With medical advances extending lifespans, people are living longer worldwide. However, more years of life does not necessarily translate into more healthy years. This trend has raised concerns about increased chronic disease and rising healthcare costs. Living Longer, But Not Always Healthier. What can be done to facilitate healthy aging?
KEY POINTS
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- Life expectancy has increased globally but gains in healthy life expectancy have stalled in some countries.
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- Poorer individuals tend to have up to 8 fewer healthy years than wealthier people, even within the same country.
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- Chronic conditions like heart disease, cancer and dementia are projected to increase costs dramatically in coming decades.
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- Preventive care and policy changes are needed to compress morbidity and enable independent, active years.
CHANGING the AGING TRAJECTORY
While longer lifespans are a triumph of modern medicine, longer lives characterized by poor health and disability are not ideal for individuals or societies. However, steps can be taken to alter this through both public policy and personal behaviors.
Potential health policy approaches include investing in prevention and education starting at young ages, making healthcare more equitable, funding research on diseases of aging, creating age-friendly communities, and regulating environmental hazards. Workplaces and caregivers also have a role to play.
At the individual level, healthy lifestyle choices, utilizing preventive care, planning for late-life needs, and staying active and socially engaged can also optimize chances of healthy aging. It’s never too late to adopt healthy behaviors.
While extending total lifespan has clear benefits, more focus is needed on adding healthy, disability-free years. With thoughtful preparation, older individuals, families, communities, and governments can work together to promote quality of life as we live longer.
WHY WE WILL LIVE LONGER
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- Medical advances are helping people live longer, but not necessarily healthier. Treatments can prolong life even with chronic conditions.
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- Rising obesity rates and less physical activity are leading to more chronic diseases earlier in life, like heart disease, diabetes, and cancer. This leads to more years spent in ill health.
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- Poor lifestyle habits like smoking, excessive alcohol use, and poor diet accumulate over time and increase the risk of chronic illnesses in later life.
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- Increasing life expectancy means people are more likely to live to very old ages when frailty, dementia, and other impairments are common.
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- Socioeconomic disparities mean poorer groups lack access to healthcare and resources to maintain health. This leads to more disability.
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- Environmental factors like air pollution and contaminants may contribute to conditions like respiratory disease, reducing healthy years.
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- Genetics play a role in susceptibility to certain diseases and longevity.
Living longer through the advancements of science is merely a pathway, an opportunity to do what people before us could never have done. To not make it as healthy as possible is squandering what not everyone has the opportunity to enjoy.
THE COST
There are some estimates on the rising costs of healthcare due to increased chronic disease and disability:
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- In the US, chronic diseases account for 90% of the nation’s $3.8 trillion in annual health care costs. The cost of treating chronic diseases could increase by 42% over the next 20 years if current trends continue.
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- Globally, the economic impact of chronic diseases is projected to reach $47 trillion by 2030, which would account for 75% of global GDP.
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- A study estimated that in China, losses due to ill health, disability, and early death cost $558 billion in 2012, or about 6.7% of GDP.
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- In the EU, estimates suggest chronic diseases reduce national income by 0.8 to 2% due to lost productivity and direct healthcare costs.
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- In terms of specific conditions, the global cost of dementia is projected to rise to $2 trillion per year by 2030. Costs of treating diabetes are projected to reach $2.5 trillion globally by 2030.
WHAT SOCIETY CAN DO
There are several things society can do to try to counter the projections of more years spent in poor health as life expectancy increases:
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- Invest in preventive healthcare and health education from an early age to promote healthier lifestyles. This includes things like diet, exercise, avoiding smoking, and managing conditions like obesity and high blood pressure.
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- Make healthcare more affordable and accessible to lower income groups. This can help reduce disparities in health outcomes.
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- Fund more research into the diseases and conditions associated with aging like dementia, arthritis, frailty, etc. Develop better treatments and support for those conditions.
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- Create age-friendly communities through better urban planning and transport for the growing aging population. This can facilitate independence and social connection.
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- Develop strategies to support family caregivers as more people require long-term care. Provide training, respite care, financial assistance.
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- Encourage employers to adopt flexible work policies so people can continue working in some capacity later in life if willing and able. This promotes activity and purpose.
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- Put regulations in place to reduce environmental hazards like air and water pollution that impact health.
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- Adopt public health programs that specifically target healthy aging through screenings, immunizations, exercise programs, improved nutrition, etc.
The key is a comprehensive societal approach across healthcare, communities, workplaces and broader environments. Healthy aging needs to become more of a priority.
IT’S NEVER TOO LATE. WHAT AN INDIVIDUAL CAN DO FOR THEMSELVES
Here are some things individuals can do to try to maximize their own chances of healthy aging:
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- Make healthy lifestyle choices – follow a nutritious diet, stay physically active, avoid smoking, and limit alcohol intake. Maintaining a healthy weight is also important.
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- See your doctor regularly for checkups, screenings, immunizations and managing any chronic conditions. This can help prevent or delay disease.
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- Keep your mind active by learning new skills, reading, puzzles, community classes or volunteering. Social connections are also very important.
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- Work on balance and muscle strength to help prevent falls and injuries. Consider taking tai chi or yoga classes. Use assistive devices like canes or walkers if needed.
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- Discuss advance care plans and end-of-life wishes with loved ones. Make legal preparations. This provides peace of mind.
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- Look into preventive health services covered by insurance or local community programs. Take advantage of free screenings and health fairs when available.
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- Find ways to manage stress such as meditation, journaling, or spending time in nature. Chronic stress takes a toll on health.
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- Set up your home to be safe and accessible as you age. Remove trip hazards, install grab bars, improve lighting, adjust countertop heights.
LISTEN TO YOUR BODY
A key factor for individuals hoping to age well is to be attuned to and proactive about their health. This means being aware of any concerning symptoms, asking questions during doctor’s appointments, getting recommended screenings and checkups, and not delaying necessary care. Each person needs to be the quarterback of their own health by listening to their body, understanding risk factors, and not ignoring issues in the hopes they will resolve on their own. Knowledge allows for early intervention which can help delay or avoid undesirable consequences. Being an informed and assertive patient and self-advocate is vital. With lifespan expanding, we owe it to ourselves and our loved ones to aim for adding quality years. Living Longer But Not Always Healthier is not an option to choose.
MAPPING GRAPHICALLY, VARIANCES BY REGION OF HEALTH AND LIFE EXPECTANCY CORRELATION
Below are a set of 4 links to maps produced by the CDC that graphically show regional variances in High Cholesterol Prevalence, Stroke Death Rates, Life Expectancy at Birth for U.S. States and Nine-Year Disparity in Human Longevity in the U.S.
SOURCES AND LINKS
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- The 42% increase in treating chronic diseases in the US by 2030 is from a study by the Milken Institute: https://milkeninstitute.org/sites/default/files/reports-pdf/ChronicDiseases-HighRes-FINAL.pdf
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- The $47 trillion global cost projection for chronic diseases by 2030 is from the World Economic Forum: https://www.weforum.org/agenda/2020/01/chronic-diseases-global-economy-forum-report/
- The $558 billion cost (6.7% of GDP) of ill health in China is from a World Bank/WHO study: https://www.who.int/healthinfo/global_burden_disease/cra/en/
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- The $2 trillion dementia cost projection is from the World Alzheimer Report: https://www.alzint.org/resource/world-alzheimer-report-2015/
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- The $2.5 trillion global diabetes cost projection is from the International Diabetes Federation: https://diabetesatlas.org/en/sections/socioeconomic-impacts-diabetes.html
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- Worldwide Trends in Healthy versus Unhealthy Remaining Life Expectancy at 60 https://www.fightaging.org/archives/2023/10/worldwide-trends-in-healthyversus-unhealthy-remaining-life-expectancy-at-60/
MAPPING HEALTH AND LIFE EXPECTANCY
Courtesy of William Faloon, Co-Founder, Life Extension https://www.lifeextension.com/magazine/2023/10
Life Expectancy at Birth for U.S. States and Census Tracts, 2010-2015
https://www.cdc.gov/surveillance/blogs-stories/life-expectancy.html
High Cholesterol Prevalence, 2018-2020 Adults Screened, 18+, by County https://www.cdc.gov/cholesterol/facts.htm
Stroke Death Rates, 2018-2020 Adults, Ages 35+, by County
https://www.cdc.gov/stroke/facts.htm
Life Expectancy in the U.S. in 2020 Nine-Year Disparity in Human Longevity
(Note lighter colors below reflect reduced life expectancy.)
https://www.cdc.gov/nchs/pressroom/sosmap/life_expectancy/life_expectancy.htm
