New Report Calls for Urgent Shift from Lifespan to Healthspan

Chronic disease now drives 90 percent of U.S. health care costs, yet half of chronic conditions are preventable. Public health leaders say the nation can no longer afford to treat illness after it appears and today released a bold new report, Healthy Longevity: Public Health’s Next Frontier, calling for immediate action to close the widening gap between how long Americans live and how long they live in good health. Dean Linda P. Fried is chair of the Association of Schools and Programs of Public Health (ASPPH)Task Force on Healthy Longevity, which produced the report.

Responding to the National Academy of Medicine’s call to action, the ASPPH report lays out Public Health 4.0—a bold approach to building a modern public health system that delivers on the promise of health for all and supports people from before birth through their final years.

For centuries, humanity has pursued longer lives, adding an average of 30 years to global life expectancy over the past century, largely due to public health advances such as clean water, vaccine campaigns, disease prevention, smoking cessation campaigns, cancer screenings, and more. But this progress has stalled, and in the United States, it is reversing. Americans now spend an average of 12.4 years in poor health at the end of life, burdened by chronic diseases that are often preventable.

“Healthy longevity is not only achievable—it is imperative for creating a just and flourishing society,” said Laura Magaña, president and CEO of ASPPH. “This new system empowers academic public health to lead a transformative shift: from a model focused on treating disease to one that promotes health, vitality, and well-being across the life course. Our field holds both the responsibility and the opportunity to reframe aging—not as a challenge to confront, but as a public health success in progress.”

Key Strategies for Action

The new report outlines an urgent agenda to redesign how we research, teach, practice, and advocate for health across the life course:

• Research: Public health institutions, policymakers, and funders must invest in a bold research agenda to uncover what drives healthy aging, from the biology of aging and the effects of loneliness to the power of social connections and safe, responsible use of AI.
• Education and Training: Academic public health programs must make healthy longevity a core part of 21st-century education. This means updating curricula, so all students understand the life course approach to health, the value of aging, the public health system’s role in promoting healthy aging, and how to deliver prevention at every stage of life.
• Practice: Public health must prioritize prevention at every stage of life, with focused strategies for older adults. This requires investing in a modern Public Health 4.0 system that promotes healthy longevity in every community and works alongside clinical care. Implementation science and cross-sector collaboration are crucial for translating evidence into effective community programs.
• Policy and Advocacy: Decisionmakers and advocates must shift policies from focusing on disease to promoting functional ability and quality of life at every age. That means tackling social and environmental factors, fighting ageism, building age-friendly communities, and investing in public health systems and the workforce. It’s time to reframe aging as a strength, not a burden.

Healthier, longer lives enable older adults to contribute their unique capabilities—such as advanced problem-solving, emotional balance, generosity, and legacy motivations—to society through employment, caregiving, and volunteering. Currently, these contributions equate to 7 percent of U.S. GDP, and intentional interventions could expand this significantly. An increase in life expectancy by one year is worth $38 trillion, and by ten years is worth $367 trillion.

“Achieving healthy longevity is one of the great opportunities of our time, and academic public health must lead the way,” said Dean Fried. “This framework charts a transformative path forward. By aligning research, education, and practice around the full arc of life, we can build a future where aging is not seen as decline, but as potential and where every additional year of life is lived with purpose, dignity, and connection. Public health has done this before, and now, it must do it again.”

This news item is based on an ASPPH press release.