First the Wealth Gap, Now the U.S. Has a Growing Health Gap

Credit: Aaron Weaver/ MidJourney

Americans are living longer than ever before, but those added years often come with a significant tradeoff: declining health. According to a recent study by researchers at the Mayo Clinic, the health gap, or the gap between lifespan and healthspan—the years lived free from serious illness or disability—has widened significantly in the United States. The findings reveal a troubling trend. While life expectancy has increased, the quality of those added years has not kept pace, leaving many Americans to endure prolonged periods of disease and disability.

Between 2000 and 2019, life expectancy in the U.S. rose modestly, from 79.2 to 80.7 years for women and from 74.1 to 76.3 years for men. However, health-adjusted life expectancy, which accounts for years lived in good health, showed far less improvement. Men gained just 0.6 healthy years on average, while women’s HALE remained unchanged over the same period. This means an American woman who lives to the average age of 80.7 is likely to spend the last 12.4 years of her life burdened by chronic illness or disability, a statistic that highlights the severity of the issue.

A Growing Health Gap

The study found that the U.S. has one of the largest healthspan-lifespan gaps in the world, with a difference of 12.4 years. This is significantly higher than the global average and surpasses countries like the UK (11.3 years) and Norway (11.2 years). Researchers point to the rising prevalence of chronic conditions, such as diabetes, cardiovascular disease and neurological disorders, as key contributors to this widening gap.

According to the researchers, these chronic diseases are not limited to any single demographic but disproportionately affect certain groups, such as older women, who tend to live longer but endure more years of poor health. Women in particular are more likely to experience conditions such as musculoskeletal disorders and neurological diseases in their later years, contributing to their larger share of unhealthy life years.

Credit: The Mayo Clinic

Why Is the U.S. Falling Behind?

The reasons behind this growing gap in the U.S. are complex. Researchers suggest that factors such as lifestyle choices, access to healthcare and preventive care all play a role. Americans generally face higher rates of obesity and diabetes compared to other nations, both of which are major contributors to chronic illness. In addition, the country’s fragmented healthcare system often leads to disparities in access to early intervention and disease management, which are critical for maintaining quality of life as people age.

While some researchers have noted that wealth disparities can exacerbate health inequities, the healthspan-lifespan gap is not solely tied to economics. Instead, it reflects broader systemic issues, including gaps in public health infrastructure and insufficient emphasis on preventive care. For example, conditions like heart disease and Type 2 diabetes are largely preventable through lifestyle changes, yet they continue to affect millions of Americans.

Addressing the Gap

Closing the health gap will require a multifaceted approach. Public health initiatives focused on preventing chronic diseases, improving nutrition and promoting physical activity could have a significant impact. Expanding access to early screenings and interventions for conditions like diabetes and hypertension is also crucial.

Additionally, researchers emphasize the need to shift the focus of healthcare systems from reactive treatment to proactive wellness. This includes integrating preventive care and wellness programs into primary care practices, as well as supporting research into aging and chronic disease management.

The Mayo Clinic study highlights the importance of addressing the healthspan-lifespan gap not just as a medical issue, but as a quality-of-life concern. While Americans may be living longer, these added years should be spent in good health. By prioritizing prevention and early intervention, the U.S. can help ensure that longevity gains translate into better health outcomes for all.

In a world where living longer is increasingly achievable, the true measure of progress will be how well we can make those years worth living.