The Wealthspan Equation: Why Living Longer Is No Longer Enough
As living longer reshapes the global health landscape, insurers face an unprecedented reckoning. The risks they price are being rewritten.
There is a quiet revolution underway in how we think about wealth. Not the kind denominated in Swiss francs or indexed to equity markets, but the kind measured in years of vitality, years free from disease, dependency and the slow erosion of capacity we have normalised as ageing. This is wealthspan: the period of life you can actually spend.
This idea matters enormously to one industry above all others: the sector that bets on how long you will live and how healthy you will be when you get there. Life and health insurers have always priced biometric risk: mortality, morbidity, the actuarial calculus of human fragility. But the landscape that underpins those calculations is shifting beneath their feet, driven by forces that no pricing table from 2005 could have anticipated.
Healthspan: The Gift That Comes With a Bill
The statistics are staggering and, depending on your perspective, either thrilling or alarming. By 2050, the number of people over 60 will double to more than two billion (WHO, 2022). In Switzerland alone, one in three people will be over 65 by mid-century. This comes with a profound question insurers must answer: what happens to the risk pool when people live longer, but not necessarily better?
The distinction between lifespan and healthspan, popularised in longevity science and now increasingly central to insurance strategy, is the core of the problem. A person who lives to 90 with ten years of managed diabetes, cognitive decline and chronic pain is not the same actuarial event as one who lives to 85 in full function. The compression of morbidity thesis, first proposed by James Fries in 1980 and still vigorously debated, holds that it is possible to push illness and disability to the very end of life. If it holds, insurers win. If it does not, if longevity extends the years of illness rather than compressing them, the financial implications are severe.
A person who lives to 90 with ten years of managed diabetes is not the same actuarial event as one who lives to 85 in full function.
The Rising Tide of Non-Communicable Disease
Non-communicable diseases (cardiovascular disease, cancer, diabetes, chronic respiratory conditions) now account for 74% of all deaths globally (WHO, 2023). This is not new. What is new is the acceleration. Obesity rates have tripled since 1975. Type 2 diabetes has become so prevalent in working-age populations that it is fundamentally reshaping disability claims, long-term care costs and the actuarial life tables that life insurers depend upon.
The health policy response has been uneven. Universal health coverage remains incomplete even in wealthy nations. Prevention is chronically underfunded, typically receiving less than 3% of health budgets in OECD countries, while curative spending climbs. For insurers, this creates a double exposure: rising claims in the present and a healthspan deficit being built into the population for the future.
Insurers must find ways to make tomorrow’s cures accessible today, without collapsing the financial architecture that makes protection possible at all.
Wealthspan as Strategic Imperative
The concept of wealthspan, the productive, vital years available to an individual, is emerging as a unifying lens through which all these forces converge. It connects the epigenetics of accelerated ageing to the economics of chronic disease. It positions health and life insurers not merely as risk-bearers, but as architects of a system that either extends or curtails the years people can genuinely spend.
The most forward-looking insurers are already moving. Prevention incentives, digital health partnerships, data-informed underwriting and engagement with health policy at the national and multilateral level are no longer corporate social responsibility exercises. They are risk management. The insurer that can shift its member population’s biological age by even one year through sustained lifestyle intervention has fundamentally improved its book.
Adrita Bhattacharya-Craven
Director of Research, Population Health Trends — The Geneva Association
The convergence of forces described in this piece (the repricing of longevity risk, the biological weight of environmental exposure, the tension between medical innovation and coverage affordability) is exactly the terrain that Adrita Bhattacharya-Craven has made her research domain. As Director of Research for Population Health Trends at the Geneva Association, the leading global think tank for the insurance industry, she works at the precise intersection where epidemiology meets financial risk.
Her research maps how biometric risks, the very foundation of life and health insurance, are being reshaped by health policy failures, rising non-communicable disease burdens, the accelerating pace of medical innovation and the compounding pressures of climate and environmental change.
Her two landmark publications — Insurance and the Longevity Economy and Insuring Tomorrow’s Cures: Balancing Promises and Practicalities — are among the most substantive contributions to this debate from within the sector itself. The first examines how extended longevity transforms the economics of risk pooling and protection design. The second confronts the most urgent near-term challenge: how to extend insurance coverage to transformative therapies (gene therapies, cell therapies, next-generation oncology) whose curative potential is matched only by their price. Together, they frame the wealthspan challenge not as a philosophical exercise, but as an operational reality the industry must navigate now.Her career, shaped over two decades across the National Health Service in England, the World Bank, the Foreign, Commonwealth and Development Office and KPMG, gives her a rare vantage point: she understands how health systems are financed, where they fail and what it takes to build the cross-sector coalitions that can actually change outcomes at scale. In a field where the distance between research and action is often vast, Adrita’s work closes that gap.
