The next national health goal should focus on health span, not life span, Dave Chokshi, MD, a physician at Bellevue Hospital and a professor at the City University of New York, both based in New York City, wrote in an opinion piece published Sept. 28 in The New York Times.
Dr. Chokshi said when he talks to patients about their long-term health goals, they seldom want to live to be 100. Instead, they talk about aging with independence and dignity.
"Yet our national dialogue around aging doesn't reflect this basic reality about what people value in their lives," he wrote.
The average life span in the U.S. is 1.5 times higher than 100 years ago, but life expectancy has stagnated. The census projects that by 2034, more U.S. residents will be older than 65 than are younger than 18. More people are also struggling with chronic disease and illnesses at younger ages, but the current politics about who "does and does not deserve" health insurance have not risen to these challenges.
"A new health moon shot should not just be oriented around increasing life spans but should focus, too, on what's referred to as health span — the years people can expect to live in good health," Dr. Chokshi wrote. "In the United States, we do not rigorously measure and report health span as we do life expectancy. Best estimates indicate that the average American can expect to celebrate only a single birthday in good health after the traditional retirement age of 65."
Dr. Chokshi suggested a target health span of 75 years for the first "bold but common-sense national goal."
Measuring health span must go hand in hand with "re-engineering our health and social systems," he wrote. This includes doubling investment in primary care, which could improve patient-physician relationships, increase disease prevention and could make medical innovations more available. Mental and emotional health issues also need to be addressed.
A new narrative about healthy aging is also needed, Dr. Chokshi said.
"Older Americans already contribute to society through working, caring for grandchildren, volunteering and civic participation," he wrote. "Social infrastructure could be further adapted around older age as a latent natural resource, waiting for us to tap it in ways that build purpose and connection. Schools could host youth mentoring programs. Employers could create additional part-time or flexible work opportunities. Even smaller campaigns that combat ageist stereotypes, like reimagining birthday cards to ditch denigrating jokes in favor of celebratory pride, could change these narratives."