Monaco holds the highest life expectancy of any country in the world, with residents expected to live past 89 years on average. Among larger nations, Singapore and Japan consistently top global rankings, with healthy life expectancies (years lived free of disease and disability) of 73.6 and 73.4 years respectively, according to the World Health Organization’s most recent data. The answer shifts slightly depending on which metric you use and whether you include microstates, but a handful of countries in East Asia and Western Europe dominate every list.
The Top Countries for Life Expectancy
Monaco, a city-state of about 40,000 people on the French Riviera, tops most rankings thanks to its extreme wealth, mild climate, and access to high-quality healthcare. United Nations population data projects Monaco’s life expectancy at roughly 89.7 years. Because Monaco is so small and affluent, many demographers set it aside and focus on larger nations for more meaningful comparisons.
When the WHO ranks countries by healthy life expectancy, which measures years lived in full health rather than just years alive, the top five are:
- Singapore: 73.6 years
- Japan: 73.4 years
- South Korea: 72.5 years
- Iceland: 71.4 years
- Luxembourg: 71.2 years
Hong Kong, while technically a special administrative region rather than a country, also regularly appears near the top of longevity rankings. These figures are based on 2021 data, the most recent year available from the WHO.
Why East Asian Countries Lead
Three of the top five spots belong to East Asian nations, and the reasons overlap: diet, low smoking rates, and broadly accessible healthcare systems. Japan’s traditional diet, built around rice, fish, vegetables, fermented foods, and seaweed, has been studied extensively as a driver of longevity. A longitudinal analysis published in MDPI found that the traditional Japanese diet is associated with longer life expectancy and more years lived in good health across international comparisons. The Japanese government has actively promoted this dietary pattern, and UNESCO recognized Japanese food as an intangible cultural heritage in 2012.
Hong Kong’s longevity advantage is even more specific. A study in The Lancet Public Health found that low smoking rates account for roughly half of Hong Kong’s survival advantage over other high-income regions for men, and about 35% for women. Hong Kong recorded just 39.7 smoking-related deaths per 100,000 people in 2016, the lowest figure among all high-income regions studied. For men, Hong Kong has maintained the lowest smoking-related death rate compared to OECD countries, Japan, Singapore, and South Korea since 1979.
South Korea and Singapore share similar patterns: universal or near-universal healthcare coverage, high vaccination rates, compact urban environments that encourage walking, and diets lower in processed food than Western countries.
How Spending Relates to Longevity
You might assume that spending more on healthcare produces longer lives, but the United States is a dramatic counterexample. The U.S. spent 17.8% of its GDP on healthcare in 2021, nearly double the average for wealthy nations. Per person, American healthcare spending is roughly four times higher than South Korea’s. Yet U.S. life expectancy in 2020 was 77 years, three years below the average for comparable countries.
Germany spends significantly less per person than the U.S. but achieves life expectancy nearly four years higher. The U.S. also has the highest infant mortality rate among high-income countries at 5.4 deaths per 1,000 live births, compared to just 1.6 in Norway. Maternal mortality tells a similar story: nearly 24 deaths per 100,000 live births in the U.S., more than triple the rate in most peer nations. These gaps suggest that how healthcare dollars are distributed matters far more than the total amount spent.
Lifestyle Patterns in the Longest-Lived Communities
Beyond national averages, researchers have identified specific communities around the world where people routinely live into their 90s and 100s. These so-called Blue Zones, found in places like Okinawa (Japan), Sardinia (Italy), and the Nicoya Peninsula (Costa Rica), share a set of common lifestyle traits that cut across culture and geography.
Residents of these communities eat primarily plant-based diets and tend to monitor their calorie intake naturally, often through smaller portions or intermittent fasting. They either avoid alcohol entirely or drink moderately, mostly red wine. Physical activity isn’t gym-based but woven into daily life through walking, gardening, and manual tasks. Stress management is a daily practice rather than an occasional effort, and most residents maintain strong social ties, with extended family members often living together. A sense of purpose and some form of spiritual or religious engagement are also consistent features. None of these factors alone explains extreme longevity, but together they create an environment where aging well is the default rather than the exception.
The Pandemic’s Impact on Global Rankings
The COVID-19 pandemic reshuffled life expectancy figures worldwide. Between 2019 and 2021, global life expectancy dropped by 1.8 years, the largest decline in recent history, erasing roughly a decade of progress. The WHO has warned that global health gains are slowing even as countries recover from the pandemic’s acute effects.
Countries that managed the pandemic’s early waves effectively, particularly in East Asia and parts of Northern Europe, experienced smaller drops and faster recoveries. This partly explains why Singapore, Japan, and South Korea remain at the top of current rankings. Nations with fragmented healthcare systems or lower vaccination uptake saw steeper declines that will take years to fully reverse.