A child who reaches their first birthday in Spain can expect to live 83.30 years. A child in the same position in Romania can expect 75.90 years. The 7.40-year difference, recorded in Eurostat's life expectancy dataset for 2024, is the widest gap among the eight member states for which current data is available.

The figures confirm what demographers and public health researchers have tracked for years: health outcomes in the European Union continue to follow a familiar east-west gradient. Spain, Sweden, Italy and France all sit above the EU average of 80.80 years. Czechia, Poland, Hungary and Romania all sit below it. The distance between the top and the bottom has barely shifted.

Eight countries, a familiar ranking

The 2024 data covers only eight of the EU's 27 member states, those that have reported figures for the most recent year. Spain leads at 83.30 years, followed closely by Sweden at 83.00 and Italy at 82.90. France comes in at 82.40. All four exceed the EU average.

Below that line, the drop is steep. Czechia registers 79.30, a full 1.50 years below the average. Poland sits at 77.80, three years short. Hungary, at 76.10, trails the average by 4.70 years. Romania, at 75.90, is 4.90 years behind. The distance between fourth-placed France and fifth-placed Czechia is three full years, wider than the gap between Spain and France.

This is not a new pattern. Southern and Nordic European countries have occupied the top positions in EU life expectancy tables for over a decade. Central and eastern members have consistently lagged. The 2024 numbers reinforce the trend rather than break it.

Post-pandemic recovery, uneven gains

What is notable about the 2024 figures is that every one of the eight countries has moved past its 2019 level. The Covid-19 pandemic drove life expectancy down across the continent in 2020 and 2021, with some member states losing more than a year of average lifespan. The recovery has been real, but its pace varies.

Romania and Czechia each gained 0.90 years between 2019 and 2024, the largest improvements in the group. Romania rose from 75.00 to 75.90; Czechia from 78.40 to 79.30. Sweden gained 0.80 years, moving from 82.20 to 83.00. Poland added 0.60 years, Spain 0.60, Hungary 0.50, France 0.40, and Italy 0.30.

The larger gains at the bottom of the table partly reflect a mathematical reality: countries with lower baseline life expectancy have more room to improve. But they also reflect something more concrete. Romania and Czechia both suffered severe Covid-19 mortality in 2020 and 2021, meaning their 2019 baselines were followed by sharp drops before the recovery. The net gain over five years disguises a volatile trajectory.

Italy's modest 0.30-year gain, the smallest in the group, tells a different story. Italy was hit early and hard by the pandemic, particularly in Lombardy, and its life expectancy fell sharply in 2020. Recovering only 0.30 years above the 2019 level by 2024 suggests that some of the pandemic's effects on mortality, whether from delayed treatment, lasting organ damage, or broader health system strain, have proved persistent.

What life expectancy at age one actually measures

The Eurostat figures measure life expectancy at age one, not at birth. The distinction matters. Life expectancy at birth factors in infant mortality, the probability of dying in the first year of life. Life expectancy at age one strips that out. It answers a different question: given that a child has survived the most vulnerable 12 months, how long can they expect to live?

For countries with higher infant mortality, life expectancy at birth would look worse than life expectancy at age one. Romania's infant mortality rate, while improved, remains above the EU average. This means the 7.40-year gap at age one probably understates the true difference in expected lifespan from birth. The full gap, were it measured from birth, would likely be wider still.

The measure also reflects conditions that accumulate over a lifetime: diet, occupational hazards, air quality, road safety, alcohol and tobacco consumption, access to preventive care, and the quality of treatment for chronic diseases. It is a composite indicator of how well a society supports the health of its population from early childhood through old age.

Why Spain leads and Romania trails

Spain's position at the top of the table is well established. Researchers have pointed to several contributing factors: a diet rich in olive oil, fish and vegetables; lower rates of cardiovascular disease than northern European peers; a strong primary healthcare system that catches conditions early; and social cohesion, including family networks that provide informal care for older people. Spain also benefits from lower smoking rates among women than in many northern European countries, though male smoking rates remain a concern.

Romania's position at the bottom reflects a different set of realities. Healthcare spending per capita remains among the lowest in the EU. The country has faced sustained emigration of medical professionals, particularly doctors, who can earn multiples of Romanian salaries in Germany, France or Britain. Preventive care is underused. Cardiovascular disease mortality is high. Smoking rates, especially among men, exceed the EU average. Air pollution from coal-fired power plants and older vehicles adds a further burden.

Hungary, only 0.20 years ahead of Romania, faces similar pressures. The Organisation for Economic Co-operation and Development has repeatedly flagged Hungary's high rates of mortality from treatable conditions, suggesting that the healthcare system is not delivering the results that its level of spending should permit. Poland, while somewhat better placed at 77.80, still lags its western neighbours by roughly three years.

Convergence, but not fast enough

The fact that Romania and Czechia recorded the largest gains since 2019 points to a long-term trend of convergence. Over the past two decades, the gap between western and eastern EU members has narrowed. Accession to the EU brought structural funds, regulatory alignment on health and safety, and pressure to improve healthcare standards. Rising incomes in central and eastern Europe have also contributed, since health outcomes are closely correlated with GDP per capita.

But convergence is slow. A 7.40-year gap between Spain and Romania in 2024 is only modestly smaller than the gaps recorded in earlier decades. At current rates of improvement, closing the gap entirely would take generations. The European Commission's State of Health in the EU country profiles, published every two years, have repeatedly highlighted the scale of the challenge: health inequalities between member states remain one of the starkest markers of economic and social divergence within the Union.

There is also a question of whether convergence will continue at all. The pandemic disrupted healthcare systems across the continent, but the disruption was not evenly distributed. Countries that entered the crisis with weaker health infrastructure lost more ground. Recovery depends on investment, and investment depends on fiscal capacity. Romania and Hungary both face constraints on public spending that Spain and Sweden do not.

A partial picture

The eight countries in the 2024 release represent a subset of the EU. Major economies including Germany, the Netherlands, Belgium and Austria have not yet reported, and their inclusion may shift the averages. Germany's life expectancy at age one has historically sat close to the EU mean, so its absence does not distort the range dramatically, but the full picture will not be clear until all 27 member states have reported.

What is already visible is enough to draw a clear conclusion. The EU's health divide has not closed. It has narrowed at the edges, with the poorest performers making up some ground after a pandemic that hit them hardest. But a child born in eastern Europe still faces meaningfully shorter life prospects than one born in the Mediterranean or Scandinavia, and the institutions responsible for closing that gap, national governments and the European Commission alike, have not yet found a way to accelerate the process.

Organisations

Eurostat