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The Future of Human Longevity--How Important Are Markets and Innovation?: The is a reprinting of testimony given before the United States Senate Special Committee on Aging (3 June 2003).

Science of Aging Knowledge Environment2 Jul 2003Vol 2003, Issue 26p. pe18DOI: 10.1126/sageke.2003.26.pe18

Abstract

In a hearing before the United States Senate Special Committee on Aging, a well-respected demographer warns that there is no evidence of slowing in the long-term rise in best-practice life expectancy in developed countries. The author discusses how these findings will affect the future of Social Security and argues for a larger, more focused effort with respect to longevity research by demographers, epidemiologists, and economists.
Mr. Chairman and members of the Committee,
Is life expectancy approaching its limit? Many--including individuals planning their retirement and officials responsible for health and social policy--believe it is. The evidence suggests otherwise.
Consider an astonishing fact. Female life expectancy in the record-holding country has risen for 160 years at a steady pace of 3 months per year. In 1840, the record was held by Swedish women, who lived on average a little more than 45 years. Among nations today, the longest expectation of life--just over 85 years--is enjoyed by Japanese women. There is no evidence of any slowing of this long-term rise in best-practice life expectancy.
In the 19th century and the first half of the 20th century, the increase in life expectancy was driven by progress in reducing infant, childhood, and early-adult mortality. Since 1950 and especially since 1970, the continued rise in the expectation of life has been fueled by substantial declines in death rates at older ages. This progress has been accompanied by progress in extending the healthy, active period of life. The progress is due to the prosperity created by market economies and to innovation based on research.
From 1900 to 1950, life expectancy increased rapidly in the United States. At mid-century, U.S. life expectancy was only a few months less than the highest life expectancy anywhere in the world. As recently as 1979, the U.S. disadvantage was only 2 years. Among people 80 years old or older, survival was better in the United States than anywhere else, a lead the U.S. held until 1992.
But health progress in the United States slowed in the second half of the 20th century and especially over the past decade or two. Other countries caught up and surpassed us. Today U.S. life expectancy at birth is 6 years behind the record. In many countries, including Japan and France, people of all ages, from the very young to the very old, enjoy better survival chances than in the United States. The United States is the world's leader in so many things that it is surprising and disturbing that the U.S. has fallen so far behind in the matter of life itself.
The Social Security Administration forecasts that improvements in U.S. life expectancy will continue to be slow. This implies that the life-expectancy gap between the United States and Japan, between the United States and France, between the United States and almost all other advanced countries in the world, will continue to widen by 1 or 2 months per year.
Consider the situation in 2050. A half-century may sound distant, but a majority of the people currently living in the United States, including nearly all children and young adults, will still be alive in 2050. The Social Security Administration's latest (2003) forecast is that female life expectancy in the United States will gradually rise from 79.5 years today to 83.4 years in 2050. This level half a century from now is less than current female life expectancy in Japan and France and 13 or 14 years less than likely Japanese and French female life expectancy in 2050. The prediction for Japan and France is uncertain, but most of the uncertainty is on the up side--breakthroughs in biomedical research could lead to even higher life expectancies.
Is it realistic to assume that the United States will fail to catch up in half a century with expectations of life already exceeded in Japan and France? Is it realistic to assume that the United States will fall more than a decade behind Japan and France? I do not think so. Market economies around the world are tightly interconnected. Research ideas and innovations quickly spring across national boundaries. The United States will, I am confident, reduce the health disparities, implement the health care and health-promoting innovations, and make the research investments needed to halt the widening life expectancy gap--and then to reduce it.
A crucial first step is to figure out why the U.S. is falling behind. There are guesses and assertions but no persuasive findings. Research by demographers, epidemiologists, and economists could uncover the answers. The National Institute on Aging is funding some pertinent research; a larger, concerted, more focused effort is needed.
Many people believe that little or nothing can be done about health at older ages. This is nonsense. Mortality and many kinds of morbidity at older ages have declined remarkably over the past half-century.
East Germany offers a dramatic example of how much can be done to improve the health of the elderly. Under communist rule, older East Germans suffered poor health and short lives. Today, a mere decade after the fall of communism, older East Germans enjoy almost the same high level of health and longevity as West Germans. The number of centenarians in East Germany has tripled. These people were in their late 80s or early 90s when communism fell. Even at their advanced ages, they were able to benefit from a Western economy and health care system.
In sum, given intelligent economic and social policy and continued investment in research, longevity and healthy longevity will dramatically increase in coming decades. This is not a problem--it is a great achievement--but it will result in challenges for policymakers, especially concerning Social Security.
The United States was once a longevity leader, especially at older ages, but the U.S. has fallen further and further behind, particularly over the past 20 years. The Social Security Administration assumes that the U.S.'s recent mediocre performance will persist. I doubt this. At the very least, the Social Security Administration should systematically assess the possibility that the United States will not fall further behind--and perhaps even catch up with--France, Japan, and other advanced countries.
Because of markets and innovation, because of the research funded by the U.S. National Institute on Aging and other organizations, human longevity is going to rise substantially--not only elsewhere but for Americans as well.
Thank you.
Fig. 1. Female life expectancy at birth (e0) from 1840 to 2050. The thick gray line shows the trend in female life expectancy in the national population with the highest life expectancy. The thin black line shows the trend in female life expectancy in the United States. The broken gray line extrapolates the long-term trend in best-practice life expectancy. The dashed black line shows the Social Security Administration's "intermediate" forecast.

References

J. Oeppen, J. W. Vaupel, Broken limits to life expectancy. Science 296, 1029-1031 (2002). [Free full text]
J. W. Vaupel, Setting the stage: a generation of centenarians? Wash. Q. 23, 197-200 (2000). [Free full text]
J. W. Vaupel, J. R. Carey, K. Christensen, T. E. Johnson, A. I. Yashin, N. V. Holm, I. A. Iachine, V. Kannisto, A. A. Khazaeli, P. Liedo, V. D. Longo, Y. Zeng, K. G. Manton, J. W. Curtsinger, Biodemographic trajectories of longevity. Science 280, 855-860 (1998). [Free full text]
J. W. Vaupel, Demographic thinking. Science 280, 986 (1998). [Full text]
For other online publications, see http://www.demogr.mpg.de or the "supplemental data" and "search for similar articles" sites accessible at http://www.demogr.mpg.de/publications/files/brokenlimits.htm. In particular, excellent articles have been written in Science, Nature, and other journals by Ronald D. Lee, Shripad Tuljapurkar, and John R. Wilmoth and colleagues.

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Published In

Science of Aging Knowledge Environment
Volume 2003 | Issue 26
July 2003

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Keywords

  1. demography
  2. Social Security Administration
  3. human life expectancy
  4. mortality

Authors

Affiliations

James W. Vaupel
The author is at the Max Planck Institute for Demographic Research, Rostock, Germany, and the Terry Sanford Institute of Public Policy at Duke University, Durham, NC 27708, USA. E-mail: [email protected]

Notes

Max Planck Institute for Demographic Research, Rostock, Germany. [email protected]

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