From one of the earliest recognized literary works, The Epic of Gilgamesh, which tells of a legendary search for immortality, to today’s media obsession with young blood-infusing biohackers, the idea of defeating aging has long held our attention. Missing rather obviously from this story, though, is an economic angle: the financial cost and value of slowing aging.
In a recent paper coauthored with economist Martin Ellison of Oxford University and biologist David Sinclair of Harvard Medical School, I estimated that an intervention that truly slows biological aging—cutting mortality and frailty at every age, so that U.S. life expectancy rises by only one year—is worth $37 trillion in net present value. That comes to about $700 billion a year, more than 3 percent of the nation’s total GDP.
These numbers are not forecasts of what will happen to income levels; instead, the analysis captures what these health gains are worth to us in dollar terms, also called our “willingness to pay.” Our estimate rests on two main components: the amount of life one has, or life expectancy, and the quality of that life, as shown by our health and standard of living. Although these economic calculations show the huge value of living longer, they also make clear that our long-standing fixation with immortality is off target. We should redirect our focus from simply extending lifespan (more time) to healthspan (years lived in good health).
Why “healthspan” matters more than lifespan
In the past, when the majority of people didn’t reach old age, health priorities and medical research focused on improving earlier years. In contrast, pre-COVID an estimated 71 percent of deaths globally were due to non-communicable diseases whose incidence correlates strongly with age, such as dementia, cardiovascular illness, cancer, and diabetes. This has created a new health imperative: not just to live longer, but to age “well” by slowing biological aging and thus reducing the frequency of age-related diseases.
My research suggests this goal is worth a vast sum, both for individuals and for society: A hypothetical intervention that added just one year to life expectancy at birth is worth $118,000 to the average American—but an additional year of healthy life expectancy is worth $242,000. Longer life is valuable, but the most valuable aim of all is to make healthspan keep pace with lifespan. This effort will have major effects across many industries, well beyond pharmaceuticals and healthcare.
While the sheer dollar value of improving how we age is striking—a collective $37 trillion for an increase in life expectancy of one year; $367 trillion for a 10-year increase—the economic mechanisms behind these figures reveal a number of insights.
That massive economic upshot derived from such a relatively modest improvement is a result of two factors. The first is how much we value health over wealth. That disparity has been magnified by Covid-19, when virus-curbing government policies and shifts in individual behavior produced a decline of 3.4 percent in U.S. GDP between 2019 and 2020.
The second factor behind this large estimated value is our progress to date in increasing life expectancy. Never before have we had a higher chance of growing old: A child born in high-income countries today is estimated to have a 50 percent chance of living into his or her 90s. In the U.S., the number of people aged 85 and older is set to rise from 6.7 million in 2020 to 19 million by 2060, and those aged 65 and older will increase from 56 million to 95 million. If the majority of people are likely to live into old age, then the value of aging well is enormous.
Our aging society has led many to speculate about an emerging “silver economy” designed to serve seniors’ needs. Yet while consumers may be willing to spend on services in later life, our research shows they are willing to spend even more on aging well throughout their lives, before they turn 65. We think this will give rise to an “evergreen” economy, one that spans a far broader population.
The economic case for aging R&D
From an economic standpoint, treatments that successfully postpone aging have two advantages over therapies aimed at single, specific diseases. The first is straightforward aggregation: When age is a major factor in so many illnesses, slowing biological aging can also slow the development of multiple diseases, creating cumulative gains.
The second benefit of targeting aging instead of single diseases is that it can create important health synergies. For instance, eliminating cancer would be an extraordinary accomplishment, but the economic value of that achievement is limited by the fact that our later years would still face the threat of dementia and other diseases. If, instead, several diseases are delayed, overall quality of life rises. That makes targeting aging worth more—by our estimates, about two-thirds more—than the mere sum of its individual parts.
Keep in mind that these are economic arguments, not scientific ones. Scientific work on aging pathways includes using stem cells, clearing senescent cells, limiting DNA damage, preventing losses in protein maintenance, or extending the energy production of mitochondria. But despite real progress, many obstacles remain. Research and development spending is not driven only by the scale of possible economic returns; investment also depends on the chance of success. Some of the current barriers are scientific—the effort to move from lab experiments to proven medicines, from worms and mice to humans. There are also significant regulatory hurdles, since interventions must be demonstrated effective through biomarkers of aging rather than by waiting decades for treatment results. But although R&D on aging pathways is still at an early stage, our economic analysis suggests spending in this area will rise in the years ahead as more attention is given to extending our healthspan.
There is also a beneficial feedback loop tied to better aging. For most diseases, the better the treatment, the less valuable future research becomes—but aging is different. The healthier people age, the more they value additional gains in aging. Put another way, if your 80s are lived in poor health, then extending life into your 90s has little value. But if people are growing older without disease and age-related ailments, living longer becomes more appealing.
The ripple effect of the evergreen economy
This brings up an even bigger question: how will society pay for these longer lives and the interventions they require? Just as better health at younger ages lifted GDP in the past, the same emphasis should now shift to healthy longevity. If we want to avoid the harmful economic effects of an aging society, we need a three-dimensional longevity dividend. Lives must be made not only longer and healthier but also productive for longer. Consider the education sector. To support longer careers, especially amid technological change, we will need major investment in adult education. That will mean broadening higher education’s reach from people aged 20 to 24 years (6.7 percent of the U.S. population) to those aged 25 to 65 years (52 percent).
The financial sector will also feel the effects. Modern pensions were created in the 20th century, when life was organized into three phases: education, work, and retirement. But if age-slowing treatments succeed, longer careers will involve several stages and transitions. As a result, long-term wealth management will focus less on retirement and more on the danger of outliving one’s health, finances, skills, and relationships.
The life insurance industry can also tap the multibillion-dollar evergreen economy by linking health insurance and life insurance, and by offering payment for treatments. Connecting wealth and health is appealing for individuals, but it also raises firms’ profitability, since longer lives mean more premiums collected and a longer wait before policies are paid out.
But the reach of the evergreen economy will extend even further. The food and beverage sector will come under increasing regulatory scrutiny as healthy aging becomes more important. Big data and AI will underpin a major component of preventative health, expanding the health tech sector. The government will be tasked with launching large-scale public health programs in support of healthy longevity, just as they were in the fight against infant mortality and midlife diseases. The list goes on.
Looking at the value of aging through an economic lens makes clear, in concrete terms, why this subject is set to matter even more in the years ahead. It is not only breathless reports about mouse blood, or progress in the study of senescence, or enthusiasm for nutritional doctrines like caloric restriction. The push for a longer, more productive healthspan will not come solely from breakthrough biological treatments; how healthily we age is shaped by many decisions made over the course of our lives.
Society is starting to recognize this new imperative—to age well, not merely longer—and the changes that this will demand. As that recognition grows and we begin to tap the $37 trillion (and rising) value of slowing aging, the evergreen economy will reach a broad demographic across many sectors. No one, whatever industry they are in, can afford to overlook the implications.