Lifespan versus Healthspan

Health is retirement’s biggest wild card – enabling retirees to lead active lives or constraining what they can do. In this adapted excerpt from What Retirees Want: A Holistic View of Life’s Third Age, by Ken Dychtwald, PhD, and Robert Morison (Wiley, 2020), we describe the importance of extending “healthspan” and the financial consequences of failing to do so.

When it comes to their health, what do Boomer retirees say they want? To take charge of their health because they don’t trust the system to take care of them. To prevent or manage their chronic conditions so they can live the active lifestyles they want. To avoid cognitive decline. And to stay healthy and look and feel their best without breaking the bank. Do they want to live to be 100 or more? It’s an intriguing prospect, but only 22% of Americans say yes. Among those already 65 and older, twice as many say no (35%) as yes (17%). The most common response, of course, is “it depends on quality of life.”

The real issue is not lifespan but healthspan – how long people live in “full health” without disabling illnesses or injuries. In ancient Greek mythology, Eos, the beautiful goddess of the dawn, falls deeply in love with the warrior Tithonus. Distraught over his mortality, she goes to Zeus to request a special favor: she wants to love Tithonus until the end of time and begs Zeus to grant her lover immortality. “Are you certain that is what you want for him?” Zeus challenges. “Yes,” Eos responds. But as she leaves Zeus’s chamber, she realizes in shock that she forgot to ask that Tithonus also remain eternally young and healthy. With each passing year, she looks on with horror as he grows older and sicker. His skin withers and becomes cancerous. His organs rot, and his brain grows feeble. As the decades pass, Tithonus’s aging body becomes increasingly frail, yet he cannot die. Ultimately, the once-proud warrior is reduced to a collection of pained, foul, and broken bones – but he continues to live forever.

Tithonus’s story is a fitting allegory for what is occurring in health care today. Until recently, most people died swiftly and relatively young of infectious diseases, accidents, or in childbirth. During the past century, however, health care breakthroughs have eliminated many, but not all, of those threats. Today, rather than worrying about dying too young, many people worry about living too long without sufficient quality of life. In the United States and most of the industrialized world, the difference between life expectancy, or lifespan, and healthy life expectancy, or healthspan, is almost 10 years. As we pursue opportunities for extending life, we also have to get much better at matching healthspan to lifespan. That requires progress against both the infectious and the often debilitating chronic conditions associated with aging, and progress toward the behaviors that protect our health and well-being.

The Health-Wealth Convergence

Retirees say the key ingredients for a happy retirement start with good health and financial security, with good health in the lead by a significant margin. But the two are closely related. Those with wealth can invest more in their health. And it’s harder to enjoy wealth – and all the activities it enables – if you’re in poor health. At the same time, unpredictable health care costs can quickly unravel financial preparations for retirement and deplete one’s wealth. As more people spend more years in retirement, they’ll need more care, and as health care costs continue their rise, health and wealth become more intricately intertwined.

Most Important Ingredients to a Happy Retirement

Even with many people postponing retirement in order to build their nest eggs or simply because they enjoy their work, nearly four in ten (39%) retirees globally and nearly three-fifths (58%) in the United States retired sooner than planned, and the number-one reason is due to their own ill health. Early retirement is for some a sign of financial success, but today it’s more often driven by health issues. That’s a double whammy: a shorter career means less in earnings and retirement savings to start retirement with, especially for people who haven’t saved enough and had hoped to plump up their nest egg by working longer. Then those savings must be tapped earlier than planned and health expenses may deplete them faster.

What catches many people off guard are the out-of-pocket health-related costs they’ll face throughout their retirement. The longer they or their partner live, the higher the accumulated cost. So it’s no wonder that health care costs, unpredictable and potentially high, are retirees’ greatest financial worry.6 And those financial concerns are a family affair. Spouses and partners naturally worry about each other’s health, and women, who are likely to live longer, often after having spent savings on the spouse’s care, are more worried than men about the long-term financial impact of health care expenses. One retiree expressed the concerns shared by many: “My husband and I have always tried to do the right things – save money, maximize our 401(k)s, even delay retirement a bit. But who knows how long we’ll live and what might happen to our health? Will that make us outlive our savings? It’s a scary thought.”

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What Retirees Want: A Holistic View of Life’s Third Age is available at Amazon, Barnes & Noble, Bookshop.org (which benefits independent bookstores) or direct from your?favorite book store.