What is health span? How to extend your years of good health, not just your lifespan

Much attention has been paid in recent years to life expectancy, particularly in the United States, where it remains lower than in many other industrialised nations that spend less on healthcare. But with data suggesting 79 per cent of American adults aged 60 and older have two or more chronic illnesses – such as diabetes, heart disease and high blood pressure – and more than half of young adults reporting at least one chronic condition, health experts are turning their focus to not only how long people manage to stay alive, but also the number of years they can expect to do so free of disease. That is called a health span. And, like US lifespans, these too have been shrinking. “Health span means living better, not just longer,” says Dr Corey Rovzar, a postdoctoral fellow at the Stanford Prevention Research Centre in the California-based university’s School of Medicine. “We’re talking about those years that are free from any significant chronic disease or any significant disability that might affect one’s quality of life,” she says. Life expectancy has rebounded closer to levels before the Covid-19 pandemic. According to the US National Centre for Health Statistics, in 2023, the average number of years a newborn in the US could expect to live was 78.4, down from 78.8 for babies born a decade earlier. In Hong Kong in 2023, the expectancy of life at birth for men was 83 years, and for women, 88. Meanwhile, according to the World Health Organization, the average health span for adults in the US dropped from 65.3 years in 2000 to 63.9 years in 2021, the latest year for which such data is available. Women are expected to live longer than men and enjoy more years of better health. Like lifespans, health spans aren’t calculated for individuals but for “an average person in the population”, says Dr Norrina Allen, vice-chairman for research in the department of preventive medicine and director of the Institute for Public Health and Medicine in the Centre for Epidemiology and Population Health, at Northwestern University Feinberg School of Medicine in Chicago. The good news is that the steps needed to extend a person’s health span are likely to extend their lifespan as well, she says. “The factors that help prevent the onset of disease are also highly related to preventing your death from those diseases,” Allen says. And there is a lot people can do to stretch out those good years. People approach lifestyle changes as all or nothing, but we need to shift that mentality to recognising that every little bit counts. Dr Corey Rovzar, Stanford Prevention Research Centre Allen co-authored a 2022 report from the American Heart Association (AHA) that detailed a checklist of eight health factors and lifestyle behaviours, known as Life’s Essential 8, for improving and maintaining good cardiovascular health. Adherence to these has been shown to lower the risk for other chronic illnesses, promote healthy ageing, and contribute to both longer lifespans and health spans. The checklist includes not smoking, staying physically active, getting enough sleep and following a healthy eating pattern that includes whole foods and emphasises consumption of fruit and vegetables, lean proteins, nuts and seeds and cooking with olive oil. The checklist also calls for achieving and maintaining a healthy weight and controlling cholesterol, blood pressure and blood glucose levels. Limiting alcohol consumption is also advised by the AHA because drinking too much can increase the risk for high blood pressure, breast cancer, liver disease, stroke, heart disease and other health problems. Beyond health factors and behaviours, strong family support, good mental health, access to good healthcare and a strong social network also contribute to a longer health span, Allen says. “These additional factors lay the groundwork for maintaining good health behaviours and ideal clinical factors,” she says. But trying to achieve all of them may feel daunting, especially for people not currently following healthy lifestyles, Rovzar says. She suggests making small changes to get started and gradually building new habits, one step at a time. “Think intentionally about what you can do today,” she says. “Add greens to your meal. Walk a little bit longer. Those things add up. People approach lifestyle changes as all or nothing, but we need to shift that mentality to recognising that every little bit counts.” A 2022 study in Nature Medicine suggests even short bursts of physical activity – just a few bursts per day lasting a minute or two – may lower cancer- and cardiovascular-related death risks. For substantial health benefits, the US federal physical activity guidelines recommend getting at least 150 minutes of moderately intense physical activity per week, along with muscle-strengthening activities twice a week. Adults who are physically unable to meet the recommendations because of chronic conditions or disabilities should be as physically active as possible, the guidelines say. Find things that you enjoy doing. Don’t try to become a runner if you don’t like running. Dr Corey Rovzar Rovzar encourages people to start building good habits early in life so they become easier to maintain over the life course. And, she says, remember that a healthy lifestyle “looks different for everyone”. “Find things that you enjoy doing. Don’t try to become a runner if you don’t like running. Chances are not high you’re going to do it if you don’t enjoy it.” Like what you read? Follow SCMP Lifestyle on Facebook, X and Instagram. You can also sign up for our eNewsletter here.

What is health span? How to extend your years of good health, not just your lifespan

‘Living better, not just longer’ is a definition of health span. But how to achieve it? By adopting a healthy lifestyle while you’re young