Do you know how long you’re likely to live? While that may seem like a strangely morbid question, in today’s world it has practical relevance for so many plans and decisions faced by everyone growing older. Those plans- Should I retire soon? Have I saved enough money for my retirement? Should I move? Do I need long-term care insurance? Should I continue all of my preventive medical screenings? What’s most important for me to accomplish as I enter my later years? – all hinge on how long a life you have. If you knew that you were likely to pass away within the next year or two, you’d probably arrange your life and your affairs differently than if you knew you likely had at least another decade. And, of course, there is also the question of whether the life that remains will be healthy or instead, you will be debilitated and suffer. It’s one thing to hope for a long life if you’ll be able to enjoy the activities and the people you cherish. It’s quite another if you experience pain, become dependent, and perhaps live out your days with a poor quality of life. In fact, it’s estimated that most older Americans will spend 12 years living with disease or disability before death, so the US “healthy life expectancy”, also known as health span, puts us as a country in 68th place among nations of the world. In essence, as a country, we’re not doing so well keeping people healthy well into their later years.

Life expectancy is determined by a complex interplay of factors, some within our control and some beyond our control. As a society, progress in science, medicine, and public health, including scientific advances, better medical care, better nutrition, and public health advances in sanitation and clean water, all led to rapid improvement in US life expectancy, beginning in the 1800s. Barriers to better life expectancy have always included such things as poverty and lack of access to health care, and those barriers continue to this day. Currently, life expectancy in this country hovers around 79 years for women and 73 years for men. This gender gap in life expectancy has always been true and in fact, it appears to be growing. At every age, men have more risk of dying than women, perhaps due to riskier behavior, less outreach for medical care, and less openness around physical and mental health.

But for all Americans, the average life expectancy has dropped in the past couple of years. COVID led to declines in US life expectancy, along with other factors, including drug overdoses, suicides, gun violence, and heart disease. The obesity epidemic, and its correlation with heart disease and Type 2 diabetes, may also play a role in declining life expectancy. In fact, data suggests that more than 50 countries currently have a longer life expectancy than the United States. To see a map of life expectancy around this country, click here. Looking at a map of the United States, you come to realize that for many, geography is destiny when it comes to life expectancy. As you can read in a long exposé on Politico, certain “red” regions of the country, including the Deep South and “Greater Appalachia” have a life expectancy approximately 4 years lower than “blue” regions along the Pacific coast. Even poor regions of the blue Northeast have higher life expectancies than well-to-do areas of the Deep South. Why is this? It’s a complicated history involving culture and politics that results in less access to care, less investment in public health, and less government involvement in the healthcare system, all leading to different results in life expectancy.

Your own unique life expectancy is the result of many factors: where you live, your genetics, your current health status, your gender, and your access to care, among other issues. But it may be important for you to try to have some sense of where you fall along the life expectancy continuum, if for no other reason than to know if you’ll have sufficient savings to support yourself in retirement. This is known as “managing the longevity risk” as you want to make sure you don’t outlive your money. Typical “life expectancy calculators” to try to understand this risk include one from Social Security and one called the Actuaries Longevity Illustrator. The problem with these calculators is that they just provide you with statistical averages that don’t take into account personal details of your unique situation. For example, if you’re a healthy male until age 70, chances are you will live a lot longer than the average male life expectancy of 73. Therefore you may want to access a “calculator” that takes into account more personal details. We’ve previously discussed the RESPECT calculator which specifically looks at frail individuals who may be nearing the end of life to help them determine how much time they may have left. There is also a calculator out of UCSF called ePrognosis, which offers healthcare professionals and consumers an evidence-based approach to considering life expectancy using scientific data and disability. For a list of some other valuable life expectancy tools and calculators, especially if you’re fortunate to be in good health in your later years, take out your long-term diary and read here. And if your goal is to maximize your life expectancy, there are always lifestyle and behavioral changes that can help. For some ideas, take a look here.