Lifespan isn't the issue. Healthspan is.

Philip J. Goscienski, M.D.

September 2008

A girl born in 2008 can expect to live 80.4 years and her male counterpart a few years less at 75.2. The miracles of modern medicine are paying off -- or are they?

Life expectancy makes great headlines but the numbers behind the numbers tell a different story. If that young lady follows the lifestyle pattern of her Stone Age ancestors she may well hit the century mark but unless the vast majority of her age group do the same she'll be quite lonely at most of her class reunions.

Quality of life doesn't depend on how long you live but how long you remain healthy. The average American has a life expectancy of 77.9 (combined men and women) but a health expectancy of only about 70 years. About 10 percent of a person's lifespan is spent with some form of chronic disease. As physicians are better able to keep us alive through illness after illness, age at death increases but the age at which good health ends does not.

As far back as 1994 one physician noted "The average number of years that people spend disabled has grown faster than those they spend healthy."

We are becoming a divided nation, the health-rich and the health-poor. Our genes are pretty much the same but our habits are not, and that is the reason for the division. Only about 30 percent of Americans are of normal weight but even that is a misleading statistic. Normal weight does not mean normal proportions of body fat and muscle mass. We have lately identified the normal weight obese individual whose spreading midsection reveals that his muscles have shrunk while fat has accumulated, especially in the abdomen.

Eighty percent of persons who are over 65 have at least one of the now-familiar chronic diseases such as heart disease, type 2 diabetes or dementia; half the persons at that age suffer from at least two.

Obesity doubles the risk of Alzheimer's disease and of a heart attack and it raises the risk of type 2 diabetes a whopping thirty-fold. The last figure is the one that demolishes the relevance of life expectancy. Diabetes can smolder for years before diagnosis, all the while damaging blood vessels that nourish the heart, the brain, the eyes and the kidneys. No wonder that fully 50 percent of those with a new diagnosis of diabetes already have evidence of complications involving those organs.

Diabetes has become a growth industry as new drugs are approved that add years to diabetics' lives. But no medication can reverse the disease. Barely half of patients seem to be able to control blood sugar levels as they progress to blindness, heart failure, the ravages of stroke, the immobility of leg amputation and the downhill slide of kidney failure.

Living longer shouldn't be our goal. We should strive for a compression of morbidity, the shortest possible period between disability and death.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at