Potential and challenges for sustainable progress in human longevity

Abstract Decelerating gains in life expectancy ( e 0 ) in high-income countries have raised concerns about the future of human longevity. To enhance our understanding of these developments, we examine subnational ( N = 450) mortality trends in Western Europe in the period 1992-2019. Between 1992 and 2005, gains in life expectancy were both substantial and widespread. Laggard regions experienced the fastest improvements, yielding rapid regional convergence. Between 2005 and 2019, however, gains in these regions decelerated, while remaining remarkably stable in vanguard regions, suggesting that it remains possible to continue extending longevity. The observed slowing of e 0 gains is strongly associated with mortality at ages 55-74, which increased in this period across large areas of Western Europe, particularly in Germany and France. In this work, we show that monitoring mortality trends at a fine geographical level is crucial for revealing both the potential for, and challenges to, sustainable progress in human longevity.