Prof Andrew Scott touts the importance of compressing morbidity and aging well to realise multi-trillion dollar benefit of increasing life expectancy.

Earlier this year, we brought you the story of a new research paper that calculated the economic value of increasing US life expectancy by ten years to be a stunning $367 trillion. That paper, authored by professors Andrew Scott of London Business School, David Sinclair of Harvard Medical School, and Martin Ellison of the University of Oxford, was this month published in Nature Aging.

Longevity.Technology: When it comes to the economic impact of our aging society, the focus is so often on the negative. Factors such as the increasing cost of healthcare are quoted alongside terms like “silver tsunami”, evoking a sense that aging is driving countries to the brink of economic collapse. This paper instead focuses on the potential economic value that longevity can deliver, and we recently spoke to Professor Scott, co-author of best-selling book The 100-Year Life and co-founder of The Longevity Forum, to learn more.

Scott explains that the origins of the paper stem from the authors’ common desire to get policymakers to start taking longevity seriously.

“By and large, I don’t find that economic policymakers are interested in this topic of longevity – they think it’s a health issue, and they don’t think about the broader economic issues. So I’ve always thought about how to get the economic and financial community engaged in seeing it differently.”

With a lot of progress having been made in recent decades, Scott is amazed how negative the general view of our aging society is.

“First of all, even if all that’s happening is more people living into a frail old age – that’s a remarkable achievement,” he says. “That means fewer children being mourned, fewer parents dying in middle age, more grandparents meeting their grandchildren – it’s a fantastic achievement. So to be miserable about it is a bit weird.”

We must adapt to aging

This miserable view of aging is also typical in the world of economics, which Scott says tends to view to as part of a “demographic transition” created by a fall in birth rates and more people living longer, leading to more old people.

“I just find it so frustrating, because if you look at the facts, on average, we’re living longer, and we’re healthier for longer – that’s good news individually and good news for the economy,” he says.

Scott feels that the bigger question facing society is what changes we need to make in order to adapt to aging.

“People don’t think about how we adapt – the general concept is there’s no change in how we age,” he says. “Given the gains that have happened already, let alone what may happen in the future, there are lots of opportunities that can lead to economic gains. And it is stunning how little focus has been placed on that.”

While there is a vast amount literature on the positive economic impact of improving health in infancy, childhood and adult years, Scott says that for some reason the same notion isn’t prevalent beyond 50.

“I find that staggering. So that’s what this paper really focuses on – this new stage where, particularly in the high income countries, a child born today will live into their 80s and 90s, which means there’s a new human imperative, which is to age well.”

Quantifying the longevity dividend

Of course, Scott points out, this isn’t just about what you do when people get old, but what you do across a lifetime, and this is part of what he and his co-authors sought to model in the Nature paper. Another interesting aspect of what the paper explores is how the additional time gained by living longer is valued.

“Having more time is a valuable thing from an economic perspective – you can work or you can have leisure, and both of those things are valuable,” says Scott. “But of course, if you’ve got more time, you’re going to do things differently, and trying to model that is important, because too much of what people look at right now for an aging society assumes our behaviour doesn’t change, even if we’re living longer. The problem is not living to 90, the problem is not changing how you behave.”

So Scott and his colleagues set about exploring how to quantify the potential of the longevity dividend that they believe exists. “There are all these debates about should we extend life expectancy or should we compress morbidity – what’s the most valuable?” he says. “We wanted to try and have a hard-nosed economic analysis.”

This work ultimately led to the calculation of a $38 trillion economic boost for every additional year of increased life expectancy in the US.

“We wanted to try and come up with a number,” says Scott. “I’m not sure we’ve got the final number quite right yet, but this is the first attempt to try and model it.”

Compressing morbidity is key

The paper explores several different models of aging – increasing life expectancy, increasing healthspan and a combination the two. But what Scott says was really striking, is just how important compressing morbidity is.

“It is absolutely critical,” he says. “Longer life is good, but making sure healthspan catches up with lifespan is staggeringly valuable. And that is why we should try to delay aging, because yes, you get a longer life, but you get it in better health.”

What Scott found particularly interesting from this work was the virtuous circle that emerges when healthy longevity is achieved.

“As you increase health relative to life expectancy, the more you want to live longer,” he explains. “If people are ill in their 80s, they don’t want to reach their 80s, but if people are well in their 80s, then they want to reach their 90s. So you get this virtuous circle effect that makes aging an unusual disease – the better we get at tackling it, the more we value further gains.”

“I think of this as the third epidemiological transition – we’ve tackled infant mortality, we’ve been tackling mid-life mortality. Now it’s this later stage, but we’re going to keep putting resources into it, because the better we get, the more valuable it becomes, which I think is a powerful logic.”