Older Americans will spend 12 years living with disability or disease — why are we so unhealthy?

By Jessica Hall

'People do not want to spend the last 12 years of their lives with the wheels coming off'

Americans may be living longer, but that doesn't mean they're living healthier.

Life expectancy in the U.S. has risen steadily over the past century. In 1900, people could only expect to live to age 47, but by 1950, life expectancy had risen to 68 years. By 2019 it had risen to over 78 years, before dropping somewhat during the pandemic to 76.4, to put the U.S. at 40th place globally.

The healthy life expectancy in the U.S., on the other hand, is 66.1 for men and women, putting the country in 68th place. Japan has the longest life expectancy, at 84.3 years for both sexes, and it also has the longest "healthspan" at 74.1 years, according to the World Health Organization's Global Health Observatory.

"In recent decades, we have successfully extended our lifespans, but our healthspans -- the years of dependable good health -- have not kept up, remaining at an average of 66 years. Americans will spend a median of 12 years living with a disability or serious disease -- and people do not want to spent the last 12 years of their lives with the wheels coming off," said Ken Dychtwald, a psychologist and gerontologist and the founder and chief executive of Age Wave, a think tank and consultancy focused on aging and longevity. Age Wave looked into this data in its recent report, The New Age of Aging.

"That means there's a lot of 60-, 70-, 80-, 90-year-olds who are in pain. We have a particularly unhealthy population," Dychtwald said.

The U.S. spent $12,914 per capita on healthcare in 2021, more than twice the comparable country average, according to a KFF analysis of National Health Expenditures and Organization for Economic Cooperation and Development data.

But such spending hasn't translated into better health outcomes, Dychtwald said.

"We think that because we spend more money than anyone else on healthcare that we must be healthier. We're not. Thirty-nine countries live longer than we do. It's outrageous," he said.

"Understanding our evolving perceptions of aging is more urgent than ever, as people over 65 make up an increasingly large portion of the U.S. population each year, with a projected 53% growth by the year 2050, according to the most recent census projections," he said.

The U.S. will soon have 100 million people over the age of 65, he noted. "That's a lot of older people living in a world of hurt," he said. He also said that the U.S. has systemic problems that must be addressed.

"Workplaces, homes, medical systems, transportation, shopping centers, lifelong education, digital technology and social media must all adapt to meet the demographic realities of this new age of aging," he said.

"I would like to hear anyone running for president answer why we are 68th in healthspan," he added.

Dychtwald cited problems such as too few departments of geriatric medicine in U.S. medical schools, as well as a fitness culture that focuses on young and healthy people.

"Fitness clubs want young, attractive people. But there are 50-, 60-, 70-, 80-year-olds who need help with balance and muscle tone," he said.

Retirees need to focus on health, relationships and purpose, Dychtwald said, noting that the average retired person in the U.S. watches 47 hours of TV a week, which he said drains people of drive and purpose.

People also need help to feel more financially educated and empowered, he said.

"You've got to be like Bill Gates to live longer," Dychtwald said, noting that the wealthiest 1% of people in the U.S. live 15 years longer, on average. "We have a longevity inequality," he said.

Dychtwald envisions the creation of an "elder corps," similar to the Peace Corps, that would recruit older adults to volunteer and do service projects.

"I do think people like to feel useful," he said. "Continuing to work should not be viewed as a failure."

-Jessica Hall

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08-23-23 1444ET

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