America faces a growing lifespan-healthspan gap

December 30, 2024

Summary: Americans suffer more years of high disease burden at the end of their lives than residents of other similar countries.

Source: Garmany, JAMA Network Open December 11, 2024 for years burdened by disease; United Nations data via Worldometer for total life expectancy

Life expectancy has not been rising as rapidly in the U.S. as in other developed countries, and new research from the World Health Organization published in JAMA Network Open shows that the gap between life expectancy and healthy years of life is growing, and is now the highest in the world. The healthspan-lifespan gap is 29% higher in the U.S. than the global mean, and the U.S. has the largest number of years lived with disability.

Gaps between life expectancy and years of health are larger in developed countries, because many in developing countries do not live long enough to get debilitating diseases of age like dementia. But the U.S. lags other developed countries in both life expectancy and healthspan.

The researchers point to mental health, substance use, and musculoskeletal disease as the major causes of increased years of illness in the U.S. Decreasing obesity can decrease the lifespan-healthspan gap by decreasing musculoskeletal symptoms as well as complications of metabolic diseases including heart disease, diabetes and kidney disease. Regular exercise can increase the number of healthy life years, too.

Implications for employers:

- Employers can offer good coverage for mental health and substance use disorder and be sure that their carrier’s network is adequate.

- Employers can minimize cost share or increase access to conservative musculoskeletal treatment interventions, like exercise, physical therapy, and chiropractic services.

- Many of the years of quality life that can be gained are during working years, which can lead to lower medical costs and better productivity.

- Employers can encourage regular exercise and healthy diets, as well.

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Tomorrow: Lower BMIs can mean lower medical costs, but GLP-1s are still not likely to be cost saving at current prices