什麼變化的預測。但它仍然有用。它能告訴我們什麼呢？
First, while it has been rising globally, it has not kept pace with improvements in overall life expectancy, according to a study of 195 countries between 1995 to 2017.
首先，根據從1995年到2017年期間對195個國家所做的一項研究，雖然全球範圍內健康預期壽命呈上升趨勢，但它沒有與總體預期壽命的提高保持同步。
Second, women might outlive men, but the number of years they can expect to live in good health is very similar. In the EU, for example, life expectancy for women in 2020 was 5.7 years longer on average than for men, but the healthy life expectancy gap was only one year.
第二，女性或許比男性活得久，但二者的健康預期壽命非常接近。比如在歐盟，2020年女性平均預期壽命比男性多5.7年，但健康預期壽命只多了一年。
Third, as with overall longevity, the correlation between healthy life expectancy and gross domestic product per head becomes pretty loose once countries have passed a certain level of development. Greece and Germany have very similar healthy life expectancy numbers, for example, even though Germany is significantly richer.
第三，與預期壽命一樣，當一個國家達到了一定程度的發展水平之後，健康預期壽命與人均國內生產總值(GDP)之間的關聯就不太強了。例如，德國的富裕程度遠高於希臘，但兩國的健康預期壽命十分接近。
There are some stark differences between neighbours, too. In 2020, a man born in Finland or Denmark could expect to live between 73 and 74 per cent of their lives free from health limitations, a raw deal compared with the 90 per cent on offer in Sweden. Cultural factors play a role, from the Mediterranean diet in Greece to alcohol use in Finland.
相鄰國家之間也可能存在明顯的差異。在2020年，出生於芬蘭或丹麥的男性一生中預計有73%至74%的歲月不會受限於健康問題，相比之下，瑞典這個比例為90%。這裡面有文化因素的作用，從希臘的地中海飲食習慣到荷蘭的飲酒風氣，不一而足。
In the UK, which ranked in the middle of the EU countries before Brexit, things aren't looking good. In the years before the pandemic, healthy life expectancy had stagnated for men at 62.9 years and had begun to fall slightly for women to 63.3 years.
英國現在的情況看起來不太好。在脫歐以前，英國的健康預期壽命在歐盟國家中排在中間位置。在暴發新冠疫情以前的數年裡，英國男性的健康預期壽命一直停滯在62.9歲，女性的健康預期壽命則開始小幅下滑到63.3歲。
The differences between rich and poor are also vast. In England, women living in the most deprived areas have a healthy life expectancy at birth of 51.4 years compared with 71.2 years for women living in the least deprived areas.
富人與窮人之間的差異也很大。在英格蘭，住在最貧困地區的女性出生時的健康預期壽命為51.4歲，而最富裕地區的女性為71.2歲。
David Finch, an assistant director at the Health Foundation, says UK policymakers should be 「very worried」 about the trend, given the country was hardly top of the league table to begin with. 「When you can see that clear space for improvement and we stop improving, it's particularly concerning.」
健康基金會(Health Foundation)的副主任戴維•芬奇(David Finch)表示，英國的政策制定者理應對這一趨勢感到「十分擔憂」，因為英國本來的排名就不算靠前。「當你看到有明顯的提升空間而我們卻止步不前，你就會感到格外擔憂。」
There are plenty of possible reasons why health has worsened, from rising obesity and alcohol misuse to the impact of government spending cuts after 2010 and the broader impact of a decade without any real wage growth.
人們的健康狀況變差有許多可能的原因，包括體型肥胖的人越來越多，酒精濫用，2010年以後政府削減開支造成的影響，以及過去十年裡實際工資水平未見增長在更廣泛層面的影響。
Britons' fraying health has now become a problem for the labour market, with a rising share of people too sick to work. That is a reason to pay attention, of course. But we should have been paying attention anyway. Health doesn't just matter because it has an impact on the economy; it matters because it's what people want.
英國人健康水平下降給勞動力市場帶來了問題，因患病而不能工作的人在總人口中占到了更大的比例。這當然是健康問題值得關注的一個原因。但健康問題本來就是我們應該一直關注的。健康之所以重要不只是因為它會對經濟產生影響。它之所以重要，是因為它是人們想要的。
The government has set an ambitious target to increase healthy life expectancy by five years by 2035. Such rapid improvements are possible: it increased by four years in the first decade of the millennium. But that was a time of sustained economic growth and higher social spending. It's hard to imagine that's what the next decade will look like, even for an optimist like me.
英國政府雄心勃勃地制定了到2035年將健康預期壽命提高5年的目標。如此飛快的提升是有可能做到的：進入2000年的頭十年裡，英國的健康預期壽命提高了4年。但那是個經濟保持增長、政府增加社會性開支的時期。即便是像我這樣的樂觀主義者，也很難想像未來十年會有這樣的光景。