We’re living in the age of the anti-aging gold rush. Biohackers are fasting and cold-plunging. They’re injecting themselves with peptides and tracking every heartbeat in the hopes of extending lifespan by months, if not years.
Silicon Valley’s fascination with “defeating death” is intense: Billions of dollars now flow into longevity tech, regenerative medicine, metformin cocktails, supplements, and comprehensive digital health platforms.
And for good reason. 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 a majority of countries reached around seven decades. This rise was achieved by crushing fatal infections and with major improvements in medicine.
Unfortunately, those gains are much smaller now in high-income countries. We’re no longer on the straight-arrow path of sustained longevity gains that optimists bet their colleagues we would stay on. If Moore’s law applies to life expectancy the way it does to electronics, then we’ll have to spend and innovate exponentially more to keep pace.
Our resources are limited, so instead of prioritizing the pushing of the longevity envelope further into triple-digit ages for the luckiest of us, we should invest in increasing our population’s overall life expectancy — that is, the average lifespan among all members in a population. Life expectancy’s calculation reflects those eldest elders, but also the proportion of folks lucky enough to just make it to the age of AARP eligibility (50 years), much less to the earliest age of Social Security benefit eligibility (62 years). Maximizing life expectancy at birth means maximizing lifespan potential for the many, a fair greatest-good-for-the-greatest-number public health win.
Therefore, a cheap and effective way to increase U.S. life expectancy doesn’t involve high-tech approaches to regenerate our cells and organs. Even if that tech was successful beyond flies and worms, and trickled down from the wealthy to the masses, the net effect on life expectancy would be low. Even curing cancer — a difficult, even impossible task — would increase life expectancy by only two to three years, because most deaths occur so late in life.
A sensible priority should be to reduce causes of death that may have little to do with aging, but still make a sizable impact on life expectancy. The U.S. trails behind other high-income countries like Sweden or Japan by more than four years, despite leading the pack in health care spending. We’re ranked an embarrassing No. 49 on the global stage. Slashing gun-related deaths and drug overdoses alone would add about two years for men and almost one year for women. Eliminating maternal mortality would add more than half a year to women’s life expectancy globally.
Even adding an hour of walking per day is estimated to increase life expectancy by at least five years. Physical activity is the best anti-aging remedy we have, an all-purpose longevity extender, but one that isn’t available in pill form.
Focusing on life expectancy will also help reduce inequality in lifespans. Global lifespan inequality has diminished over the past centurybut a recent report by the World Health Organization leaves little room for celebration. It shows a gap of over three decades in average number of years lived between those belonging to the richest and poorest countries. If you’re born in Norway, you can expect to live 83 years; in Chad, 52 years. Globally, millions still die before reaching old age.
At a global scale, life expectancy could be extended cheaply. Insecticide-treated malarial bed nets cost mere dollars, but eliminating malaria could increase life expectancy in endemic areas by a whopping six years. Even basic preventative care, like vaccines and routine screening, could increase life expectancy by about three years. More schooling early in life also makes a huge difference. Each additional year of schooling lowers adult mortality by 2%, a level on par with changes in diet, physical activity, and quitting smoking. The effect is dose-dependent, meaning more schooling, even lower mortality. The life expectancy boost applies everywhere, not just to countries where opportunities for higher education are more limited.
You might be thinking: Why can’t we work to both improve life expectancy and cure that nefarious universally experienced “disease” we call aging?
Because if the past half-century is any indication, any extra years of life we gain in late adulthood are likely to be spent unhealthy as healthy. Pew polls suggest that a majority of Americans fear unhealthy aging more than they do dying itself. Most want the time spent frail at the end of our lives to be brief, but the gap between an expected total lifespan and a healthy one is more than 12 years in the U.S. That’s currently the largest gap observed of any country, and it’s been this way since long before the recent pandemic. No wonder the majority of Americans think the ideal lifespan is at most 90 years.
But reducing that gap won’t happen with next-generation cures or technology. It’s largely 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 prioritize friends and family.
There’s still plenty of room for a longevity economy to boom, but one perhaps more focused on improving the quality, rather than the quantity, of life in our later years. We need new approaches to address growing caregiving needs, social isolation, and loneliness. From smart canes, robotic feeding systems, fall prevention devices, exo-skeletons, and AI-driven smart homes, emerging technologies may soon reduce the need for expensive care and help elders stay in their homes for longer. Digital platforms that integrate real-time vital sign monitoring from wearable tech could aid prevention efforts through early detection. Treatment plans could be made more effective by improvements in high-tech data analysis.
Loneliness and isolation may be tougher nuts to crack. However, if tech lessens 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 that they are valued buddies that considerably improve well-being. Animatronic pets offer affection with no mess.
Deeper fixes, of course, require broader structural changes to our communities. For example, innovative and affordable housing options can promote multigenerational co-living. University student-elder co-residence programs do the same but are still uncommon. These types of fixes don’t require new technologies but will need greater buy-in driven by consumer demand.
We need to stop treating aging and longevity as niche concerns for fitness devotees and the wealthy. Aging is a universal human experience, and the disparities in how we age are a mirror of broader social inequities. By reducing mortality in early life and middle adulthood, by closing the lifespan-healthspan gap, and by focusing on adding life to years and not just years to life, we could become the most longevous nation we ought to be.
Michael D. Gurven is distinguished professor of anthropology at the University of California-Santa Barbara and the author of “Seven Decades: How We Evolved to Live Longer” (Princeton University Press).
