A new study is predicting that some health issues will get better, while others will get worse.

A new study shows that life expectancy may increase overall by the year 2040, but certain countries will actually experience a life expectancy decrease, Health is reporting. Researchers looked at over 250 causes of death between the years 1990 and 2016 — to determine if humans are likely to live longer as time goes on in 195 different locations. The good news is, life expectancy is estimated to increase an average of 4.4 years for both men and women, globally speaking. The bad news is, certain countries will thrive while others will falter.

While most factors affecting health could improve by 2040, researchers found that unfortunately, 36 out of 79 factors are actually likely to get worse. The factors that are expected to become poorer include body mass index, air pollution, high cholesterol, and diet. Spain and Japan are the top 2 countries expected to experience an increase in life longevity, and a lot of this can be attributed to their healthy diet of grains and fruit, The Guardian reported.

The top three causes of death — heart disease, stroke, and lower respiratory infection — are neither expected to improve or to get worse. Causes of death like chronic obstructive pulmonary disease (COPD), road injuries, and diarrheal disease will also stay about the same. But causes of death such as malaria, pre-term births, HIV/AIDS, and neonatal encephalopathy are all expected to decrease — with mortality markers such as chronic kidney disease, Alzheimer’s disease, diabetes, and lung cancer set to replace their spots in the top 10 causes of death.

Citizens of Japan and Spain — along with places like Singapore and Switzerland — are expected to live over 85 years on average. On the lower end of the scale, however, are places like Central African Republic, Lesotho, Somalia, and Zimbabwe, where the average age will be under 65. As for the United States, it is expected to drop 20 places in the rankings, making its way from 43rd to 64th place. This means that the U.S. will experience the largest rankings drop out of all of the higher-income countries.

“In my mind the difference between better and worse outcomes is what governments and the global community could achieve,” said Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington. “Inequalities will continue to be large. In a substantial number of countries, too many people will continue earning relatively low incomes, remain poorly educated, and die prematurely. But nations could make faster progress by helping people tackle the major risks, especially smoking and poor diet.”

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