How can you maximize your healthspan?

Americans have been paying close attention to life expectancy — and for good reason. Though we spend more on health care than many other industrialized nations, our average lifespan remains lower than in similar countries.

However, the conversation is shifting: It’s not just about how many years we get, but how many of those years are spent in good health. Consider that 79% of adults 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 report at least one chronic condition.

Health experts are shifting their focus from how long people manage to stay alive to the number of years they can expect to do so free from disease. That’s called healthspan. And, as with U.S. life expectancies, these too have been shrinking.

“Healthspan means living better, not just longer,” said Dr. Corey Rovzar, an instructor at the Stanford Prevention Research Center within the university’s School of Medicine in California. “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.”

While life expectancy in the U.S. has rebounded to near pre-pandemic levels — 78.4 years for babies born in 2023, just a slight dip from 78.8 a decade earlier — the average healthspan is moving in the opposite direction. According to the World Health Organization, the average American could expect 65.3 years of good health in 2000, but only 63.9 years by 2021. Women, on average, not only live longer than men but also enjoy more years of better health.

As with lifespans, healthspans aren’t calculated for individuals but for “an average person in the population,” said Dr. Norrina Allen, vice chair for research in the department of preventive medicine and director of the Institute for Public Health and Medicine in the Center for Epidemiology and Population Health, both at Northwestern University Feinberg School of Medicine in Chicago.

The good news is that the steps needed to extend a person’s healthspan are likely to also extend their lifespan, she said. “The factors that help prevent the onset of disease are also highly related to preventing your death from those diseases.”

And there’s a lot people can do to stretch out those good years.

Allen co-authored a 2022 report from the American Heart Association that detailed a checklist of eight health factors and lifestyle behaviors, known as Life’s Essential 8™, for improving and maintaining good cardiovascular health. Adherence to these same components has been shown to lower the risk for other chronic illnesses, promote healthy aging and contribute to both longer lifespans and healthspans.

The checklist includes:

• Not smoking
• Staying physically active
• Getting enough sleep
• Following a healthy eating pattern that includes whole foods and emphasizes fruits and vegetables, lean proteins, nuts, seeds and cooking with non-tropical oils such as olive and canola oil

The checklist also calls for reaching and maintaining a healthy weight and controlling cholesterol, blood pressure and blood glucose levels.

Limiting alcohol consumption is also advised 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 behaviors, strong family support, good mental health, access to good health care and a strong social network also contribute to a longer healthspan, Allen said. “These additional factors lay the groundwork for maintaining good health behaviors and ideal clinical factors,” she said.

But trying to achieve all of them may feel daunting, especially for people not currently following healthy lifestyles, Rovzar said. 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 said. “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 recognizing that every little bit counts.”