Living longer is good news. Living longer while sick, sore, or sidelined is not the deal most of us think we signed up for. That difference has a name: the gap between lifespan and healthspan.
Healthspan vs. lifespan: the difference
Your lifespan is the total number of years you live. Your healthspan is the part of those years you spend healthy and able to do what matters to you. Merriam-Webster added “health span” to its dictionary in March 2018, describing it as the time a person is healthy, not just alive.
In UNSPLODE, I use HealthSpan in a slightly more personal way:
“HealthSpan” is a word that combines health and lifespan. It is the recognition that your overall health, longevity, and sense of purpose and fulfillment requires that you take control of your physical and mental wellbeing.
Caleb O. Pinegar, D.O., A.T.C., UNSPLODE
The 12-year gap
In December 2024, Mayo Clinic researchers Armin Garmany and Andre Terzic published a study in JAMA Network Open comparing life expectancy with health-adjusted life expectancy in 183 World Health Organization member states, using data from 2000 to 2019. What they found:
- Worldwide, people lived an average of 9.6 years in poor health by 2019, a 13% increase since 2000.
- The United States had the widest gap of any country studied: 12.4 years, up from 10.9 years in 2000.
- Women’s gap was 2.4 years wider than men’s.
As Dr. Terzic put it in Mayo Clinic’s announcement, “Growing older often means more years of life burdened with disease.” For most people, those years land right in the stretch they’ve been saving for.
Where the gap really starts
The gap in that study is measured at the end of life, but it starts much earlier, as the distance between what people think their bodies can do and what their bodies can actually do. I’m guilty of it too. In the book I admit to deciding I could build my own backyard retaining wall, followed by several sleepless nights of back pain.
The gap between what you think you are capable of and what you can actually do will only widen.
Caleb O. Pinegar, D.O., A.T.C., UNSPLODE
That isn’t meant to scare you. It’s meant to move the starting line. Unless you’re in your early twenties, your body has already passed its natural peak, which means the best time to protect your healthspan is now, while gains still come relatively easily.
Be the insurance company of your wellbeing
Insurance companies work hard to prevent expensive claims, because every claim costs them. In UNSPLODE I suggest borrowing that discipline, but pointing it at your own health instead of a balance sheet.
In other words, do the work now to prevent the surgery from happening later.
Caleb O. Pinegar, D.O., A.T.C., UNSPLODE
Take stock with a health portfolio
Trevor asks clients to inventory their finances before building a plan. I ask the same of your body. Think of your health as a portfolio of “asset classes,” each with a current value and a direction:
- Muscle mass: muscle is protective against nearly every cause of age-related decline.
- Cardio endurance: what your weekly routine actually looks like, not what you intend.
- Flexibility and agility: how freely and efficiently your body moves.
- Brain health: the habits that help or hurt how you think and cope.
- Gut health: how you’re treating the system that touches everything else.
- Sleep: how much your body asks for when there’s no alarm.
- Calorie intake: what you eat compared with what you need.
- Purposeful pleasure: the joy that keeps you moving and coming back.
For each one, ask three questions: Where am I today? Where is it headed? What would I like it to look like in five years? Then ask your own physician which screenings make sense for you. The book covers several, from standard screenings for your age to bloodwork and VO2 max testing.
One small step this week
Pick one asset class. Rate it honestly from 1 to 5. Write one change you could keep for a month, not just a week. Small, repeatable moves are what close the gap over time.
- Download the free Health Portfolio worksheet to rate all eight and build a goal.
- Take the HealthSpan version of the Unsplode Score for a quick baseline.
This article is general education, not medical advice. Talk with your own physician before you change your exercise, nutrition, or testing.
About the author
Caleb O. Pinegar, D.O., A.T.C.
Caleb O. Pinegar, D.O., A.T.C., is an orthopedic surgeon at C.O.P. Orthopedics and co-author of UNSPLODE. He wrote the HealthSpan side of the book.
From the book UNSPLODE: The Bold New Approach to Reconstruct Your WealthSpan and HealthSpan. Read both introductions free.