Global life expectancy at birth reached 73.3 years in 2024. Global healthy life expectancy, the number of years a person can expect to live in full health, was estimated at just 61.9 years as of 2021, the most recent year with comparable WHO data, and roughly 63.7 years before the pandemic. The gap between the two figures, commonly referred to as the health-expectancy gap, sits at roughly nine to ten years worldwide and has been widening rather than narrowing over the past two decades, according to longitudinal research tracking life expectancy and healthy life expectancy since 1995.
That gap is the hidden cost of living longer. Most public conversation about aging populations focuses on headline life expectancy, how many years people live, while the years that matter most for household budgets, family caregiving, and government spending are the years lived with functional limitation, chronic disease, or dependency. This article moves beyond the visible healthcare bill to map the fuller set of costs that longer lives generate: personal, family, public, and labor market, while also acknowledging where longevity creates genuine economic benefit rather than pure cost.
Key Findings
- The global gap between life expectancy and healthy life expectancy stood at roughly 9.7 years as of the most recent comparable analysis, and has been widening since at least 1995.
- OECD public long-term care spending is projected to nearly double by 2050, reaching 2.8% of GDP across member countries.
- Legislated retirement-age increases across OECD countries (about 1.5 years by 2050) fall well short of the roughly 8.4 years needed to stabilize old-age dependency ratios at 2015 levels.
- Global healthy life expectancy fell from about 63.7 years (2019) to 61.9 years (2021) during the pandemic, illustrating how quickly the healthspan-lifespan gap can widen under acute stress.
- The cost of longevity is distributed unevenly across countries depending on whether pensions, healthcare, and long-term care are primarily public, private, or family-financed.
- Extended healthy working lives are one of the few demonstrated levers for offsetting the fiscal cost of an aging population.
Longer Life Is Not the Same as Longer Healthy Life
Life expectancy (LE) measures total years of life. Healthy life expectancy (HALE) measures years lived in good health, adjusting for time spent with disability or chronic illness. Research covering 195 countries and regions between 1995 and 2017 found that while both LE and HALE rose globally, LE from 66.2 to 73.0 years, HALE from 57.6 to 63.3 years, the gap between them widened from 8.6 to 9.7 years over the same period, and is projected to keep widening in most countries through 2025.
This matters because the years in that gap are disproportionately expensive. They are the years most likely to involve hospitalization, long-term care, mobility aids, home modifications, and family caregiving, the years that generate cost without necessarily generating the labor force participation or consumption gains associated with the healthy years that came before.
The Personal Financial Cost
For individuals, a longer life extends financial exposure across several categories simultaneously:
- Longer retirement. More years without employment income means retirement savings must stretch further, raising the risk of savings depletion late in life, a risk actuaries call longevity risk.
- Housing. Aging in place often requires home modifications for accessibility; moving to assisted living or a retirement community carries substantial and rising costs in most markets.
- Healthcare and long-term care. Out-of-pocket healthcare spending tends to rise with age, and long-term care, whether in-home aides or residential facilities, is typically only partially covered by public systems, with the remainder falling on personal savings or family contributions.
- Insurance. Premiums for supplemental health coverage and long-term care insurance generally rise with age and are structured around actuarial assumptions about remaining years of life.
- Inflation exposure. A longer retirement horizon means more years of exposure to inflation eroding the purchasing power of fixed pension income or savings.
The Family Cost
Longer lives shift a meaningful share of care costs onto families, most often in the form of unpaid time rather than direct payments. Adult children, and increasingly, grandchildren, provide informal caregiving for aging relatives, an arrangement that carries real economic cost even when no money changes hands: lost wages from reduced work hours, forgone career advancement, and the physical and emotional toll documented extensively in caregiver research.
Because longer lives now frequently overlap with delayed childbearing, growing numbers of adults find themselves simultaneously supporting aging parents and dependent children, the dynamic examined in detail in coverage of the sandwich generation and of intergenerational caregiving more broadly. Intergenerational financial transfers also flow in both directions across a longer lifespan: parents supporting adult children for longer, and adult children eventually supporting aging parents, sometimes for a decade or more.
The Public Cost
Government exposure to longevity runs through three main channels, each covered in detail elsewhere in this dataset:
- Pensions. Every additional year of life expectancy, absent an offsetting increase in retirement age, extends the average duration of pension benefit payments.
- Healthcare. Public health systems bear a growing share of costs concentrated at older ages, though, as with individual costs, a meaningful portion of lifetime healthcare spending clusters near the end of life regardless of age at death.
- Long-term care and social protection. OECD projections show public long-term care spending across member countries nearly doubling by 2050, reaching 2.8% of GDP, driven by the growing number of people living into the ages where care needs become most intensive.
The Labor Market Cost and Opportunity
Longevity is not purely a cost to the labor market. Longer healthy years extend the period during which people can remain economically active, and rising participation among workers past traditional retirement age has been identified by OECD researchers as one of the few levers capable of meaningfully offsetting pension and dependency-ratio pressure.
The catch is that legislated retirement-age increases across OECD countries have so far totaled only about 1.5 years on average by 2050, far short of the roughly 8.4-year increase that OECD modeling suggests would be needed to fully stabilize old-age dependency ratios at their 2015 level. Where labor shortages exist, older workers with accumulated skills and experience represent an underused resource; where they persist in physically demanding occupations, longer careers can compound health costs rather than offset them.
The Hidden Housing and Infrastructure Costs
Longer lives generate infrastructure costs that rarely appear in headline aging statistics: retrofitting housing stock for accessibility, expanding assisted living and residential care capacity, adapting public transportation for reduced mobility, and building community infrastructure, from grocery access to social spaces, suited to an older population. These costs fall on a mix of private homeowners, developers, municipalities, and national housing agencies, and tend to be underestimated in fiscal planning that focuses primarily on pensions and healthcare.
Where the Cost of Longevity Falls
| Cost Category | Primary Payer | Nature of Cost |
|---|---|---|
| Extended retirement income | Individual / pension system | Direct financial |
| Long-term care | Individual, family, public system (mixed) | Direct financial + unpaid time |
| Family caregiving | Family members | Unpaid time, lost wages |
| Public pensions | Government / current workers | Direct fiscal (pay-as-you-go) |
| Public healthcare | Government | Direct fiscal |
| Housing and accessibility | Individual/public housing agencies | Capital cost |
| Insurance premiums | Individual | Direct financial |
Why the Costs Differ Between Countries
Countries with strong social insurance systems, much of Western Europe, for instance, socialize a larger share of longevity costs through pensions, universal healthcare, and public long-term care programs, reducing individual and family exposure but increasing public fiscal pressure, as detailed in analysis of who pays for longer lives.
Countries with weaker public systems but strong extended-family norms shift more of the cost onto unpaid family labor. Countries relying heavily on private markets for healthcare and long-term care place the greatest direct financial burden on individuals and families, with outcomes that vary sharply by income level.
When Longer Life Also Creates Economic Benefits
The cost framing should not obscure the genuine economic upside of longevity. Longer healthy lifespans extend potential working careers, expand the pool of experienced labor, and, in aggregate, represent one of the great achievements of modern public health and medicine, as the UN Population Division has noted in its own analysis of rising global life expectancy.
Older populations also represent a substantial and growing consumer market, and accumulated skills among older workers can offset some of the productivity losses associated with a shrinking working-age population, provided health status permits continued participation.
The key variable, again, is the gap between lifespan and healthspan: longevity that comes with extended healthy years produces far more economic benefit, and far less pure cost, than longevity accompanied by extended years of disability and dependency.
Conclusion
The most expensive years of a longer life are rarely the ones people picture when they imagine living to 90, they are the years in the widening gap between lifespan and healthspan, currently averaging close to a decade globally. That gap, not raw life expectancy, is the real driver of rising personal, family, and public costs. Countries and households that manage to compress that gap, extending healthy years rather than simply extending years, will face a fundamentally different, and far more manageable, cost profile than those where longevity gains arrive mostly as additional years of dependency.
Frequently Asked Questions
1. What is the cost of living longer?
It spans personal retirement savings, family caregiving time, public pension and healthcare spending, housing modification, and insurance, with the size and distribution of these costs varying significantly by country and by whether additional years are lived in good health.
2. Does longevity always increase healthcare costs?
Not proportionally. A significant share of lifetime healthcare spending clusters in the period immediately before death regardless of age, so the real cost driver is how many years are lived with chronic illness or disability, not simply how long someone lives.
3. What is longevity risk?
It is the financial risk that an individual outlives their retirement savings because they live longer than the assumptions used to plan their retirement income.
4. Why does longer life affect families financially?
Because informal, unpaid family caregiving, provided mostly by adult children and grandchildren, absorbs a large share of eldercare need, generating real economic cost through lost wages and reduced work hours even without direct payments.
5. Can longer lives benefit economies?
Yes, longer healthy lifespans extend working careers, expand the labor pool, and support a growing consumer market of older adults, particularly where health status allows continued economic participation.
6. What is the difference between life expectancy and healthy life expectancy?
Life expectancy measures total years lived. Healthy life expectancy (HALE) adjusts that figure for years lived with disability or chronic illness, producing a more accurate measure of years lived in good functional health.
7. Is the health-expectancy gap growing or shrinking?
Research covering 1995–2025 shows the gap between life expectancy and healthy life expectancy has been widening globally, even as both figures individually rise.
8. Which costs of longevity are hardest to measure?
Unpaid family caregiving time and housing/infrastructure adaptation costs are among the least visible in standard economic statistics, despite representing substantial real costs.
9. How much is public long-term care spending projected to grow?
OECD projections show public long-term care spending nearly doubling across member countries by 2050, reaching about 2.8% of GDP on average.
10. Can working longer offset the cost of living longer?
Partially. OECD analysis shows that legislated retirement-age increases so far fall well short of what would be needed to fully offset rising dependency ratios, meaning longer working lives help but do not fully solve the fiscal challenge on their own.
Sources
- World Health Organization, World Health Statistics 2024.
- United Nations, World Population Prospects 2024: Summary of Results, UN DESA Population Division.
- OECD, “Future long-term care expenditure trajectories across OECD countries,” 2026.
- OECD, “Long-term projections of public pension expenditure,” Pensions at a Glance 2025.
- “A comparative, correlate analysis and projection of global and regional life expectancy, healthy life expectancy, and their GAP: 1995–2025,” PMC/NIH.
- PAHO, “Health-adjusted life expectancy (HALE),” Americas regional data.
