One of the great worries of ageing societies is that, although we are living longer, we spend the additional years ill and in need of care. A new analysis by economists led by Amy Finkelstein of the Massachusetts Institute of Technology (MIT) paints a considerably more optimistic picture.
The study
The researchers analysed data from the Medicare Current Beneficiary Survey, a large survey of older people in the USA. They tracked how the health and independence of respondents developed from year to year – over a period from about 1993 to 2017. The work was published in June 2026 as a working paper of the National Bureau of Economic Research (NBER).
The key results
- Life expectancy at age 66 rose by 2.4 years over the study period.
- According to the authors, these additional years were “entirely” healthy years of life – without severe physical or cognitive impairment.
- The time people spend with severe impairments fell by around 30 %.
- Accordingly, the expected need for nursing home and home care decreased.
- Women spent less time in the most severe stage of illness than before.
What does this mean for health systems?
The analysis also calculates the consequences for the social security systems: the expected expenditure of US Social Security rose by 14 % as a result of longer life spans. Expenditure by the Medicare health insurance programme, by contrast, rose by only 6 % – less than feared, mainly because people need less intensive treatment at the end of life.
Why are we ageing in better health?
The study itself does not explain why health in old age has improved. Another study referred to in this context cites better medicines and the successes of public health measures, such as anti-smoking campaigns, as possible reasons.
Important limitations
This is a working paper that has not yet been published in a peer-reviewed journal. The data extend only to 2017 and come from the USA – developments such as the COVID-19 pandemic or the increase in obesity in younger age groups are not reflected. Whether the results can be transferred to Germany or Europe remains open.
Conclusion
The analysis contradicts the widespread assumption that a longer life inevitably means more illness. It shows that advances in prevention and medicine can not only add years to life but also life to years.
Note: This article is for general information only.
Sources
- TIME: People Are Living Better at the End of Their Lives (23.06.2026) – original paper: NBER Working Paper w35346
