The Healthspan Hierarchy
I don’t want to just live a long time. I want to be as healthy as possible which may result in me living for a long(er) time. That is the plan anyway. I think it is a good plan for any of us. If you agree, please join me in this conversation.
My wife only half agrees with me. The half she agrees with is the healthy part. She has never been a fan of living a long time. So, I am wondering if she will read only half of this conversation. However, she does buy into the whole “Healthspan” concept, so she may stick around for a while.
Healthspan, the part of a person’s life during which they generally live in good health, free from chronic disease and disabilities that may come with aging. How do we achieve this magnanimous goal? A topic that I have been researching for 4 years. (How fun do I sound?) And now, I would like to share a summary of the results of my “fun” research (details in the future).
I call this summary the Healthspan Hierachy for good reason. The term Hierarchy refers to a system of elements or levels that can be classified to relative importance. Kinda like Maslow, where we need to achieve the first level before moving to the next. My levels may be subject to opinion, but lets get to them.
Level 1-Foundational Health: Any longevity expert would tell us this is where we need to start. This includes the boring basics of sleep well, eat well, exercise and avoid unhealthy habits.
Level 2-Chronic conditions: In the United States, over 85% of people over the age of 65 live with at least one chronic health condition, and more than half manage two or more. Why is this not Level 1? In some cases it should be, but for most of us general good health will help with current conditions and help in avoiding more problems.
Level 3-Social Behavior: The former US Surgeon General Dr. Vivek Murthy has declared we have a loneliness epidemic that can lead to premature death at levels comparable to smoking 15 cigarettes a day. Yes friends, we need to get our friend game going. Call me, or call someone.
Level 4-Mental and Emotional Health: So much to jam into this level-stress management, attitude toward aging, optimism, living with purpose and more. All very much a part of our healthspan.
Level 5-Biomarker management: Yes, go to the doctor, get your annual physical, have the tests done to catch problems before they become a bigger problem. Enough said.
Level 6-Spirituality: My sister and many others would suggest this should be Level number 1. Given my Baptist background I will not argue and do wonder if my #6 placement may cause problems for me at the Pearly Gates someday. The fact is spirituality (scientifically) increases our well-being, often leading to a happier, longer life. Ask my sister, or the people living in the Blue Zones.
Level 7-Lifestyle hacks: This level is meant to capture all of the latest trends(hacks) that we read about that may make us healthy. Intermittent fasting, cold exposure, red light therapy, morning sun, belly breathing, walk barefoot. Have fun with this level. If they give you a healthy mindset, that is great, even if the science has not yet caught up.
Level 8-Supplements: Finally we are getting to where you wanted to be-magic pills. Yes, there are many supplements that can help us on our aging journey, and we will talk about them in future conversations. Please note what level of importance these are ranked, just sayin’.
Level 9-Gero-therapuetics: More magic pills, but this time you need a script. There are many molecules in various stages of research, and some hold big possibilities to slow and even reverse the effects of aging. Please review my blog from May 15, 2025 for some highlights.
Level 10-The future frontier: A number of therapies are being explored including cellular reprogramming, gene editing, and plasma therapy. Some may be available in 5-10 years.
So there you have it. A structured, science-based framework showing how to think about aging interventions. Much more detail to be covered in future conversations. Aging is inevitable. But the rate at which we age-the quality of our years-is increasingly within our control.
Healthspan-the goal isn’t just to live longer, but to live better for longer. Even my wife agrees with this plan.
Enjoy your day,
Just a little extra-
Todays conversation has been a little longer than normal so I will skip “ a little extra”.
Except to say this topic has so much more to cover, I do think you will be seeing details in the future.
Maybe the topic of my next book.
Thoughts?
References
Friedman, Harvey. May 30, 2017. Healthspan is More Important Than Lifespan.
Institute for Public Heath
Mikhail, Alexa. April 15, 2023. Healthspan May Be More Integral to Well-being Than Lifespan.
Fortune Well
Smith, Abby. Mayo Clinic Q&A: Lifespan vs Healthspan. Mayo Clinic
Williams, Buffy. May 2, 2025. Healthspan vs Lifespan. Well&Good
Summers, Juana. May 2, 2023. America Has a Loneliness Epidemic. NPR
Cole, Garry. Book- Are We Old Yet? A Casual Conversation About Aging
(Yes, I am quoting from my own book.)