Healthier Aging will Inject Trillions into the Economy
Although life expectancy continues on an upward trajectory, the proportion of years lived in good health has not wavered. The drawback to this is that people live more years in poor health. What’s more, causes of mortality have been trending away from infectious diseases to non-communicable ones — those that do not transmit from person to person like Alzheimer’s, cancer, and heart disease.
So, what’s the best way to approach the problem of improving the number of years people live in good health by targeting individual non-communicable diseases, aging, or longevity? What’s the economic cost or benefit of doing so for society and individuals?
A new analysis shows that increasing the proportion of healthy years lived by targeting aging instead of individual diseases offers the most significant economic impact. Improving how we age by expanding the years we live in good health, even by one year at the population level, has significant value — on the order of tens of trillions of dollars.
Calculating the Economic Value of Targeting Aging
The researchers analyzed existing data to evaluate the economic value of increases in life expectancy, improvements in health, and treatments that target aging. Specifically, the experts used the value of statistical life (VSL) methodology to place a monetary value on the gains from more extended life, better health, and changes in the rate at which we age.
VSL models have two distinct advantages. First, government agencies use VSL models to evaluate different policy measures and treatments, for example. Second, the researchers can calculate the current gains from targeting aging and how these gains will evolve in response to future health and life expectancy changes.
In the model, individuals make choices about consumption, hours worked, and leisure based on wage rates, interest rates, retirement age, and knowledge of remaining life expectancy and likely future health. Changes in health or longevity lead to changes in these economic decisions, enabling the researchers to estimate an individual’s willingness to pay (WTP) for these improvements. WTP is measured in US dollars and reflects the increase in VSL induced by improvements in health and longevity.
X-men and Gulliver’s Travels: Aging Fairytales and Fantasies
To test the model, the researchers used four extreme aging cases conjured by literary minds: life extension, compressing morbidity, slowing aging, and reversing aging. They first focused on improving life extension, which, with reference to Gulliver’s Travels, the authors refer to the Struldbrugg case. Struldbruggs, both male and female, are born immortal but age typically, so they live in continuously worsening health.
Next, they have life extension fixed but improve the relationship between health and age. Under this scenario, referred to as the Dorian Gray case, healthy life expectancy rises as a proportion of life expectancy to create a ‘compression of morbidity.’ In the eponymous novel, Dorian Gray has a portrait painted, and while the picture ages, Gray himself does not, retaining his health and looks until he dies.
They also considered the WTP for slowing aging itself, leading to simultaneous improvements in health and mortality. They assumed aging occurs through the accumulation of biological damage and that slowing aging lessens the pace at which health and mortality deteriorate with age. In the extreme case, where aging is not just slowed but eliminated, mortality and health become independent of age. The individual is ‘forever young’ — or the ‘Peter Pan’ case, after the play and novel about a boy who never grows old.
A hypothetical alternative to the Peter Pan scenario is a reversal of aging, in which biological damage is repaired rather than slowed. For a literary reference, they turned to the Marvel character Wolverine and his daughter X-23, who both possess a healing factor enabling body tissue to be regenerated. Recent advances have shown that such regeneration is possible in mice and humans.
The Economic Value of Targeting Aging
So, what did these cases, based on fantasies and fairy tales, teach the experts? This analysis shows that the economic value of gains from targeting aging is considerable because delaying aging produces complementarities between health and longevity. Delaying aging also affects many diseases due to the rising prevalence of age-related comorbidities and creates synergies arising from competing risks.
Crucially, delaying aging leads to a virtuous circle in which slowing aging begets demand for further slowing in aging. This virtuous circle arises because society’s gains from delaying aging rise with the average age of society, increase with the quality of life in old age, and depend on the number of older people. This cycle provides a distinctive dynamic to targeting aging compared to treatments aimed at specific diseases, in which gains diminish once successful therapies are discovered.
“We show that a compression of morbidity that improves health is more valuable than further increases in life expectancy and that targeting aging offers potentially larger economic gains than eradicating individual diseases,” said the experts in their article published in Nature Aging. “We show that a slowdown in aging that increases life expectancy by 1 year is worth $38 trillion (USD), and by 10 years, $367 trillion. Ultimately, the more progress that is made in improving how we age, the greater the value of further improvements.”
Scott, A.J., Ellison, M. et al. The economic value of targeting aging. Nat Aging (2021). https://doi.org/10.1038/s43587-021-00080-0