The Gap Between Lifespan and Healthspan

Photo taken while walking on a glacier in Sutton, Alaska

Recent articles about the widening gap between lifespan and healthspan have increased the already palpable fear of aging. Some of them hit the mark saying that the medical industry has given us more years but they are not necessarily good years. In other words, lifespan (chronological age) has increased but healthspan (how well you live, the quality of your years) lags so far behind that many people fear their later decades will be spent debilitated, suffering, not thriving.

The Gap Between Lifespan and Healthspan Widens

One doctor, Ezekiel J. Emanuel an oncologist, bioethicist, and a vice provost of the University of Pennsylvania wrote that he hoped to die at 75. Looking at what medical professionals are trained to do, I can understand. They are trained to diagnose and treat disease. Diagnosis comes usually when disease is embedded and treatments are usually given in these later stages of disease. Death is delayed.

And typically, presence of disease or at least risk (diabetes, heart disease, metabolic syndrome, cancer, dementia) increases with age.

Diagnosis and treatment usually come at the stage of entrenchment. For example, there is limited intervention for diabetes until your insulin resistant and your sugar (A1C) is off the charts because there is no mechanism (payment structure) for close (personalized) monitoring. And the early interventions for pre-diabetes are (preventive) recommendations for mild amounts of exercise, unclear dietary changes with annual monitoring to wait for the real disease to kick in. The primary reason for this inertia is health insurances do not recognize doctor’s coaching patients toward prevention or lifestyle changes and healthier choices as ‘medical treatment.’ But they will pay for administering insulin and related treatments for (the real disease) type-2 diabetes treatment. That’s our system.

Same situation for cancer. The effort and attention to personal details necessary to get an early enough diagnosis is costly and time consuming. Doctors don’t have the time (nor incentive) for this kind of care. The best (I would argue most economical too) medical care would key in on prevention and careful monitoring, especially as we age. The way our system works now, at diagnosis the disease has taken hold. This is the point where you get the required attention of medical professionals. Doctors will treat the disease and the patient’s life is prolonged but at what quality? That is the crux of the problem—good lifespan and poor healthspan and why aging scares the hell out of most of us.

We are embedded in a health care system that treats disease far better than it promotes health. Thus, many older adults aren’t thriving, they linger (past 75). I would not call this healthcare, it’s more like ‘illness care.’

Contributor to The Gap Between Lifespan and Healthspan

The medical industry operates on a reactive rather than a proactive model. Preventing disease isn’t as exciting or rewarding as treating disease.  

If you were diagnosed with some type of cancer your doctor would have a firmly developed, well-explained treatment plan from A to Z. You would be placed on a tight regimen and intensely monitored.

But, if you ask your doctor, “what can I do proactively to live longer and live better for longer?  This happened to me, direct experience. That’s one reason why this site exists! Your doctor would likely give you the vague prescription to move more, sit less and follow the U.S. Government guidelines. That is: engage in 30 minutes of moderate-intensity aerobic activity 5 times per week (or 150 minutes). Supplement your aerobic activity with two days of strength training that targets all the major muscles…… Yawn, these guidelines are the bare minimum, acceptable if you want to stroll along, play bridge and bingo. But if you want to fly fish with vigor into your 90s, you’ll have to be more engaged in fitness and advocating/creating your own best quality of life.  

Please note, I am not criticizing healthcare professionals or the medical industry. We need doctors. I speak from experience and I write from inside the subject. If it seems forceful, I am trying to cut through the fog and the conditioning. I am trying to reach that place within where you already know prevention must be prioritized over treatment. 

Researchers Owning Up to the Gap Between Lifespan and Healthspan

In the book, Cancer, The Emperor of all Maladies (also a Ken Burns Documentary), there’s a speech given by Harold Varmus, when he was Director of the National Cancer Institute. “There’s a paradox that we must now honestly confront. Despite the extraordinary progress we’ve made in understanding the underlying defects in cancer cells, we have not succeeded in controlling cancer as a human disease to the extent that I believe is possible.” Varmus went on to say, “one of the missing pieces is we focus too much on cancer treatment and not enough on prevention. If you wanted to get the next big leg up in the war on cancer, you had to make prevention the front line. But prevention is boring, especially compared to the science and prestige of cancer treatments. So even if we know how important it is, it’s hard for smart people to take it seriously.”

MIT cancer researcher Robert Weinberg once described it this way: “You can’t die from cancer if you don’t get cancer in the first place. But that simple truth is easy to overlook, because it’s not intellectually stimulating. Persuading someone to quit smoking is a psychological exercise. It has nothing to do with molecules and genes and cells. And so people like me are essentially uninterested in it. That’s in spite of the fact, that getting people to quit smoking can make a bigger impact in the war on cancer than anything he, as a biologist can do in his lifetime.”

Can you imagine how someone who lost a loved one to cancer would feel knowing this?

Flyfishing Harder and Aging Better (Reducing The Gap Between Lifespan and Healthspan) is in Your Hands

Medical professionals don’t have the interest, time nor the training to give you the kind of care and attention needed that will help you live and fly fish vigorously into your later decades. The shift from reactive medicine to proactive medicine may come someday but we can’t wait. Nature’s gravitational pull toward aging is working on us every moment of everyday. It’s time to leave the herd and become your own health care advocate.

You will not fully discover this truth secondhand. The best teacher is still your own experience. You must get involved. When you commit and become an athlete of aging you begin the never-ending, ever-changing process of growth. The conclusions you have one day will evolve and change the next. You will grow, evolve and become wiser, better informed, you will know first hand! 

What could be more important?

The Best Medicine You Prescribe Yourself

Exercise is the most potent thing you can do now to ensure vitality into your later decades. No other intervention will do as much to invigorate your flyfishing and prolong your lifespan. You can even be functionally younger than your chronological age. But a rote prescription it is not. The athletic approach to aging is rooted in science but how to apply the science to individual situations, family history, genes and established habits requires a little art, creativity and experimentation, and a lot of personal input, time and effort!!!  

It’s up to you and me to create this change. We can’t wait for others to act. We are aging!

Some 70% of premature death (before 80) is lifestyle related and what we call “normal aging”—weakness, stiff joints, reduced balance is not normal. It’s what we have accepted as normal because the bar is set so low.

In addition, 50% of all illness and injuries in the later decades of your life can be eliminated by lifestyle changes.     

Lastly, those who exercise are better equipped to deal with stress, disease, fatigue from treatments if disease does find us. 

The bottom line is fitness—high levels of muscle mass and strength along with high aerobic capacity are potent products of a lot of work. And they are the sine qua non predictor of a healthspan that will at the very least equal lifespan.  

Download a Quick Guide to Strength, Stamina and Sturdiness. Want action? Use the contact form to ask about Virtual Fitness coaching for fly fishers and outdoor types.

Categorized in: General Knowledge