Today, the average American can expect to live well past the age of retirement and into their late 70s, and early 80s if you are a woman. This number in itself is a tremendous achievement of modern medicine and technology. At the time of America’s founding in 1776, the average newly-minted American citizen could expect to live to the ripe old age of 35, giving them a few months to run for the presidency before they keeled over. And while Americans’ lifespans have been steadily increasing, just over 100 years ago, in the early 1900s, life expectancy was still rather modest at 47 years.
Today’s life expectancy across 50 US states ranges between 81.3 years for the lucky Hawaiians and 74.7 years for not-so-lucky West Virginians – the discrepancy being attributed to wide differences in the burden of diseases as well as risk factors, such as drug and alcohol use, high body mass index and poor diet.
On a global level, the US and even its top-performing states in terms of life expectancy are lagging behind other developed countries with respect to this parameter – Japan is currently in the lead at 84.1 years, closely followed by Switzerland (83.7 years) and Spain (83.4 years).
While we strive to have a long life, we all know that the gap of time between our birth and date of death engraved on our tombstone is not alone a measurement for a good life – what truly matters is a healthy life expectancy, defined as how long a person can enjoy a healthy, disability and disease-free life.
“Scientific research on life extension is certainly worthwhile. But it’s not central, in my view,” says Paul Irving, chairman of the Milken Institute Center for the Future of Aging and distinguished scholar in residence at the University of Southern California Davis School of Gerontology. “Our priority should be to extend health span— to compress mortality and morbidity—ensuring that people at all levels of wealth and education can enjoy not just longer lives, but healthier, happier, and more productive lives.”
Research shows that the average American can expect to live just 67.7 healthy years. In the decades we imagined filled with travel, new hobbies, and newfound time, Americans instead find themselves spending their golden years and resources playing whack-a-mole with the various diseases of old age, popping prescriptions for their growing number of ailments and relying heavily on family members to tend to their daily needs. This is not how we want to live, nor how we want to die.
Funds must be re-prioritized to help advance breakthrough science that helps answer fundamental questions about why we age.
If we want to live both a good and long life, America must begin focusing on a more important measurement than lifespan alone – our health-adjusted life expectancy or “HALE”. When measured against comparable countries, the US is not doing well in this category. Out of the 10 countries – and the European Union – ranked in an over 300 page report compiled by Aging Analytics Agency, the US came in dead last, behind China.
Ironically, while America comes in last in HALE, the US has the highest per capita health care spending among developed countries at $9,892. Moreover, the US’s health expenditures are projected to grow at an average annual rate of 5.5% during 2018–27 and represent 19.4% of gross domestic product in 2027. However, despite the projected increase in its health care spending, the US is expected to take a further plunge in life expectancy rankings by 2040 – from 43rd place to 64th – the largest decrease for a country defined as “high income.” China’s global ranking is expected to rise from 68th to 39th place.
By 2030, when all Baby Boomers reach retirement age, seniors will outnumber children for the first time in US history and 1 in 5 residents will be of retirement age.
The consequences of continuing our current approach to aging are morbid, both literally and figuratively. By 2030, when all Baby Boomers reach retirement age, seniors will outnumber children for the first time in US history and 1 in 5 residents will be of retirement age. It is projected that by the year 2050 the US will be home to 83.7 million individuals over the age of 65, almost double from 43.1 million in 2012. This demographic shift brings an additional strain on our healthcare system, with Medicare headed for insolvency by 2026, and Social Security by 2035. The economic burden of an aged and sick population of this size will be tremendous.
So what actions must America take to improve our HALE and avoid the economic tidal wave of the so-called “Silver Tsunami”? We must start by treating the root cause of the ailments of old age – aging itself. Eight out of the ten leading causes of death in the US today are diseases of the aged body or are more deadly for elderly individuals.
“The number one threat to our health and our healthcare system is aging, and it is certainly in our collective interest to understand and mitigate this threat,” says Eric Verdin, CEO and President at the Buck Institute for Research and Aging. “Research investigating the fundamental causes of aging are at a tipping point. We must accelerate that effort and make it a leading priority. The long term dividend from doing so could prove to be extraordinary.
America has the opportunity to get ahead of the international crowd if scientists and federal regulators come together to determine agreed “end points” …
Seniors go from ridding themselves of one disease, just to develop another. Decades of research have helped improve care, but these debilitating age-related diseases still find us all one way or another. Even curing cancer, it is predicted, would only extend our lifespan by three years.
As Dr. David Sinclair of Harvard Medical School put it, “Aging is a risk factor for all [age-related diseases]. In fact, it’s the risk factor. Truly, by comparison, little else matters.”
But there is hope – scientists, entrepreneurs and researchers are working on treatments that address what have been identified as the hallmarks of aging with the aim of preventing, slowing or even reversing the development of age-related diseases.
However, America’s current regulatory framework and research grant system is, in many cases, creating substantial roadblocks preventing potential and future treatments from reaching the public. For starters, similar to other regulators across the globe, the Food and Drug Administration (FDA) does not recognize aging as a disease. Without this classification, treatments developed to specifically target aging are unable to move through the regulatory body. Regardless of whether the FDA decides to classify aging as a disease, America has the opportunity to get ahead of the international crowd if scientists and federal regulators come together to determine agreed “end points” that will allow aging drugs to move through clinical trials, and if safe and effective, through the FDA.
… countries facing the oncoming Silver Tsunami have taken proactive measures to prepare their economy and communities for the wave.
While funds given to the National Institute on Aging (NIA) have tripled since 2013, very little of these funds actually go to scientists researching the biology of aging. Funds must be re-prioritized to help advance breakthrough science that helps answer fundamental questions about why we age.
Despite the tremendous market potential of the aging industry, the inadequate regulatory and institutional support from the federal government, as well as longstanding taboos associated with the aging field, have made some financiers hesitant to invest in research or startups, which in turn discourages scientists and entrepreneurs from entering the aging field.
As noted by Aging Analytics, other countries facing the oncoming Silver Tsunami have taken proactive measures to prepare their economy and communities for the wave, ranging from Japan’s plan for an Ageless Society, to Singapore’s initiatives focused on smart-homes for seniors, to Seoul’s “2020 Master Plan for the Aged Society,” to programs for a preventive medicine approaches to aging, such as the UK’s genomic medicine service and even to financial innovations such as St. Gallen’s (Switzerland) elderly bank where retired volunteers “deposit” hours worked looking after elderly people (and in return can use any “deposited” time for the own care provision later in life). Further, there are global initiatives aimed at the biology of ageing itself, such as the Netherlands’ Deltaplan for Dementia and Switzerland’s Masterplan for the Promotion of Biomedical Research as well as BIRAX Ageing, the joint UK-Israeli geroscience research initiative. Aging Analytics projected that the UK stands best equipped to face the Age Wave due, in part, to launching its Ageing Population Industrial Strategy Grand Challenge as well as the establishment of the All-Party Parliamentary Group for Longevity in 2019.
The UK has also been a leader in the application of Artificial Intelligence (AI) for preventive medicine. As a major international player in the AI industry and with a substantial AI federal support system already in place, this is an area where the US is well-positioned to move to the front of the pack and pioneer new, cutting-edge treatments. But to make this leap, the US must prioritize its efforts and resources committed to applying AI in healthcare toward preventative treatments that will not just treat disease, but slow or halt the development of diseases in the first place.
America is currently losing the race toward healthy longevity. Even as the world superpower, the current path will leave the American people weak and the economy increasingly fragile. Without adapting policies amenable to increasing Americans’ health-adjusted life expectancy, the US is doomed to be submerged in the impending Silver Tsunami, while foreign competitors learn how to swim.
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