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Why Andorrans Have the World’s Best Life Expectancy

Miniature people and the concept of an aging society.In early February of 2020, just before the coronavirus pandemic caused the world to grind to a halt, I had the opportunity to visit Andorra—a tiny nation perched high in the Pyrenees Mountains on the border between Spain and France. Though just 50,000 in number, Andorrans are renowned for their happy and hardy nature; and they enjoy the longest life expectancy of any country. For this reason, I have always wanted to visit Andorra to experience their culture firsthand and get a feel for why they have such exceptional longevity.
When I was invited to the Global Omega-3 conference in Spain, I pulled up a map of Europe and saw that Andorra was only 135 miles north of Barcelona—where the meeting was to be held. I jumped at the opportunity and invited my son Evan and daughter Kathleen to join me. Our 3-hour road trip from Barcelona to Andorra was an awe-inspiring drive through snowcapped peaks and alpine lakes. We went through 20 tunnels, some of them several miles long, and the road was constantly switching back and forth with hairpin curves and steep climbs. Thankfully, the highway was meticulously maintained and there were few other vehicles on the road. I realized one of the reasons that so few people live in Andorra is that it would have been nearly impossible to get there in centuries past.
Andorra, comprised of a scant 181 square miles, has always maintained neutrality, never getting into conflicts with its neighboring countries. Plus, its secluded setting in the middle of snowcapped peaks has allowed them to live undisturbed for 1,200 years.
Skiing is their national sport in the winter. When the days get longer, and the bright sun melts the snow, the Andorrans hike along streams, kayak in lakes, and climb up into the mountains. In the summer, competitive cyclists come to Andorra to train on steep and winding roads.
Though Andorra is a mountainous country, it is only 100 miles from the Mediterranean Sea. Through the ages, the Andorrans have followed a version of the traditional Mediterranean diet they call Catalan cuisine, with its emphasis on vegetables, nuts, berries, and olive oil. Fish from the alpine lakes remains a staple, but the Catalan diet also includes moderate amounts of lamb, chicken, and goat cheese, with a glass or two of red wine at the evening meal.
Everyone we met was friendly and relaxed and they all seem to know each other, which may in part explain why there is almost no crime in Andorra. Their health care system is very good, with a strong emphasis on prevention.
Evan and I snowboard, whereas Kathleen prefers to ski, but we all agreed that our time cruising down the pristine slopes in Andorra was one of our favorite winter adventure trips ever. There were no lift lines, and the lift ticket prices were about half of what they are in Vail, Beaver Creek, Aspen, or Keystone. The altitudes at the peaks of the ski areas in Andorra are about 8,000 feet, compared to 12,000 feet at the peaks of the Colorado resorts. This made exercising in the Pyrenees much less taxing than we were used to in the Rocky Mountains.
According to the World Health Organization, the average Andorran lives for 85 years—the best life expectancy of any country, with Japan coming in a close second.
We got to know one local citizen, Alex, a 36-year-old chef who owns and operates a superb little restaurant called La Cort in the mountain village of Soldeu, where we stayed.
Evan and Kathleen in Andorra. His relatives have generally lived into their 80s and beyond in good health, and his grandfather lived to age 96. When I asked him why he and his fellow Andorrans enjoy such remarkable vitality he said, “It’s very quiet and relaxed here, with no traffic, honking horns, or stress.”
Indeed, we noticed that the people strolling around the cobblestone streets never seemed to be in a hurry. Alex told me, “We breathe fresh air, and drink pure water.” The mountain air did seem crisp and fresh; and their crystal-clear water comes from glacial runoff and alpine lakes. Alex told us that as a boy he and his friends routinely drank water straight from the lakes and streams.
Andorra is not a wealthy nation, but there is virtually no poverty. The economy is based on banking and tourism. The low tax rates encourage many Europeans to deposit money in Andorran banks, and there is no tax on food or liquor, so some locals use gin as their windshield washer fluid because they can buy it for about $2 per liter.
Alex says sometimes Andorrans’ slow pace of life can irritate some visitors. “Grandpas play card games on outdoor tables at restaurants, and sometimes we take two hours to do something that can be done in half an hour.” I will have to admit that we noticed the service was not the speedy pace we are used to in the U.S.
He also said, “It is a very nice place to raise your children. It’s super safe, which means people are not concerned about their security at any point. If you feel safe and calm, then you enjoy your life better.” We certainly enjoyed life while we stayed in Andorra, which seems like a long-ago, surreal dream looking back now from the depths of the pandemic. But this too shall pass, and one day soon we will all be able to get back out there, exploring our amazing planet once again.
In Good Health,
James O'Keefe, MD, FACC