Living life well: Healthspan vs. lifespan
Living life well: Healthspan vs. lifespan
Joy Stepinski, MSN, RN-BC
June 2, 2023
On the Joy in Whole Health Facebook page, I shared an article titled “Healthspan may be more integral to your well-being than lifespan” [1]. The authors explained that while lifespan refers to the total number of years lived, healthspan encompasses the number of years lived without a debilitating disease.
Over the twentieth century, there was a large focus on increasing life expectancy. In 1900, the average life expectancy in the United States was 47.3 years, which dramatically increased over the century to 78.7 years in 2010 [2]. Infectious diseases almost disappeared, while chronic illnesses dominated the causes of death. However, the recent decades have concentrated on healthspan.
While I disagree with the author that the solutions to improving a healthy life should focus on studying the aging process, she does make some valid points that health can be improved without scientific discovery. Aging is a natural process. In fact, birth and death are two certain events that happens to every single person. However, we have the ability to age well. We have the ability to intentionally make choices in our life about how we eat, the frequency of our mobility, our social connections, and how we handle stress.
In his book Less Medicine More Health, author Dr. H. Gilbert Welch discusses that one assumption driving too much medical care is that life is all about avoiding death [3]. He states that most Americans surveyed would likely choose to die in their own homes, surrounded by loved ones, and without medical equipment or frantic healthcare professionals. Yet the majority of Americans actually die in the hospital setting.
American healthcare is certainly focused on “saving lives,” a common mantra. Patients may want to try everything possible for their families or to please their healthcare provider. Families may assume that the patient wants patient wants everything possible, or that they may fail their loved one if they do not choose everything available to lengthen life. This can be such an emotional and heart-wrenching time when faced with these types of decisions. Perhaps this sounds familiar to you.
Three questions presented by the book are worth considering.
1. Is extending life always a desirable goal?
2. Is extending life always an achievable goal?
3. Is extending life the only goal?
If you reside in a long-term care facility and cannot recognize anyone, would extending life be an important goal? If widespread prevention measures lead to overdiagnosis and extreme fear, do they make sense for everyone? What if life is tried so hard to be extended, but ends up being shortened? How far do we go? The author writes that a fixation on death can deeply diminish life.
I think these questions can help to realize that life is not so black and white. Each of these questions will likely be answered differently by everyone reading this. Personal goals and values are profoundly important.
Yet, quality of life is worth considering. In the original article I posted, the author cautions that pursing longevity may come at the cost of quality of life. “Solely focusing on lifespan can have a damaging effect, impacting people’s well-being as they age” [1]. Fixating on lifespan can be overshadowed by meaningful experiences and relationships that help provide for a life worth living.
Although genetics play a role in some diseases, the consideration of modifiable risk factors is an important aspect of health. Aging well to reduce the risk of chronic health conditions includes being intentional about holistic daily lifestyle practices, including physical health, mental health, feeling joy and connection, and reducing stress. One aspect is not more important than the other. Eating well is equally significant as connecting with others.
The article provides some suggestions on how healthspan can be prioritized.
1. Have a goal. Changing habits to engage in more healthy behaviors may help with a future aspiration in mind.
2. Eat well. The Blue Zones, where the longest-living people on earth are found, eat primarily a plant-based diet and limited animal protein [4].
3. Get outside and move around.
4. Engage in healthy ways to manage stress.
5. Maintain strong social connections and have people to count on to reduce loneliness.
The article concludes by stating that “it is important to remember that aging is a normal and natural process that should be embraced rather than feared or avoided” [1]. In his book, Welch shares the same sentiment [3]. He writes that people have been taught to fear death, and even view it as a failure. Society may suggest that there is just one right way to approach to life and death. However, health is a balance. Focusing on aging well, making intentional choices, and embracing life may very well be the key to healthspan.
References:
1. Mikhail, A. (2023). Healthspan may be more integral to your well-being than lifespan. Here’s how to lengthen it. Fortune. https://fortune.com/well/2023/04/15/healthspan-may-be-more-integral-to-your-well-being-than-lifespan-how-to-lengthen-it/?fbclid=IwAR1opnTZ-sC4xd2jhuj9f32TRs0dFv5A9lc_vexHQAdyKqY65bnyGTfvW4M
2. Crimmins, E. (2015). Lifespan and healthspan: Past, present, and promise. The Gerontologist, 55(6), 901 – 911. https://doi.org/10.1093/geront/gnv130
3. Welch, G. H. (2015). Less medicine more health: 7 assumptions that drive too much medical care. Beacon Press.
4. Buettner, D., & Skemp, S. (2016). Blue zones: Lessons from the world’s longest lived. American Journal of Lifestyle Medicine, 10(5), 318-321. https://doi.org/10.1177/1559827616637066