New Report Calls for Urgent Shift from Lifespan to Healthspan as Chronic Disease and Health Care Costs Soar  

Experts say new “Public Health 4.0” system could extend healthy life by one year, saving $38 trillion

June 24, 2025

(Washington, DC)— Chronic disease now drives 90% of US health care costs, yet half of chronic conditions are preventable. Public health leaders say the nation can no longer afford to treat illness after it appears and today released a bold new report, Healthy Longevity: Public Health’s Next Frontier, calling for immediate action to close the widening gap between how long Americans live and how long they live in good health.

Responding to the National Academy of Medicine’s call to action, the Association of Schools and Programs of Public Health (ASPPH) lays out Public Health 4.0 — a bold approach to building a modern public health system that delivers on the promise of health for all and supports people from before birth through their final years.

For centuries, humanity has pursued longer lives, adding an average of 30 years to global life expectancy over the past century, largely due to public health advances such as clean water, vaccine campaigns, disease prevention, smoking cessation campaigns, cancer screenings, and more. But this progress has stalled, and in the United States, it is reversing. Americans now spend an average of 12.4 years in poor health at the end of life, burdened by chronic diseases that are often preventable.

“Healthy longevity is not only achievable—it is imperative for creating a just and flourishing society,” said Dr. Laura Magaña, President and CEO of ASPPH. “This new system empowers academic public health to lead a transformative shift: from a model focused on treating disease to one that promotes health, vitality, and well-being across the life course. Our field holds both the responsibility and the opportunity to reframe aging—not as a challenge to confront, but as a public health success in progress.”

Key Strategies for Action

The new report outlines an urgent agenda to redesign how we research, teach, practice, and advocate for health across the life course.

• Research: Public health institutions, policymakers, and funders must invest in a bold research agenda to uncover what drives healthy aging, from the biology of aging and the effects of loneliness to the power of social connections and safe, responsible use of AI.

• Education and Training: Academic public health programs must make healthy longevity a core part of 21st-century education. This means updating curricula, so all students understand the life course approach to health, the value of aging, the public health system’s role in promoting healthy aging, and how to deliver prevention at every stage of life.

• Practice: Public health must prioritize prevention at every stage of life, with focused strategies for older adults. This requires investing in a modern Public Health 4.0 system that promotes healthy longevity in every community and works alongside clinical care. Implementation science and cross-sector collaboration are crucial for translating evidence into effective community programs.

• Policy and Advocacy: Decisionmakers and advocates must shift policies from focusing on disease to promoting functional ability and quality of life at every age. That means tackling social and environmental factors, fighting ageism, building age-friendly communities, and investing in public health systems and the workforce. It’s time to reframe aging as a strength, not a burden.

Healthier, longer lives enable older adults to contribute their unique capabilities—such as advanced problem-solving, emotional balance, generosity, and legacy motivations—to society through employment, caregiving, and volunteering. Currently, these contributions equate to 7% of US GDP, and intentional interventions could expand this significantly. An increase in life expectancy by one year is worth $38 trillion, and by ten years is worth $367 trillion.

“Achieving healthy longevity is one of the great opportunities of our time, and academic public health must lead the way,” said Dr. Linda P. Fried, Dean, Columbia University Mailman School of Public Health and Chair of the ASPPH Task Force on Healthy Longevity. “This framework charts a transformative path forward. By aligning research, education, and practice around the full arc of life, we can build a future where aging is not seen as decline, but as potential and where every additional year of life is lived with purpose, dignity, and connection. Public health has done this before, and now, it must do it again.”

Task Force Members

The task force is comprised of fourteen leading public health officials from distinguished institutions across the country.

A Call to Lead and Learn More During an Upcoming Webinar

The framework issues a national call to action: Academic institutions should integrate healthy longevity into core missions, public health systems should be redesigned, and partners across sectors, such as urban planners and clinicians, should collaborate in creating the conditions for health throughout life.

To explore the report’s insights and implications, ASPPH will host a webinar,
The Healthy Longevity Framework for Academic Public Health on July 9 from 12:00 PM – 1:00 PM ET. This live event will feature Task Force leaders discussing the vision, strategies, and next steps for the academic public health community.

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New ASPPH Economic Impact Report Warns of Setbacks to Public Health Progress Amid Federal Budget Cuts

May 20, 2025 

The Association of Schools and Programs of Public Health (ASPPH) released a new report today, Broken Lifelines: The Economic Consequences of Defunding Academic Public Health, detailing the far-reaching impacts of 2025 federal funding cuts on public health infrastructure, research institutions, workforce development, and the broader US economy.