Americans spend about 12 years in poor health, which makes healthspan the number to watch

Key takeaways

• In January 2026, the CDC reported that U.S. life expectancy reached 79.0 years in 2024, the highest level ever recorded.
• A Mayo Clinic analysis of World Health Organization data found Americans lived an average of 12.4 years with illness or disability in 2019, the largest gap of 183 countries.
• In Boston University’s study of people who lived to 110 or beyond, the first major disease typically didn’t arrive until about age 109.
• In a 30-year Harvard study of 105,015 adults, only 9.3% reached 70 free of major disease with mind and body intact, and the people with the healthiest diets were the likeliest to get there.
• Use the self-inventory below to find the area of your health that has slipped most, then start with one matching step.

In January 2026, federal statisticians had good news. Life expectancy in the U.S. reached 79 years in 2024, the highest level ever recorded⁴⁵. The death rate from drug overdoses fell 26% in a single year⁵.

That headline counts years. It doesn’t say how many of those years feel good.

Researchers at the Mayo Clinic asked that second question. Using World Health Organization (WHO) data for 183 countries, they compared how long people live with how long they live in good health¹². In 2019, the latest year they studied, Americans averaged 12.4 years with illness or disability. No other country had a wider gap¹².

That gap is the difference between lifespan and healthspan. For people who put prevention first, healthspan is the number that matters. Few people hope to add a decade in a hospital bed. The goal is more years of walking, gardening, cooking and lifting grandchildren.

Below, we cover how the gap is measured, why it’s wide in the U.S., what the best case looks like, and what the evidence says adds healthy years.

Three different numbers hide inside one question

“How long will I live?” can mean three different things.

Lifespan is the length of one life, or the upper limit the human body seems able to reach. Researchers with Boston University’s New England Centenarian Study put the practical limit at roughly 110 to 115 years¹¹.

Life expectancy is an average. The WHO describes it as the number of years a newborn could expect to live⁷. It changes as you age. By 2024 figures, Americans who reached 65 could expect about 19.7 more years⁴.

Healthspan is the part of life spent in good health. There’s no single official yardstick for it. The WHO uses one called healthy life expectancy, or HALE: the average number of years a person can expect to live in full health⁷.

Subtract HALE from life expectancy, and you get an estimate of the years lived with disease or disability¹. In the WHO’s newest estimates, the world’s life expectancy was 73.3 years in 2023 and HALE was 62.8⁶. By our math, that leaves about 10.5 years in less than full health.

The pandemic cut into both numbers. Between 2019 and 2021, global HALE fell 1.5 years, and the Americas lost about 2.5 healthy years⁸.

Healthy years have also been slower to bounce back. Global life expectancy in 2023 nearly matched its 2019 level, but HALE was still 0.4 years behind⁶.

The U.S. gap is the widest of 183 countries, and it grew

The Mayo study, by Armin Garmany and Andre Terzic, appeared in JAMA Network Open in December 2024¹². Across all 183 WHO member states, the average gap was 9.6 years in 2019, up 13% since 2000¹.

That figure is an average across countries, built from an earlier round of WHO estimates, which likely explains much of the difference from the newer global figure above. Both point the same way: the average person now spends about a decade in less than full health.

The U.S. stood out. Its gap grew from 10.9 years in 2000 to 12.4 years in 2019¹³. Across countries, a heavier load of noncommunicable disease, the chronic illnesses that don’t spread from person to person, went with a wider gap².

The researchers named three main drivers of Americans’ unhealthy years¹:

• mental health conditions
• substance use disorders
• musculoskeletal conditions, the problems of bones, joints and muscles

In the U.S., women outlive men by about five years⁴, but they don’t escape the gap. Across the 183 countries, women’s gap was 2.4 years wider than men’s, about 25% larger¹³. Neurological, musculoskeletal, urinary and genital conditions added to women’s years in poor health¹.

The study’s data end in 2019. Life expectancy has since climbed to a record⁴, but no one yet knows whether healthy years kept pace.

Americans get sick sooner, not only die sooner

The warning signs came earlier. In 2013, a National Academies panel compared the U.S. with 16 other wealthy democracies, including Canada, Japan, Australia and much of Western Europe⁹.

The U.S. ranked at or near the bottom in nine areas. They included obesity and diabetes, heart disease, chronic lung disease, drug-related deaths, injuries and disability⁹.

The illness started early. Measured by years of life before 60 affected by disability, the U.S. ranked in the bottom quarter of its peers¹⁰. Older Americans reported more arthritis and more limits on daily activity than people their age in Europe, Japan and the U.K.¹⁰.

Deaths before age 50 explained about two-thirds of the life expectancy shortfall for U.S. men and about one-third for women¹⁰. The panel found the gap in death rates had been growing for three decades¹⁰.

One finding deserves attention from anyone who believes good habits are the whole answer. Even Americans with every advantage the panel looked at, from insurance and a college degree to a higher income and healthy habits, seemed to be in worse health than their peers abroad⁹. Personal habits matter, but they can’t explain the whole gap.

The U.S. came out ahead in a handful of places. Americans who reached 75 tended to outlive their peers, fewer died of stroke or cancer, more had their blood pressure and cholesterol under control, and fewer smoked⁹. Medical care likely earns some credit there.

The best case: illness squeezed into the final years

In 1980, James Fries proposed a hopeful idea in the New England Journal of Medicine. He called it the compression of morbidity¹¹. If disease and disability could be pushed later in life, healthspan would stretch toward lifespan, and the sick years would shrink into a short stretch at the end.

The clearest real-world picture comes from Boston University’s New England Centenarian Study. In 2012, Stacy Andersen, Thomas Perls and colleagues compared 104 people aged 110 and older with 430 people aged 105 to 109, 884 centenarians, 343 people in their 90s and 436 comparison participants aged 47 to 96¹¹.

They tracked six major diseases: cancer, heart disease, chronic lung disease, dementia, diabetes and stroke. The comparison group spent a median of 17.9% of their lives with one or more of them. People 110 and older spent 5.2%¹¹.

The typical age when the first major disease appeared was 71 in the comparison group, 95 in the centenarians and 109 in those 110 and older¹¹. About 1 in 10 of the oldest group had no major disease until the last three months of life or less, compared with 3 in 100 centenarians¹¹.

This wasn’t a random sample. It drew heavily on families with a history of long life, and only 13% of the people 110 and older were men, so the results may not apply to everyone¹¹. Our article on purpose and the Blue Zones looks at why extreme-age records deserve a careful look.

The lesson isn’t that you’ll reach 110. It’s that a long life with a short decline at the end is a real biological pattern, not a fantasy.

A chart in words: years lived and years lived well

Picture each row below as a bar. The full bar is the life, and the shaded end is the time spent sick.

Group	Life expectancy	Healthy years	Time in poor health
World, 2023 (WHO)	73.3 years6	62.8 years6	About 10.5 years (our math)
Average of 183 countries, 2019	Not shown	Not shown	9.6 years1
U.S., 2000	Not shown	Not shown	10.9 years13
U.S., 2019	Not shown	Not shown	12.4 years13
Comparison group, Centenarian Study	Not shown	Not shown	17.9% of life with major disease11
People 110 and older, Centenarian Study	Not shown	Not shown	5.2% of life with major disease11

For the U.S., the shaded end of the bar grew by a year and a half in two decades, by our math. For the people 110 and older, it shrank to a sliver.

What the evidence says adds healthy years

The biggest recent test of food and healthy years came from Harvard. A team led by Anne-Julie Tessier and Marta Guasch-Ferré followed 105,015 nurses and other health professionals for up to 30 years, from 1986 to 2016, and reported the results in Nature Medicine in 2025¹²¹³.

The bar was high. To count as aging well, a person had to reach 70 free of 11 major chronic diseases, with thinking, physical function and mental health intact¹³. Only 9.3% made it, roughly 1 person in 11¹².

Diet tracked closely with who cleared that bar. Before any statistical adjustment, about 56 of every 1,000 people with the lowest diet scores aged well, against about 137 of every 1,000 with the highest¹³. After adjustment, top scorers on the strongest pattern had 1.86 times the odds of bottom scorers, and all eight eating patterns tested pointed the same way¹³.

The limits matter. This was an observational study, meaning researchers watched what people ate rather than assigning diets, so it can’t prove cause. Participants rated their own thinking and physical function, and the group was not diverse in income or ancestry¹³. The NIH and other funders paid for the work, and one author leads a grant from the International Nut Council, an industry group¹³.

Our companion article on eating patterns compares the eight diets and the foods they share.

Diet is one piece. Harvard’s well-known study of five habits and life expectancy is covered in our article on whole-person health. Later articles in this series cover activity, sleep and tobacco.

The Mayo findings point to the rest of the work. Mental health, substance use and musculoskeletal problems drive much of the U.S. gap¹. The 2024 drop in overdose deaths⁵ shows that these numbers can move, and fast.

How strong is the evidence?

Claim	Evidence level	What the research shows
Americans spend more years in poor health than people in other countries	Strong evidence	WHO data for 183 countries; National Academies peer comparison1910
The U.S. gap widened from 2000 to 2019	Strong evidence	10.9 to 12.4 years; these are modeled estimates, not head counts13
Illness can be compressed into the last years of life	Promising but early for most people	Clear in people who reach 110, a select group from long-lived families11
Healthy eating patterns help people age well	Promising but early	A consistent link in 105,015 people over 30 years, but one observational study can’t prove cause1213
Good habits alone explain the U.S. disadvantage	Evidence says no	The gap persisted even among Americans with healthy behaviors9

Your healthspan self-inventory

This tool is ours. Read each row and mark it steady, slipping or struggling. Then pick the one row that worries you most and start with the article listed.

Area	Ask yourself	A first step to read
Getting around	Can I climb stairs, rise from the floor and carry groceries?	Mobility means getting up, reaching and carrying, so practice the real moves
Strength and balance	Am I weaker or less steady than a year ago?	Frail 90-year-olds nearly tripled their strength, proof that muscle responds at any age
Chronic conditions	Do I know my blood pressure, blood sugar and family risks?	Your family tree and free risk calculators can show you where to start
Mood and substances	Have I felt low for weeks, or used alcohol or drugs more than I want?	Self-care supports mental health, and these are the signs it’s time to add a professional
Bones and joints	Does back or joint trouble limit what I do?	Most back pain fades on its own, and dizziness and bladder leaks respond to rehab
People and purpose	Who would I call in a crisis? What do I look forward to?	What eases loneliness, which depends less on how many people you see
Food	Are most meals built on plants, whole grains, beans and nuts?	A classic Mediterranean diet trial used canola oil, so the pattern travels well
Movement and sleep	Do I move most days and wake rested?	Exercise benefits start below 150 minutes and keep rising well past it

Repeat the check every few months. A row that moves from struggling to slipping is real progress.

Healthspan fits natural-health values, and the word is also for sale

Healthspan puts into numbers something natural-health communities have long said. A good life is measured in what you can do: walk to a friend’s house, tend a garden, sleep well, think clearly. Function, not the birthday count, is the goal.

The research also adds two honest edges. First, personal effort has limits. The National Academies found that even Americans with healthy habits fared worse than their peers abroad⁹. That points beyond personal choices, to communities, safety and access to care.

Second, “healthspan” has become a sales word. It now appears on supplement labels and clinic menus. Our guide to longevity clinics sorts proven care from pricey experiments, and a companion article decodes “reverse your biological age” claims.

Questions readers ask

The bottom line

Americans are living longer than ever, but many of those years come with illness, pain or disability, more than anywhere else in the world by one major analysis. Healthspan, the years lived in good health, is the better goal, and the best case is a long, active life with a short decline at the end.

The evidence points to familiar foundations: a healthy eating pattern, plus attention to mood, substance use and pain. Take stock of your own areas, pick one to improve, and bring real changes to a clinician who will look past “it’s just your age.”

Related reading

• Most of your health is shaped outside the exam room
• Purpose tracks with a longer life, while the Blue Zones story is less certain
• How to sort longevity clinics that mix proven care with pricey experiments
• Biological age tests can disagree with themselves by years
• Eight healthy eating patterns faced a 30-year test and mostly agreed

Sources

1. Mayo Clinic News Network. “La división global entre una vida más larga y una buena salud” (Spanish-language release on Garmany A, Terzic A, “Global Healthspan-Lifespan Gaps Among 183 World Health Organization Member States,” JAMA Network Open, 2024). Mayo Clinic, 2024. newsnetwork.mayoclinic.org
2. HealthDay. “Health Span-Lifespan Gaps Widening Globally.” HealthDay, 2024. healthday.com
3. Frisch S. “Closing the lifespan-health span gap.” Minnesota Medicine, March/April 2025. pubs.royle.com
4. Xu J, Murphy SL, Kochanek KD, Arias E. “Mortality in the United States, 2024.” NCHS Data Brief No. 548, National Center for Health Statistics, 2026. cdc.gov
5. National Center for Health Statistics. “U.S. Life Expectancy Hits Record High as Drug Overdose Deaths Decline in 2024.” CDC press release, 2026. cdc.gov
6. World Health Organization. “Life expectancy and healthy life expectancy.” Global Health Observatory, accessed October 2026. who.int
7. World Health Organization. “United States of America” country data page, with definitions of life expectancy and healthy life expectancy. WHO Data, accessed October 2026. data.who.int
8. World Health Organization. “COVID-19 eliminated a decade of progress in global level of life expectancy.” WHO news release, 2024. who.int
9. National Academies of Sciences, Engineering, and Medicine. “Americans Have Worse Health Than People in Other High-Income Countries; Health Disadvantage Is Pervasive Across Age and Socio-Economic Groups.” News release on U.S. Health in International Perspective: Shorter Lives, Poorer Health, 2013. nationalacademies.org
10. National Research Council and Institute of Medicine. “Poorer Health Throughout Life.” Chapter 2 in U.S. Health in International Perspective: Shorter Lives, Poorer Health. National Academies Press, 2013. nationalacademies.org
11. Andersen SL, Sebastiani P, Dworkis DA, Feldman L, Perls TT. “Health Span Approximates Life Span Among Many Supercentenarians: Compression of Morbidity at the Approximate Limit of Life Span.” Journals of Gerontology Series A, 2012. pmc.ncbi.nlm.nih.gov
12. Tessier AJ, Wang F, Ardisson Korat A, et al. “Optimal dietary patterns for healthy aging.” Nature Medicine, 2025;31(5):1644–1652, doi:10.1038/s41591-025-03570-5 (abstract record, University of Copenhagen research portal). researchprofiles.ku.dk
13. Tessier AJ, Wang F, Ardisson Korat A, et al. “Optimal dietary patterns for healthy aging.” Nature Medicine, 2025, doi:10.1038/s41591-025-03570-5 (full text, journal-format PDF copy hosted by a third party; the publisher’s page could not be opened). lee.org
14. Rabheru K, Byles JE, Kalache A. “How ‘old age’ was withdrawn as a diagnosis from ICD-11.” The Lancet Healthy Longevity, 2022 (copy hosted by UConn Center on Aging). health.uconn.edu