There are 2 neighbours on the same street, both 82. One cycles to the market, takes his grandchildren to the park and meets friends for coffee and a game of chess. The other takes tablets for several chronic conditions and needs help with the shopping and daily chores.
You could swear they were not the same age. Researchers have a word for the years we spend in good health, and that is "healthspan". It is what most of us mean when we say we want to live longer.
So how does healthspan differ from lifespan, and how far apart are the two for most of us?
What Is the Difference Between Healthspan and Lifespan?
Lifespan is how long you live. Healthspan is how many of those years you spend in good health, before a long-term illness or disability starts to hold you back (1).
Healthy years are harder to count, and 2 people with the same condition can feel very different (1). For whole countries, the World Health Organization (WHO) uses a related figure called healthy life expectancy: how many years people can expect to live in full health once illness and disability are taken into account (2).
How Big Is the Gap Between Healthspan and Lifespan?
In 2023, people worldwide could expect to live 73.3 years on average, 62.8 of them in full health, a difference of about 10.5 years (2).
This doesn't mean a decade of illness at the end of life. Those 10 or so years are a total spread across a whole life, with more serious problems counting for more. That might be a few years managing diabetes, a spell of painful joints and some time needing help at home.
The gap has been growing. Between 2000 and 2019, people gained 6.5 years of life on average but only 5.4 healthy years, so the gap widened from 8.5 to 9.6 years (3). One likely reason, according to the Mayo Clinic researchers behind these figures, is that fewer people die early from sudden illness, so more live long enough to develop long-term conditions (3). WHO has since changed how it calculates these figures, so the 2019 and 2023 numbers can't be compared directly.
Women tend to outlive men, but their gap was also 2.4 years larger. Germany had the largest difference between men and women of any country, at 3.6 years, and the United States had the biggest gap overall, at 12.4 years (3).
Can You Add Healthy Years Rather Than Sick Ones?
In 1980, the Stanford doctor James Fries suggested that if people could delay their first serious illness, the time spent unwell would shrink into a short stretch at the very end of life (4). He called this the compression of morbidity, which means squeezing illness into fewer years.
Fries's team later tested this, following 1,741 former University of Pennsylvania students from their 40s into their mid-70s. Those with the healthiest habits, based on smoking, body weight and exercise, became disabled more than 5 years later than those with the least healthy habits. In their final years, they also had about half as much difficulty with everyday tasks (5).
Harvard researchers saw the same pattern in more than 111,000 nurses and other health professionals. A 50-year-old woman with 4 or 5 healthy habits could expect about 34 more years free of cancer, heart disease, stroke and type 2 diabetes. A woman with none of those habits could expect about 24. For men, the figures were 31 and 23.5 years (6). The habits included not smoking, regular exercise and a good diet. Read more about healthy habits that support a longer, healthier life.
People with healthy habits often have other advantages as well, such as more money, less stress or better access to doctors, so the habits may not explain all of the difference.
Can You Measure Your Own Healthspan?
Not directly, as there is no single test for it (1). Regular check-ups for blood pressure, cholesterol and blood sugar show how your risk of disease is changing over time. Your strength, fitness and how easily you climb the stairs or get up from the floor show how well your body is working. None of these is a healthspan score, but together they show which way things are heading.
The Takeaway
People are living longer, but around 10 of their years are lived in less than full health. Medicine has added years faster than it has added healthy ones. Yet those healthy years are not fixed: people who had healthy habits in their 40s and 50s stayed free of disability and chronic disease for several years longer.
This article is for general information and is not medical advice. If you have a medical condition or take medication, talk to your doctor or pharmacist before changing your diet or exercise routine.
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Literature Sources
- Kaeberlein M. How healthy is the healthspan concept? GeroScience. 2018;40(4):361-364. https://doi.org/10.1007/s11357-018-0036-9
- World Health Organization. Global Health Estimates 2000-2023: life expectancy and healthy life expectancy. Released 2 October 2026. https://www.who.int/data/global-health-estimates
- Garmany A, Terzic A. Global healthspan-lifespan gaps among 183 World Health Organization member states. JAMA Network Open. 2024;7(12):e2450241. https://doi.org/10.1001/jamanetworkopen.2024.50241
- Fries JF. Aging, natural death, and the compression of morbidity. New England Journal of Medicine. 1980;303(3):130-135. https://doi.org/10.1056/NEJM198007173030304
- Vita AJ, Terry RB, Hubert HB, Fries JF. Aging, health risks, and cumulative disability. New England Journal of Medicine. 1998;338(15):1035-1041. https://doi.org/10.1056/NEJM199804093381506
- Li Y, Schoufour J, Wang DD, Dhana K, Pan A, Liu X, et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ. 2020;368:l6669. https://doi.org/10.1136/bmj.l6669
