Yes, improved sanitation and health care technology have resulted in the extension of human lifespan, but what are the evolutionary consequences?
First, human lifespan is not, per se, subject to selection. What may be subject to selection is
reproductive lifespan, as that can directly affect fitness. Any increase in the former could be merely a secondary consequence of selection acting on the latter.
In animals, lifespan appears tightly linked to reproductive strategies. Lifespan is often negatively correlated with reproductive effort or positively correlated with onset of reproduction. For example, in the extreme case of semelparous organisms, reproduction results in death immediately.
So we can ask the following questions:
1. Are we reproducing less? (that should, in theory, help us live longer). The answer is largely 'yes' in developed countries and 'no' in undeveloped countries, so such a correlation does appear consistent, but does not necessarily imply any causation.
2. Are we reproducing later in life? (in theory, this can also lead to longer lifespans under situations where more resources must be garnered before initiating reproduction in porder for it to be successful). Again, the answer is generally 'yes' in developed countries, and 'no' in underdeveloped countries, so the corrlation between reproductive strategy and longevity holds again.
So we consider that the developed countries have most of the technology and sanitation to extend not only human life, but human reproductive lifespan. This has lead to consequences quite consistent with evolutionary theory - delayed onset of reproduction (possible because of reduced risk of dying prior to having any offspring) and reduced numbers of offspring (possible because the chances of survival of each are greatly improved).
These trends are not evident in the developing world because lifespan is still substantially shorter there and consequently there is still strong selection for early reproduction and higher fecundity in those environments.
The conclusion? If we could improve health care, sanitation and human longevity in the developing countries, the effect would be to reduce their population explosion problem because we would be relaxing selection for early onset of reproduction and high individual fecundity.