This article first appeared on Smerconish.com on February 15, 2023
In the latest charge against the promise of healthy aging, Dr. Ezekiel Emanuel, oncologist and bioethicist, doubled down on his infamous 2014 essay stating that 75 is the ideal age to die. Now 65, he maintains that after age 75, he will no longer receive medical screenings and interventions like colonoscopies, cancer treatment, flu shots, and heart valve replacement.
Like other doomsayers from Thomas Malthus to Paul Ehrlich, Emanuel’s basic and profound flaw is his lack of imagination about the human project. While he makes an important distinction between “quality of life” and mere “longevity,” he still advances an all-too-familiar ageist approach to life and death that has ignored the tremendous progress from the past few decades. Pessimism like this hinders much-needed awareness of the myriad of medical innovations and societal progress, enabling longer, healthier, and more productive lives well beyond 75.
We must reimagine 21st-century life where 75 plus marks a robust time of engagement and work. Just ask Jane Fonda, Lilly Tomlin, Rita Moreno, or Sally Field in their latest Hollywood adventure, “80 for Brady,” demonstrating for all of us what life after 75 ought to be. Indeed, several of the cast have been diagnosed with diseases Dr. Emanuel claims he would decline treatment for.
Whether Dr. Emanuel is still with us or not, by mid-century, there will be two billion adults over 60 on the planet – double the number today – who will all benefit from the innovation, invention, and creativity that powers the possibility of healthy longevity. We cannot sacrifice the momentum critical to achieving our society’s healthy aging goals to pessimistic, regressive notions of what getting old is “like.”
Nowhere is the collision of outdated, ageist tropes and life-changing innovation more evident than in the field of heart health. For example, heart valve disease is nearly perfectly aligned with aging – it impacts almost 1 in 10 Americans over 75 and 84 million worldwide. While symptoms like chest pain, tiredness, or feeling “off” risk being dismissed as all too common among older adults, they shouldn’t. Valve disease can often be detected with a simple stethoscope check, and innovations developed in just the last few decades mean it can usually be treated with a minimally invasive procedure in patients of all ages. Most importantly, and particularly relevant during American Heart Month, awareness and early detection are critical to improving treatment outcomes and ultimately saving lives.
We must invest in and prepare for the opportunity of healthy aging before it’s too late. Rather than dismiss the innovation pipeline that will support active and productive contributors into “old age,” consider the economic upside. The spending power and financial contributions of those 75 and older across the globe are valued at $15 trillion, which would rank as the third largest economy in the world behind the US and China. Innovation only occurs in an environment and under economic and political systems that encourage it. As our populations continue to age, we have a golden opportunity to create jobs, drive medical progress and improve health outcomes for old and young alike.
Finally, Dr. Emanuel misses the most fundamental point about age demographics in the 21st century. Whether we’re content living until 75 or not, we face an impending demographic tidal wave – our society will soon have more old than young. While individual decisions on how to age are important, society as a whole must prepare for the opportunity that comes with an aging population, or we risk our future to fatalistic arguments about arbitrary expiration dates. It is essential to empower older individuals with autonomy in their healthcare choices and shift the focus from dying at 75 to maintaining health, wealth, and social contributions into older age.
Heart valve disease is one place to start the conversation, and this month is the moment to begin. February is American Heart Month, and on February 22, more than 119 organizations across the U.S. and worldwide – including our organizations, the Alliance for Aging Research and the Global Coalition on Aging – will mark Heart Valve Disease Awareness Day. So join us, get your heart listened to, and tell a friend. It might just save a life.
Lindsay Clarke, JD, is the Senior Vice President of Health Education and Advocacy for the Alliance for Aging Research. Michael Hodin, Ph.D., is CEO of the Global Coalition on Aging (GCOA) and Managing Partner for High Lantern Group.