In this blog, Patrick Swain compares how well countries and territories performed at the Paris 2024 Olympics and a hypothetical “Healthy Ageing Olympics” based on findings from the ILC’s Going for gold project.

• At a “Healthy Ageing Olympics”, African and European countries would lead the way in terms of medals and top 10 finishes
• Japan also leads the way in healthy ageing and excelled at this year’s Olympics in Paris too
• Once again, the USA and China dominated the Summer Olympics medal table, but they would fail to make it to the podium for a Healthy Ageing Olympics
• Healthy ageing and physical activity don’t necessarily correlate with Olympic success, but every country has an opportunity to embrace policies that achieve better population health outcomes

With the Paris 2024 Olympics now over and the Paralympic Games just around the corner, ILC has been comparing how countries performed at this year’s Games and our Healthy Ageing Medal Table.

Our Going for gold project showed that only a handful of countries would win more than one medal if there were an Olympics for healthy ageing. Countries like Japan and South Korea perform well on a range of healthy ageing metrics (finishing 1st and 2nd respectively at a Healthy Ageing Olympics) and achieved huge success at this year’s Olympics too: Japan finished 3rd in the medal table with 45 medals and 20 golds, while South Korea finished 8th with 32 medals and 13 golds.

Yet despite their continued domination at the Olympics, our research suggests that the US (1st in Paris) and China (2nd) wouldn’t make it to the podium for healthy ageing. The same can be said for Australia (finishing 4th) and this year’s host, France (5th).

So, with this in mind – does Olympic success correlate with healthy ageing? Are strong sporting nations as physically active at a population level and living well for longer?

A recap: our eight sporting categories explore healthy ageing through a holistic lens

Taking data from the OECD, UN, WHO and the ILC’s Healthy Ageing and Prevention Index, we created eight “sporting” events to understand how countries and territories perform in “healthy ageing disciplines” like immunisation, preventative healthcare, healthy life expectancy and physical activity:

• Jab-elin: how well nations perform on coverage across five childhood immunisation programmes.
• Archery: how well nations perform on meeting WHO immunisation targets for measles and influenza (flu).
• Prevention Triathlon: how nations score on diet, the prevalence of diabetes and tobacco use.
• Sport climbing: how far countries have ‘climbed’ the Healthy Ageing and Prevention Index.
• Race walking: how well nations perform when it comes to physical activity.
• Marathon: how well nations perform on healthy life expectancy.
• 100m sprint: nations with the most centenarians as a percentage of their population.
• Relay race: how economic and political blocs perform on the Healthy Ageing and Prevention Index.

We awarded medals to delegates from the best-performing countries at an awards ceremony in Paris in July. But how does the final medal table from the 2024 Olympics compare to ours?

Jab-elin (Javelin)
Key: M = Men’s | W = Women’s

Despite never competing at the actual Olympics, Niue wins gold in the Jab-elin for its impressive 99% average coverage across five childhood immunisation programmes. At the javelin event in Paris, small island nations also picked up medals, with Grenada’s Anderson Peters winning bronze. However, at a Healthy Ageing Olympics, Grenada finishes 148th in the Jab-elin with 69% coverage. Asian countries appear on the podiums across both Olympics, but at a Healthy Ageing Olympics, Pakistan and India finish 162nd and 150th respectively. Japan, on the other hand, finishes well in 12th place for Jab-elin while winning gold in the women’s javelin in Paris. And although Czechia won bronze in Paris, it finished 126th in the Jab-elin; this is in part due to missing data for pneumococcal vaccination uptake. Otherwise, Czechia achieves over 90% coverage across the four other immunisation programmes.

Archery
Key: M = Men’s | W = Women’s
Note: Paris 2024 Olympics results for men’s and women’s individual competition.

Just like the Healthy Ageing Olympics, South Korea dominated this year’s archery event: it has won gold for archery at every Olympics since 1988. When it comes to hitting immunisation targets too, South Korea was the only country to reach the WHO’s goal of 95% for measles and 75% for influenza (flu), achieving 95% and 80.1% respectively. While coming 2nd in the men’s event at Paris, the USA did come 4th on the Healthy Ageing Medal Table – it narrowly missed out on bronze by 0.1 percentage points.

Prevention Triathlon (Triathlon)
Key: M = Men’s | W = Women’s
Note: Paris 2024 Olympics results for men’s and women’s individual competition.

Unlike Paris 2024, our Triathlon podium only features African countries. The only non-African country to place inside the top 10 was Japan (10th). At this summer’s Olympics, however, the UK dominated once again, as did France. Yet France and the UK finish 43rd and 48th respectively for preventing poor diet, diabetes and tobacco use. Switzerland fares better in 25th, but New Zealand surprisingly finishes 67th despite its strong Healthy Ageing and Prevention Index rank (8th). This is because New Zealand’s diet score (combined score on undernourishment and obesity) of 37.3 is higher than the average score (32) but is still significantly lower than the highest score on the Healthy Ageing Medal Table (68.7 in Samoa).

Sport climbing
Key: M = Men’s | W = Women’s
Note: Paris 2024 Olympics results for the Sport Climbing “Speed” final event.

Making only its second appearance at the Summer Olympics, the sport climbing “Speed” event results seen in Paris completely varied from our findings. Again, African countries dominated this event at the Healthy Ageing Olympics: Botswana climbed an impressive 24 places on the ILC’s Index between 2019 and 2022, while Zimbabwe and the Republic of the Congo climbed 13 and 11 spots respectively. In contrast, Poland climbed just three places, China rose by two, Indonesia fell two places, and the USA fell by four on the Index.

Race walking
Note: Paris 2024 Olympics results for men’s and women’s individual competition.

Thanks to the WHO’s breakdown in physical inactivity levels by sex, we’re able to compare both competitions for this event at the Paris and Healthy Ageing Olympics. Although our final report suggests Mozambique, Uganda, Lesotho, Tanzania and Niue make it to the podium for race walking (lowest levels of physical inactivity), Vanuatu would win bronze in both events thanks to only having an adult physical inactivity rate of 8%. China also performs well: it places 13th for race walking at the Healthy Ageing Olympics (only 14% of Chinese adults are physically inactive). However, Spain ranks 52nd with an adult physical inactivity rate of 27%, Ecuador comes 54th (27.5%) and Australia ranks 65th (30.5%). Brazil – despite winning silver in Paris – ranks 120th with the fourth-highest adult physical inactivity rate in the world (46.5%).

Marathon

As with the previous event, WHO healthy life expectancy (HLE) data enables us to compare both the men’s and women’s Marathon podiums. While Israel finishes 11th overall in the Healthy Ageing Olympics, it would win silver for male HLE at birth (the number of years spent in good health). Japan, South Korea and Singapore’s exceptional HLE means it dominates the Healthy Ageing Olympics’ podium, but it’s Ethiopia and Keyna who once again take the Marathon top spots at Paris 2024. Yet Ethiopia comes 129th for male HLE (58.05 years) and 130th for female HLE (59.63 years), while Kenya places 135th (57.28 years) and 133rd (59.19 years) respectively. Belgium and the Netherlands, on the other hand, both come in the top 20 for male HLE (19th and 15th respectively) and inside the top 30 for female HLE (23rd and 27th respectively).

100m sprint
Key: M = Men’s | W = Women’s

While Monaco is the longest-competing country at the Summer Olympics to never have won a medal, it does win gold for having 1.056% of centenarians as a proportion of its population. At Paris 2024, another small nation shone brightly: Saint Lucia’s Julien Alfred won her country’s first-ever Olympic medal. Just like at our Healthy Ageing Olympics, a country with a small population pushes a large country into 2nd place. Similarly, Caribbean countries and territories[1] perform well across both Olympics. At the Healthy Ageing Olympics, the USA comes 19th for the number of centenarians as a percentage of its population (0.027%), while Saint Lucia comes 128th (0.001%) and Jamaica ranks 133rd (0.0009%).

Relay race
Key: M = Men’s | W = Women’s
Note: Paris 2024 Olympics results for the 4 x 100m Relay race

The Healthy Ageing Olympics “Relay race” is the only event where country comparisons are not made. However, when considering the membership of each country bloc, the G7 is a clear winner across both events: Canada, the USA, the UK and Germany all won medals at Paris 2024 in the 4 x 100m relay, as well as collectively scoring well for healthy ageing. Germany also claims bronze as an EU member, as did their women’s sprint team in Paris. Yet despite their impressive gold for healthy ageing, no member of the Nordic Council[2] made it to the final of the 4 x 100m relay race in Paris. South Africa won an impressive silver medal in Paris 2024, but the African Union would finish 11th in this event at a Healthy Ageing Olympics.

In summary

Apart from South Korea winning archery in Paris and at a Healthy Ageing Olympics, there’s not a lot of correlation between events across both competitions. Japan is the only country to finish in the top three for the Healthy Ageing Medal Table and the Paris 2024 medal table, while countries like the USA fail to make a podium appearance at a Healthy Ageing Olympics despite being triumphant in the French capital.

Between those who won medals at Paris 2024 and those who won medals at a Healthy Ageing Olympics, there is a correlation between only a handful of countries:

It seems, therefore, that there isn’t much of a correlation between sporting success and healthy ageing. We saw in Paris that some countries performed better than others at specific sporting disciplines, and the same can be said for healthy ageing: no single country or territory dominates this space, but each nation has its strengths and weaknesses when it comes to achieving longer, healthier and more fulfilling lives.

What happens next?

With the dust now settling from Paris 2024 and all eyes turning to Los Angeles 2028, how can countries and territories improve their healthy ageing scores over the next four years?

The Healthy Ageing Medal Table shows that living healthier for longer is a broad-ranging topic; policymakers and health stakeholders around the globe must take a holistic approach to healthy ageing and prevention if they are to improve their country’s longevity.

To achieve healthy ageing, countries and territories should:

1. Invest in health systems: governments should invest more in preventative healthcare and public health initiatives. Policymakers should commit to spending at least 6% of their healthcare budgets on prevention, and they should implement national immunisation and screening programmes.
2. Inspire and engage key actors: policymakers, health leaders and citizens need to work together. Policymakers should ensure healthcare professionals (HCPs) are equipped and trained to deliver preventative interventions. Financial incentives should also be considered to encourage healthy lifestyle choices and uptake of preventative health interventions.
3. Democratise access to healthcare: barriers to preventative interventions need to be removed. HCPs should form partnerships with trusted local actors to deliver prevention in local settings. Person-centred care should be at the heart of healthcare delivery, which should also be made universal.
4. Use technology to deliver prevention: technology should support access to preventative healthcare services, and patients should have better access and control over their health data. Policymakers should seek to improve digital skills and literacy among individuals, and HCPs should receive adequate training on using technology for their practices.

Athletes have four years to train for the next Olympics. Most importantly, countries and territories have the next four years to invest more in population health and prevention to ensure their citizens are living longer and healthier lives, achieving greater healthy ageing in the process.

Notes

[1] Although Guadeloupe is an overseas department of France and not an independent country that competes at the Olympics, it is in the Caribbean.

[2] Nordic Council members include: Denmark, Finland, Iceland, Norway and Sweden

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