By Judith Davey
I had heard the phrase “longevity dividend” in the literature, and recently thought I should find out precisely what it meant and if it was a useful concept in the study of ageing.
The phrase was coined by Jay Olshansky and colleagues in 2006 to describe “the economic and health benefits that would accrue to individuals and societies if we extend healthy life by slowing the biological processes of aging…… shifting our emphasis from disease management to delayed aging.” [1]
This idea was first raised among medical/biology professionals and a book “Extending the Human Life Span: Social Policy and Social Ethics”, was published by Bernice Neugarten and colleagues in 1977. This asked several questions –
- Should the science of biogerontology be devoted to improving older people’s quality of life? Or should it extend the lifespan of the human species?
- If lifespan is extended, what would be its deleterious and beneficial effects on society?
- What social and ethical implications would follow from a “magic elixir” that would extend active life expectancy?
Certainly, lifespans have been extended by decades, but, at the same time demographic trends – larger numbers of very old people – have led to rapid increases in chronic and disabling diseases – cancer, heart disease, stroke, dementia, arthritis, sensory impairments – and, as a result, an increase in the number and proportion of very old people requiring intensive care. Could life be extended, without extending health?
Changing the Medical Model
The current medical model approaches chronic degenerative diseases one at a time, as they arise. This is on the assumption that all diseases are independent of each other—with their own origins and causes. But many risk factors – such as poor nutrition, poverty, behavioural factors and environmental pollution relate to more than one condition. And even if we make progress against specific diseases, the biological processes of aging continue.
The Longevity Dividend can be seen as an approach to public health based on a strategy of fostering health for all generations through health promotion and disease prevention. It seeks to prevent or delay the root causes of disease and disability by attacking the one main risk factor for them all—biological ageing.
All living things have biochemical mechanisms which influence how quickly they age, and it is possible to adjust these mechanisms —by dietary intervention or genetic alteration—to extend life span and postpone ageing-related diseases (I can go into this aspect later). Slowing down the processes of ageing—even by a moderate amount—could bring dramatic improvements in health for current and future generations, allowing them to live healthier and longer lives.
Multimorbidity, where people are suffering from several degenerative diseases at the same time is characteristic of very old age. But it is associated with a high treatment burden, reduced quality of life and greater health service use. Co-ordination can be easily lost, leading to fragmented care and we need to know more of the best way to manage groups of diagnoses. Improving the well-being of older people through better management of complex multi-morbidity would be a way of realising this aspect of the longevity dividend.
Could longevity have economic benefits?[2]
While we can celebrate longer life in social terms, an increase in the older population is often framed as economic burden. As populations age, governments worry about an increasing stress on pension systems and the social care sector, especially with fewer younger people supporting growing numbers of retirees. Ageing has also been framed as a problem for employers, having to cope with less physically capable and less adaptable older workers.
But analysis of international data, published by the International Longevity Centre, suggests that. as life expectancy increases, so does “output per worker, per hour worked, and per capita” in other words, economic productivity. I have previously written about how older workers are and could be valued for their skills and experience and ability to mentor younger people. Many older people are also contributing to social welfare by taking on caring roles such as looking after grandchildren and elderly parents. In these ways they are contributing in economic terms.
The longevity dividend, like most economic benefits, is attainable, but needs to be worked for. Mobilising older workers’ skills, expanding labour forces and fostering intergenerational solidarity will mean that rising life expectancy can be both socially and economically good.
[1] S. Jay Olshansky, is from the School of Public Health, Division of Epidemiology and Biostatistics at the University of Illinois, Chicago. He wrote about the Longevity Dividend in the March/April 2013 issue of Aging Today.
[2] https://theconversation.com/the-longevity-dividend-how-ageing-populations-could-boost-economic-productivity-102056
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