Where the longevity economy should focus its energy – and its dollars

We live in the age of the anti-aging gold rush. Biohackers fast and plunge into the cold. They inject themselves with peptides and track each heartbeat in hopes of extending lifespan by months or even years.

Silicon Valley’s fascination with “defeating death” is intense: billions of dollars are now invested in longevity technologies, regenerative medicine, metformin cocktails, supplements and comprehensive digital health platforms.

And for good reason. The once-impressive gains in life expectancy are no more. In 1800, no country had a life expectancy at birth greater than 40 years, but by the turn of the century, life expectancy in the majority of countries reached around seven decades. This increase was achieved through the elimination of deadly infections and major improvements in medicine.

Unfortunately, these gains are now much smaller in high-income countries. We are no longer on the straight path of sustained longevity gains that optimists are betting their colleagues on that we will continue. If Moore’s Law applies to life expectancy in the same way it applies to electronics, then we will have to spend and innovate exponentially to keep up.

Our resources are limited, so instead of prioritizing increasing the longevity envelope into triple-digit ages for the luckiest among us, we should invest in increasing the overall life expectancy of our population, that is, the average lifespan of all members of a population. The calculation of life expectancy reflects these elders, but also the proportion of people lucky enough to reach the AARP eligibility age (50), let alone reach the earliest eligibility age for Social Security benefits (62). Maximizing life expectancy at birth means maximizing the lifespan potential of the greatest number of people, which is a fair public health victory for the greatest good for the greatest number.

Therefore, an inexpensive and effective way to increase life expectancy in the United States does not involve high-tech approaches to regenerating our cells and organs. Even if this technology succeeded beyond flies and worms, and spread from the rich to the masses, the net effect on life expectancy would be small. Even curing cancer – a difficult, if not impossible, task – would only increase life expectancy by two to three years, because most deaths occur very late in life.

A reasonable priority should be to reduce causes of death that may have little to do with aging but nevertheless have a considerable impact on life expectancy. The United States lags behind other high-income countries like Sweden or Japan by more than four years, although it leads the pack in health care spending. We are ranked an embarrassing 49th on the world stage. Reducing gun-related deaths and drug overdoses alone would add about two years in prison for men and nearly a year for women. Eliminating maternal mortality would add more than six months to the life expectancy of women worldwide.

It is estimated that even adding an hour of walking per day would increase life expectancy by at least five years. Physical activity is the best anti-aging remedy we have, a versatile longevity extender, but it’s not available in pill form.

Focusing on life expectancy will also help reduce inequalities in lifespan. Global inequalities in lifespan have declined over the past century, but a recent report from the World Health Organization leaves little room for celebration. It shows a gap of more than three decades in terms of average number of years of life between people belonging to the richest and poorest countries. If you were born in Norway, you can expect to live 83 years; in Chad, 52 years old. Worldwide, millions of people still die before reaching old age.

Globally, life expectancy could be extended at lower cost. Insecticide-treated anti-malaria bed nets cost just a few dollars, but eliminating malaria could increase life expectancy in endemic areas by six years. Even basic preventative care, like vaccines and routine screening, could increase life expectancy by about three years. Increased schooling early in life also makes a huge difference. Each additional year of schooling reduces adult mortality by 2%, a level comparable to changes in diet, physical activity and smoking cessation. The effect is dose dependent, meaning greater schooling and even lower mortality. The increase in life expectancy applies everywhere, not just in countries where higher education opportunities are more limited.

You may be wondering: why can’t we work both to improve life expectancy And cure this universally felt harmful “disease” we call aging?

Because if the last half century is anything to go by, any extra years of life we ​​gain in late adulthood will likely be spent in poor health and good health. Pew polls suggest that a majority of Americans fear unhealthy aging more than death itself. Most want the time spent in frailty at the end of our lives to be brief, but the gap between a total expected lifespan and a healthy life is more than 12 years in the United States. This is currently the largest gap observed in any country, well before the recent pandemic. It’s no wonder that the majority of Americans believe the ideal lifespan is 90 years or less.

But it will not be possible to narrow this gap with next-generation cures or technologies. Much of this is due to the chronic diseases of aging, which are best delayed and managed through old-fashioned prevention and the usual hard-to-swallow mottos: eat healthier, move more, smoke and drink less, and put friends and family first.

There is still plenty of room for a longevity economy to thrive, but perhaps it would be more focused on improving the quality, rather than the quantity, of life in our later years. We need new approaches to address growing care needs, social isolation and loneliness. Smart canes, robotic feeding systems, fall prevention devices, exo-skeletons and AI-powered smart homes, emerging technologies could soon reduce the need for costly care and help older adults stay in their homes longer. Digital platforms integrating real-time vital signs monitoring from wearable technologies could contribute to prevention efforts through early detection. Treatment plans could be made more effective with improvements in high-tech data analysis.

Loneliness and isolation can be more difficult problems to resolve. However, if technology reduces caregiver workload, then family caregivers would be freer to focus on quality time together. Other approaches include immersive virtual reality hangouts, online peer networks, and virtual hobby groups to foster belonging and shared interests. Robotic companions like ElliQ may seem far-fetched, but pilot studies show they are valued companions that significantly improve well-being. Animatronic animals offer affection without the mess.

Deeper solutions of course require broader structural changes in our communities. For example, innovative and affordable housing options can promote multigenerational cohabitation. University student-senior co-residency programs do the same, but remain rare. These types of fixes do not require new technology, but will require greater buy-in, driven by consumer demand.

We need to stop treating aging and longevity as niche concerns reserved for fitness enthusiasts and the wealthy. Aging is a universal human experience, and disparities in how we age mirror broader social inequities. By reducing mortality in early life and middle adulthood, closing the gap between lifespan and lifespan, and focusing on adding life to years and not just years, we could become the long-lived nation we should be.

Michael D. Gurven is Distinguished Professor of Anthropology at the University of California, Santa Barbara and author of “Seven decades: how we evolved to live longer» (Princeton University Press).