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How are you aging?

Lifespan vs. Healthspan in the United States

Author: Dr. Britt Dalton, PT, DPT, OCS, COMT, FAAOMPT

"Beautiful young people are accidents of nature, but beautiful old people are works of art." - Eleanor Roosevelt 

The longer I work with people, people of all ages, the more I see the truth in the former First Lady’s quote. However, when I think of beauty as we age, it is not just in the outward appearance of the person, but rather in the person’s quality of life. For me, it’s someone’s ability to maintain a strong social, emotional, mental, spiritual, and physical state despite the ups and downs that come with living a long life. It’s my 70-year-old grandfather that is able to go out and play with his grandkids. Or my 80-year-old grandmother who goes hiking on the weekends. My 75-year patient who works in her garden most days, or my 60-year-old triathlete. Even my 50-year-old mom and dad who goes to the gym with their teenager.I have worked with thousands of people over the years, and in doing so have seen the value not just in trying to live a longer life, but in maintaining a strong quality of life throughout it.  

That is why a recent article from JAMA, or the Journal of the American Medical Association, stood out to me. It discussed the average lifespan vs. healthspan in the United States, as well as 182 other countries. For reference, lifespan refers to the number of years a person lives. Healthspan refers to the number of years a person lives healthy and free of disease.  

According to JAMA, in the United States, the average lifespan for women is 80.7 years, and for men it’s 76.3 years. Compare that to healthspan, or the years lived without burden of disease or disability, which is 12.4 years LESS (13.7 years for females!). This is the largest lifespan-healthspan gap of the 183 member countries in the World Health Organization (WHO) and is 29% higher than the global average. In other words, for the average American, the last 12 years of your life are likely to be of poorer quality and associated with a decline in doing the things you enjoy most.  

What contributes to this? First, part of it is because of the increase in lifespan. With the advances that have come in the medical field, people are living longer with diseases that even two decades ago would have resulted in earlier deaths. It cannot be dismissed that the US has a much longer lifespan that many of the countries in the WHO that have lower lifespan-healthspan gaps. However, the rate of healthspan increase is coming nowhere close to increasing at the same rate.  

So, what are the main issues contributing to a lower healthspan? In the United States, the two largest contributors are musculoskeletal diseases and mental and substance abuse disorders. Other conditions that round out some of the largest contributions are cardiovascular diseases, diabetes mellitus, and respiratory conditions.

Looking at the top contributors listed above, all of them are considered non-communicable diseases, or diseases that cannot be passed from one person to another. They are influenced by our genetics, our environment, and our behaviors.  

So, what can we do to mitigate this large gap that JAMA is reporting? Some of the obvious answers are choosing our foods wisely and incorporating exercise into our life and routine. I could write a whole other blog on the issues with food in the Western diet, but choosing more non-processed foods with few ingredients, including more fruits and vegetables, is a good start. Regarding exercise, the minimal activity guidelines recommended by the American College of Sports Medicine (ACSM) is 150 minutes of moderate intensity aerobic activity, or 75 minutes of vigorous aerobic activity, per week, along with two days of muscle strengthening activities that involve all major muscle groups.  There are guidelines at their website as to what constitutes “moderate” and “vigorous” exercise. 

Admittedly, exercise and diet are not the only answers to all of these problems, but they are a good place to start. Working with your medical team to get the help needed for mental and substance abuse disorders, as well as many of the other disorders on the list, is just as important.  

If you are having trouble finding a starting place, or if there is a musculoskeletal or neurological condition that is preventing you from exercise, consider reaching out to us for a free consultation. I will finish with one of my favorite quotes that always is emphasized by the Institute of Clinical Excellence, a group I have trained with and have immense respect for: “Grow older, not weaker.”

Reference: Garmany A, Terzic A. Global Healthspan-Lifespan Gaps Among 183 World Health Organization Member States. JAMA Netw Open. 2024;7(12):e2450241. doi:10.1001/jamanetworkopen.2024.50241