The median age of the New Zealand population at the 2018 census was 37.4 years, with life expectancy in 2017-2019 being 80.0 years for males and 83.5 years for females. While New Zealand is experiencing sub-replacement fertility, with a total fertility rate of 1.6 in 2020, the fertility rate is above the OECD average. By 2050, the median age is projected to rise to 43 years and the percentage of people 60 years of age and older to rise from 18% to 29%. In 2016 the leading cause of death was cancer at 30.3%, followed by ischaemic heart disease (14.9%) and cerebrovascular disease (7.4%). , total expenditure on health care (including private sector spending) is 9.2% of GDP.