New research from Mayo Clinic sheds light on growing disparities between life expectancy and years spent in good health.
A study recently published in JAMA Network Open has revealed a concerning trend: while global life expectancy has steadily increased, the number of years individuals live in good health has not kept pace. Spanning two decades and encompassing data from 183 World Health Organization (WHO) member states, the research by the Mayo Clinic‘s Armin Garmany and Dr Andre Terzic highlights an average healthspan-lifespan gap of 9.6 years globally – a disparity that poses significant implications for healthcare systems, public health strategies and individual quality of life and that raises important questions about the quality of life in later years and the role of health systems in addressing this challenge.
Longevity.Technology: Metrics such as health-adjusted life expectancy (HALE) offer a nuanced perspective on longevity – they capture not just the number of years individuals live, but the quality of those years. These measures are instrumental in formulating policies aimed at closing the gap between lifespan and healthspan; they provide robust evidence to support preventive health strategies, shaping government approaches to prioritize wellness over reactive care. While understanding this gap can offer a foundation for advocating policy change, it is vital that governments take heed and embed preventive strategies into their approaches to healthcare.
Global disparities and widening gaps
The report’s findings indicate a persistent lag between increases in life expectancy and improvements in health-adjusted life expectancy. On average, life expectancy rose by 6.5 years globally from 2000 to 2019, while health-adjusted life expectancy increased by just 5.4 years over the same period [1]. This discrepancy reflects a growing burden of years lived with disease or disability, underlining the need for targeted interventions to improve healthspan.
High-income nations such as the US, Australia and the UK exhibited some of the largest healthspan-lifespan gaps, with the United States recording the widest gap at 12.4 years. This disparity was attributed to the rising prevalence of noncommunicable diseases (NCDs) such as musculoskeletal and neurological conditions, as well as mental health challenges [1]. In contrast, nations with smaller gaps, such as Lesotho and the Central African Republic, reflect the differing healthcare burdens and resource constraints that influence these metrics. The numbers spotlight the complex interplay between longevity, disease burden and healthcare systems. While advances in medical technology and chronic disease management have extended lifespan in many countries, they have not always been accompanied by equivalent gains in years lived in good health.
Sex differences in healthy longevity
The study also highlights notable disparities between men and women; globally, women experience a healthspan-lifespan gap that is, on average, 2.4 years wider than that of men, with countries such as Germany, Spain and France exhibiting the largest disparities [1]. This difference is partly explained by women’s higher life expectancy and their disproportionate burden of chronic conditions such as musculoskeletal disorders. The gap is most pronounced in high-income countries, where healthcare access and advancements extend lifespan but do not always translate into healthier years.
In the US, the healthspan-lifespan gap for women increased from 12.2 years in 2000 to 13.7 years in 2019, compared with a rise from 10.9 to 12.4 years for men [1]. This trend highlights the necessity of addressing sex-specific health challenges, particularly those linked to chronic diseases and access to preventive care.
The role of noncommunicable diseases
Noncommunicable diseases were identified as a primary driver of the healthspan-lifespan gap, with conditions such as diabetes, cardiovascular disease, and neurological disorders accounting for a significant proportion of years lived with disability. In high-income nations, the burden of NCDs is exacerbated by lifestyle factors and aging populations. The United States stands out as a case study: its high NCD burden and lack of significant gains in health-adjusted life expectancy contribute to its position as the country with the largest healthspan-lifespan gap.
Addressing the burden of NCDs requires a multifaceted approach, combining early detection, access to preventive healthcare and interventions targeting modifiable risk factors. Countries with smaller gaps may offer valuable lessons in integrating community-based health initiatives with national healthcare policies.
Hevolution Foundation – prevention as a cornerstone
Hevolution Foundation, a global non-profit dedicated to extending healthspan, emphasized the importance of prevention in addressing the challenges highlighted by this study. The organization focuses on understanding the biological processes of aging and increasing access to preventive measures as a means of narrowing the healthspan-lifespan gap. By investing in research and fostering collaborations across scientific disciplines, Hevolution Foundation aims to accelerate the development of interventions that promote healthy aging and reduce the prevalence of chronic diseases.
“We have figured out how to live longer, but we have not figured out how to live longer healthier,” said Dr Mehmood Khan, CEO of Hevolution Foundation. “The biggest gap right now is not simply extension of life, but extension of healthy life.”
“Our life expectancies over the last 100 years have almost doubled – we’ve gained almost 30 years of life expectancy, but as we’ve lived longer, the last 10-20 years of our life are now burdened with several age-related diseases,” he said. “That difference has the potential to become disease-free periods.”
Bridging the healthspan-lifespan gap
The findings of this study call for a shift in healthcare systems from reactive models that address diseases after they emerge to proactive, wellness-centered approaches. Investments in public health infrastructure, coupled with initiatives that promote early intervention and access to preventive care, are critical in narrowing the healthspan-lifespan gap.
Metrics like HALE can help policymakers identify areas of greatest need, enabling targeted investments in healthcare resources. Countries with smaller gaps often demonstrate the efficacy of prioritizing public health measures and addressing social determinants of health – approaches that may be adapted to other contexts to promote equitable health outcomes.
Longevity.Technology spoke to Dr Khan about the findings – and what needs to change, and he started by explaining that co-operation and prioritization is key.
“To effectively address the gap between lifespan and healthspan – the number of years spent in good health – governments and policymakers need to prioritize healthy aging and invest financial resources in extending healthspan,” he explained. “Currently, countries spend trillions on treating symptoms of age-related diseases, such as heart disease, cancer, and dementia, yet invest little in understanding the root causes of aging that are linked to these ailments. Redirecting a portion of this budget toward aging research could yield significant long-term benefits.”
Khan was clear that the impact of aging populations extends beyond healthcare, affecting economic productivity and labor markets. “A slowdown in aging that increases healthy life expectancy by one year could result in almost $38 trillion per year in healthcare cost savings and productivity increases – a significant economic benefit,” he said.
“Faced with a silver tsunami, global leaders are beginning to recognize the importance of improving healthspan. Countries like the United Kingdom and Singapore have set measurable goals backed by policy changes to increase healthspan by five years. Similarly, Saudi Arabia’s Vision 2030 includes preventing chronic and age-related diseases as a key pillar. South Korea’s establishment of a Population Ministry in 2024 to address low birth rates and an aging population is another recent proactive measure.”
Dr Khan explained that it is crucial for policymakers to understand there is no current regulatory path that allows aging-related treatments to come to market. “As we continue to make advancements in aging research, creating regulatory paths for treatment availability will be crucial to allowing therapeutics to be scalable for all,” he said.
Organizations like Hevolution Foundation can collaborate with governments and healthcare systems to promote a preventive approach to aging that aligns with public health priorities.
“Governments and the private sector often work in silos from country to country – we need to convene and collaborate across borders to share discoveries and accelerate progress,” he said. “To secure our future health, we need a global knowledge ecosystem and greater collaboration among governmental leaders in partnership with scientists and industry. This is part of our mission at Hevolution, to convene key stakeholders to create a healthier future for everyone.”
Khan told us that governments play a crucial role in driving spending and supportive policies needed to address aging societies. “As a highly regulated sector, pharmaceutical research and investment is heavily influenced by the incentives laid out by regulators,” he said. “Hevolution, as a global non-profit, is able to invest in early-stage research and make impactful investments in potential therapeutics.”
Khan pointed out that our current healthcare system – on a global scale – is unprepared to handle the influx of older adults.
“This is devastating for many parts of the world, where patients often have a hard time seeking access to the care they need – as two-thirds of people over 60 live in low- and middle-income countries,” he explained. “In a survey conducted by Hevolution Foundation, 63% of healthcare professionals believe healthcare systems risk collapsing by 2030 if there isn’t a breakthrough in aging research, or geroscience. Hevolution and many other stakeholders concerned about extending healthspan are encouraging healthcare systems to prioritize a shift from traditional healthcare models and ways of thinking to focus more on prevention and addressing the underlying causes of aging.”
Considering the significant burden of noncommunicable diseases is widening the healthspan-lifespan gap, public awareness and education play key roles, but they need to be scaled globally to drive change.
“Increasing public awareness of the importance of extending healthy years of life is essential,” explained Dr Khan. “At Hevolution, we are working to shift the global conversation from simply extending lifespan to enhancing healthspan and quality of life in later years.
“We must transition from our current reactive healthcare model to focusing on prevention, rather than accepting age-related diseases as inevitable. Forty years ago, cancer was seen as inevitable, but public awareness changed that perception. Similarly, increasing awareness about aging as a treatable condition can drive behavioral change in societies before key demographic groups begin to see the negative effects of aging.”
Khan made the point that aging is the single most important risk factor for many devastating diseases, including Alzheimer’s, most cancers, heart disease, osteoporosis, kidney failure and diabetes.
“Public education on how healthspan is a more important metric than lifespan can help prioritize aging research,” he said. “Healthspan science is no longer science fiction. Advances in understanding aging biology and research on compounds like metformin, rapamycin, and taurine show that delaying age-related diseases is possible.”
Khan explained that growing awareness of these advances can attract more funding and researchers to the field, helping to drive change on a global scale. “And as our general populations accept healthspan as an important health metric to prioritize, we can make inroads into improving the years we live in good health.”
A global challenge needs local solutions
The widening healthspan-lifespan gap is a global issue that requires localized solutions. While the study makes clear the universal nature of the problem, it also highlights significant regional differences in the factors contributing to the gap. Understanding these variations is key to developing tailored strategies that address the unique healthcare challenges of different populations.
For organizations like Hevolution Foundation and policymakers worldwide, the challenge lies in transforming knowledge into action; bridging the gap between life expectancy and healthspan is not merely a matter of medical advancement – it is a societal imperative that demands comprehensive, collaborative efforts across disciplines and sectors.
[1] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827753
