Health and longevity: conceptual twins, separated at birth

The following section is an excerpt from my HDAC paper that I’ve finalised today, as I’m giving a talk in London on the HDAC conference on the 9th of September. I’m happy that finally I have articulated this problem, cause it was the back of my mind for long and always seen framings around approaching the topic of healthy longevity without reflecting to this conceptual issue, that might or might not have serious policy consequences. I think, the way it is formulated is standalone and no need to read the full paper to understand it. So here we go.

There is a big and unresolved conceptual issue around the concepts of healthspan and healthy longevity, that of the connection between health and longevity. The problem is a bit of a chicken-egg one. Life expectancy and longevity are related to the biological life aspect of an individual, the highlight being on the postfix of ‘biological life’, that is ‘life’. Health, also, primarily seems to be related to the ‘biological life’ aspect of an individual, but here the highlight is on the prefix, the ‘biological’, including the physiological and the physical constitution of the bodies of individuals. Yet,  life expectancy and longevity assumes a minimal viable level of health and health assumes the presences of a chunk of life. Life comes with health issues, health comes with life pre-packaged. To repeat, there’s only health when there’s a quantity of life and there’s only a quantity of life when there’s a a threshold, viable amount of health present. The philosophical problem concerns establishing a proper connection between these two concepts, the primacy/priority of one or the other, and the potential prospect of deriving one from the other. Which is more fundamental, which one can be used to define the other, which one can be applied more specifically and more broadly in particular domains? I tried to express these bundle of problems neutrally as health and longevity are conceptual twins, but they were separated at birth. To push this analogy a little further, seeing the problems that arise, these two concepts seem to be fraternal twins, not identical twins. 

In terms of discussing the prospects of healthy longevity in a philosophical manner and also on the stage of global policy there are two kinds of approaches present, depending on which concept plays a fundamental role.  I think the better published, more accepted approach takes health as its starting point and considers questions of life expectancy and longevity as one of the aspects of health, inclusively. The other, smaller camp thinks that longevity is a standalone issue, deserving a separate handling and conceptualisation, yet it acknowledges that ‘longevity’ needs ‘health’ to be applicable in a broader domain and it does not think that ‘health’ is derivable from ‘longevity’. By now it should be clear to the reader, that the author is in that smaller, less accepted camp.

The good news is that on the level of global policy the merged approach that puts ‘health and longevity’ on centre stage, prioritising these over other issues, can utilise both philosophical starting points without being incoherent. Which is not the same as saying that short term political priorities are going to be the same for both camps within the united health and longevity’ camp.