From longevity literacy to
longevity fitness

Insights Report

Our society is transforming, and fast. The biggest challenge—and the biggest opportunity—will be helping people improve not just the length of their lives, but also the extent of their health and wealth.


Longevity is perhaps the greatest gift of our time and one we’ve almost come to take for granted. But as life-prolonging medical advancements proliferate, how do we help people improve not just the length of their lives, but also the extent of their health and wealth? In other words, how do we match people’s life span with their health and wealth spans? This report provides a blueprint, including individual and societal actions, for maintaining an aging population’s health, wealth and happiness.

Key Insights

  • Longevity fitness requires accruing three types of capital: social, health and financial.
  • Maintaining physically, emotionally, cognitively healthy lifestyles while in your 20s and 30s can substantially impact your quality of life in later years.
  • The key to long-term retirement security isn’t wealth, it’s income—specifically, ensuring you will maintain your standard of living in retirement and not run out of money.
  • The healthcare industry, nonprofits and governments will all need to play a greater role in helping people maintain good health as they age.
  • Large differences in typical life spans persist based on wealth, race and gender.

Longevity fitness might best be described as longevity
literacy converted into action.


The author analyzed several decades worth of government and industry data pertaining to longevity, health and retirement readiness, and then formulated recommendations for supporting the wide-ranging needs of an aging society.

Watch a discussion of this topic at The Wall Street Journal ’s Future of Everything Festival.


Everybody. TIAA does a lot of, uh, research into longevity, into retirement. What, um, is the latest research telling you about all these issues?


Jack, thank you. It was a great introduction.

SPEAKER A: And you have 6 hours to answer that question.




I'm a researcher, so you're going to get me going here. Cut me off when you need to. Cut me off. Um, so you were making this point about us living longer and racing towards 100 year lives, and you mentioned that the average age has gone into the seventies.

But if you were to jump past infant mortality, because that number that Jack shared includes infant mortality, so we figured age 55 or 65, you've jumped past it. So then what's the age? According to the Society of Actuaries, women, uh, live up to age 87 and men to age 85. So that's ten more than the average that we talk about.

So we said in our research, can we ask people and understand whether they know this? You might instinctively know we're living longer, but do you know by how much? Because that question is going to be very important to plan our, uh, financial lives. So we call that research, uh, longevity literacy.

And so we asked this technical question, if you get to age 65 and if you're a man or a woman, how long should you expect to live? Um, and we gave answers along with the. I don't know, as multiple choice questions. Only a third of the

survey respondents across the board in the US got it right.


Um, and were most people lower than expected?


Lower than expected. I was about to also say, who underestimates and who overestimates men underestimate that number. Right. But a third, for me, the AHA was a third of the respondents, even though we gave answers, said, I'd rather say I don't know because it's a question that we have not grappled with.

Now, I'll just stop with this one other insight. Uh, we also do a companion study around financial literacy. You understand a stock, do you understand a bond? You understand inflation?

Simple questions. In that financial literacy research that we have done for a decade, women lag men, and that, uh, women lagging men has stayed steady for about a decade. And I said to myself, that is the very definition of insanity. You ask the same question, you get the same answer, nothing changes.

So we said, let's ask this other question about longevity literacy. And here'swhat happened. By the same amount that women lag men in financial literacy, women lead men in longevity literacy. And so we can have a whole conversation, uh, which I'm sure we will, as to why did that happen.

Flip. But, uh, the bottom line for me is when a financial advisor is having a conversation, the financial advisor better have both the male and the female in the conversation to get both these perspectives.


Yeah, that is very important. And interestingly, I didn't know the point about literacy, but women are better investors for men. And when researchers dug into
that, it was for a very simple reason. They traded less, they were less cocky, and, uh, they bought in whole, um, no pun intended.


Um, uh, Colbert, uh, I'm trying to recover from that.


Speaking of financial, the retirement system to pay for this increased longevity has moved in the wrong direction. It used to be that people had pensions, which were defined benefits for the rest of your life. Now we're in a defined
contribution, which is really a euphemism. It's a 401K.

You put as much in, you can only take out what you got and how it gained. Do, uh, people understand the seriousness of that issue?


No. Thanks for the question, Jack. I don't think they do. I think a lot has transpired the last 50 years, so I'm going to try and summarize what's occurred.

1978. 401K has become established as sort of the vehicle for folks to save, and that, um, responsibility shifted from companies to individuals. Um, under a pension, you worked a certain number of years, and there was an income replacement ratio, and you know that you were to receive that supplemented by Social Security. That's changed.

Um, 401ks are great, but they also have some shortfalls. I think the number one shortfall is we're the only industrialized country that does not have a requirement or mandate, if you will, that a company has to offer a retirement plan, an employee has to participate in a retirement plan. So as a result of that, you have suboptimal participation. There are some folks who are not participating at all, not making any contributions, and you have companies who don't offer it, particularly small companies.

And people think, is that really relevant? Well, half Americans work for companies, less than 200 people. So you probably have 40, 45% of the population that does not have access to a plan. And we see some attempts from states that require IRA mandate and all these other state sponsored plans which are really slow on the uptake.

So we have a lot of work to do. But really, the movement from the responsibility has created some challenges. Right. So I think, uh, from a public policy perspective, if we required folks to participate, employers to offer, that would help.

The other thing is understanding basic finance. Right. I think what 401s are the catch all for a lot of things. They're not just retirement savings.

I think the way they've been constructed, they're also emergency savings. And so politicians want, um, employees to be able to access to their money in case of emergency, all reasonable and rational. But what it's does is it's changed the priorities around. So people are taking money out of their 401 case for things that they probably should not be doing right.

And then compounding that, um, is they also are investing differently. So if folks knew that if you just kept the money in, right, even when you changed jobs, you've moved it into an IRA, um, and you also didn't try and take the money out, and then you could have an illiquidity premium. So, say you could earn another 150 basis points for 30 years.


One and a half percent.


One and a half percent over 30 years. That could be 500, 600, $700,000 if people had the option to do that. So some of it is public policy needs to shift, that will change behavior. And then there needs to be much more financial education about the value of not taking the money out for things that probably don't reach the same level of importance as retirement savings.

And during this entire period, people are living longer. The pharmaceutical industry has vastly accelerated. Right. But the financial system, the retirement system has not modernized itself in the same way that pharmaceuticals are doing.

Right. Arp is very strong. All the things you need to do to live longer. Right.

I get Arp now. So I read it. Um, it's a great magazine for those who receive it. Um, and if you're not receiving it yet, when you do, you're coming.

Wow, that's pretty good. Um, so, uh, I would say, uh, there's just a lot. This is a very complicated problem, and it's going to come at some cost. And so if we realize what the costs are, then we'll do something about it.

The other challenge is that we need to overcome is it's not a two year election cycle problem to solve. And so you can do all these things for public policy when you're going back for reelection, you can't talk about, I've helped to

modernize the retirement system.




And if it's not tangible, there's no evidence to it, then that creates some challenges.


In fact, the system actually disincentivizes the smart approach to this. So obviously, there are both health and financial hurdles that we need to clear. We've got 22 minutes to do it. Let's start with health, then we'll move to financial, and we're going to talk about both public policy and personal responses.

Mary, I'll start with you. Uh, data and trends that you're seeing that pose a risk to the health side of longevity.


Um, well, most of us are going to enter 65 with one chronic condition, but four out of five are going to have multiple two or more chronic conditions. And I think what's important to understand is that these are often accompanied by other kinds of challenges, visual and hearing deficits. So I'm going to paint this picture for you, because there's really, really excellent research about what it is that we can do about this. Uh, but right now, understanding the threats to, to quality of life are so essential.

First of all, people living with multiple chronic conditions in the current healthcare system are cared for by too many people, um, too many clinicians. And nobody is taking care of misses Smith, 75, with five chronic conditions.

Uh, as she lives longer, those chronic conditions are going to be accumulating and creating deficits, functional deficits, cognitive deficits, physical deficits that we right now do not support. Well, Medicare does not cover, uh, support for people living who need personal health needs support with just, uh, caring for themselves every day.

Uh, and these challenges are not equally distributed. We have certain segments of our population, women, especially women of color, uh, people as they're aging 80 and 90, having more and more of these challenges. And we need to think about how we can make universal care support available to these populations. The last thing I'll say is that all of this does also have financial effects.

Uh, the health issues, uh, result in consumers, older adults spending more and more out of pocket for support in order so they're still paying co pays and for drugs and for supplies. So all of these combined suggest to us that we have a need to interrupt what is a negative trajectory in aging, really impeding high quality living. And we now have the research to know how to do it. We just need the will to act on that.


Jack, may I add a quick point? So I want to add a different lens to what Mary just shared. So when we talk about, uh, aging and caregiving and saving for a long life, we're thinking about ourselves. But I want to shift the lens to the
caregiver, meaning, um, my father is 88, so it's not that his planning, it's my planning for him.

So what is out of my pocket as a caregiver, as an informal caregiver, that's going to cost me. So there's a study that Mary and I did last November where we estimate that out of pocket costs for an informal caregiver, son or daughter, for their parents is $7,000 on average a year. If the elder in the family had no chronic conditions, if there was Alzheimer's disease or Parkinson's disease, Mary and I estimate it could be two and a half times as high per year on average. So if you're on the coast, if you have multiple elders in the family with these issues, you become the family banker.


Uh, I pick up on that because the issue, we have a lot to say, but the issue of dementia, dementia in particular, is something that I think we really need to pay attention to. So we have 16 million Americans today delivering over 17 billion hour of unpaid support to people with dementia in the last five years. Uh, over $60,000 of an older adult's wealth is depleted as a result of dementia. But for the caregivers, uh, they're paying 80% more than if they were caring for an older adult with any other chronic condition, depleting about a third of their wealth.

So these are real important, significant opportunities that have health consequences. Big health consequences.


Yeah. The only thing I would say is there's an affordability crisis as well, across not just the caring for someone older, but also just childcare. On average, Americans are paying $10,000, $15,000 for child care. Compound that with elder care, and then now you have inflation, which really didn't exist in this country for a couple of decades.

You put all that in and the pressure psychologically on folks, because this also impacts, uh, folks mental well being, about feeling the pressure of having to have so many different priorities that you're trying to address. That I think that also has an impact on, um, employee sort of, uh, confidence performance, um, and the ability to focus because you have so many other issues, ah, impacting your daily life and.


A productivity drain that strain, financial strain is one of the top reasons for psychological stress. And all of these lead, they're like, it's a cascade of issues. Somebody has financial strain because they can't, they don't have the assets to pay for expenses, um, or they perceive that they don't. This is different than, um, all other kinds of issues because it's chronic and it absolutely accelerates the stress response, accelerates all of these diseases that we're talking about.


We could, and people have written books on this, Mary, but I'll put you on the spot. Give us one or 2oz of prevention that people in the room at their young age could take to at least mitigate, um, these problems later on in life.


Well, just on the issue of dementia itself, since it's a big one. There's a recent review that says 40% of cases of dementia could either be prevented or delayed if we did right things early in life. Um, of course everybody knows about smoking, um, but physical exercise, diet, all of these are investments we're making in order to have a health production function, in order to be able to live longer, higher quality of lives. It's not just living longer, it's living longer with a sense of meaning and purpose.

So thinking in your twenties and thirties, and I'm looking at this audience, many of you are in that category, uh, this is the time to be investing in your future because those investments pay off dramatically, um, going forward.


The only thing I would add is we're hurling towards this proverbial fork in the road because we can tell people what to do and like, this is what's best for you versus I want my individual freedom and freedom to make even bad choices.
So that's kind of where we are. And that's why I'm in the camp of, we have to have some requirements and mandates because the country cannot simply afford. Right.

Because we're talking about trillions of dollars. There's no way to alleviate this issue. So then it's going to, uh, evolve into, well, there's some people who can afford to do all this and others can't. And you see what happened in our sort of, um, um, medical, uh, system where there are folks using emergency rooms as their primary physician.

It's not sustainable. Right. And so we have to come up with some sort of approach that makes people feel heard, but also at the time, gives them sort of hope for the future by requiring them to do certain things.


And when you demand the freedom to do certain things, then you put the country in a tough position if you ask to socialize. Uh, the solution to the problem.


Exactly. Uh, but we already socialize certain things. Social Security, Medicare, Medicaid, these are social programs.


Sure, exactly. Um, so on top of all this, there is a vast inequality in the way these problems strike different groups. In your research, Surya, I saw that, um, between the poorest and the wealthiest cohorts, the life expectancy for men was a 15 year spread. I think for women it was ten years.

Tell us briefly about that.


Yeah, so I want to just make an overarching statement that this is joyous news that we are racing towards 100 year lives. Right. But the question is, we've been afforded a longevity bonus. How do we navigate this 100 year life?

With longevity fitness. That's the overarching headline. So this is very positive for society. But we must, uh, appreciate that if you double click on that number, it's different by gender, it's different by race, it's different by levels of affluence, it's different by literacy levels.

So we need to appreciate that. Um, so first of all, there's difference between males and females, uh, by any level of affluence, women live longer than men. Um, but troublingly, at lower levels of affluence, women outlive men by women

lot longer. So it's a one and a half year difference between males and females.

At the highest levels of affluence, it's close to six years, where they make it to the lowest levels of affluence. So how do you kind of make that equal? We went

to the CDC and said, uh, what is this affluence by race and ethnicity? And I said to myself, if it's correlated to affluence and women live longer than men, then I could deduce that white caucasian females live the longest.


But, uh, the CDC data came back and said asian american women live the longest, followed by hispanic latino women. So that confounds the affluence question. Uh, and then when you look at Social Security income by those same race and ethnicities, hispanic latino women earned the least.

So now you have this gulf between income and life expectancy. So this is a much more complicated issue. Rather than just saying it's unequal to say what are the levers that drive that equality?


Sure. Um, I think we should transition there to finance. Just looking at the clock here. So, uh, Mary already referred to the fact that there's a real tie between the financial life and the health life.

Financial stress. Stress hurts your health. Colbert what can be done to make people more aware of what they will need and maybe throw out some advice for this audience, what they should be.


Doing, what they will need. I think the state of financial literacy in this country, there's a lot of opportunity there. Um, I think there are some things that, to me, it's a life skill. And if more folks were aware of that, they would make different decisions.

I think you make the best decisions you can make under the information that you have available to you in many cases. And some of that is tied to some of the things, the variables that Surrey just mentioned, education, race, gender, socioeconomic status, all those reading things.


Wall Street Journal.


Reading the Wall Street Journal. I was just about to say that it was my 6th bullet point, but, um, there's a lot of things that we can do, um, that are sobering. But I think we are in a very consumer driven economy and always wanting the next thing. We had a whole generation during the great Recession in 2005.

A lot of that was fueled by credit expanding, um, and not trying to make better long term decisions. So I think we need to do more of that. We need to make people aware. What do you want your life to look like when, um, you retire?

Most people don't think about that. It creates a lot of anxiety. Right. I want to enjoy my life now.

I'm 35. So I think financial literacy is the foundation of things, uh, to do. I think it should be required in every high school. I think the challenge is that's a state by state process.

We live in a very balkanized, uh, country, and so every state's going to decide what that curriculum needs to be. But I think that should be standard. Um, and then people need to know exactly at different points. Just like, um, when you have a situation where the credit card companies down, there's a statement that says if you make the minimum deposit, minimum payment, it will take you 35 years to pay off your debt.

I think within a retirement plan construct, people need to know, if you continue doing this, you will have x amount available to you. Right. That's just savings. And then to change the conversation, just savings to income, how much income will you need, if you will, to replace.


How you're living now in retirement, that's very different from, you just need to save to a number and then you need to draw down. And now we're seeing, because of equity market volatility and these huge drawdowns, like we saw you retire with a million dollars, and then three months later, through no fault of your own, you're down to $600,000. Right.

And so that 4% is a very different construct. So we think there's a combination of things people need to think about is Social Security. If we can modernize it, right. Because right now it's going to run out of money in 2034.

That's one piece having an annuity or something that gives you income. Right. That's sort of, um, insulated from market volatility, etcetera, especially now when interest rates are high.


And importantly, you're talking about that would be an income stream for life rather.


Than income stream for life, taking 4%.


Out of your life.


Right? So someone and people, these are not either or situations. These are in addition to. You should think about having some equity exposure.

You should think about having some annuitized income. You think about having some equity exposure, like, all these things are part, if you will, of a package to get you to where you need to be. So that's, I think, what we would recommend.


That's kind of a policy point to Surya or Colbert. Would you want to address what people in their personal lives, in addition to deferring gratification at age 35, which you referred to, what are some solid steps they should be taking in order to make sure that that income is there 30, 40 years hence?


Well, I think a couple things they need to look at their total picture, just like saria mentioned, et cetera, which is, are you going to be, um, taking care of someone older? Are you going to help to supplement your child's education? Like, there are all these other factors to give a very holistic view of what your financial future looks like. I think we try and dimension in very narrow, siloed ways, you're going to come up with a suboptimal sort of response.

So you have to look at it in terms of its total sort of, what do you think it's likely to be? If there's a history of certain types of illness in your family, what does that mean? Should you think about long term medical care insurance? It's just a very complicated sort of process that we need to figure out.

But people have to attack it earlier. Right, because most people don't understand compounding. You start serving earlier, saving early, even if it's $5, $5 a day for 30 years is a few hundred thousand dollars. Like, the numbers kind of speak

for themselves.

But to get people into that mindset is to get going. That is the biggest impediment.


I think that high school financial literacy would help. Um, so we have microphones somewhere for anybody who has questions. So put up your hand. Um, in the meantime, briefly tell us, what is TiAA doing directly to address some of these issues?


Yeah. So I will double click on the point that Colbert made around lifetime income. Uh, so the way one should think about, uh, having financial stability, or let's call it financial fitness, through these lives is to say I have a base layer of
Social Security and a layer on top of an income stream I've set for myself, which Tia is very much in the business of helping people do. And then the layer on top of that is what can ride with the market.

Right. So that you have peace of mind. If the first two layers pay for your day to day expenses, then you're not worried about you don't become a reluctant spender in retirement. So that notion of lifetime income, I, uh, would say, is the key component that Tia is addressing.


One of our board members coined, uh, a phrase, income is the new outcome. And so I think that's appropriate, because I think people think about this magical number that's going to solve everything that they need, and that's not the case. So it's having an income strategy, I think, is what's important, as opposed to a number.


Got it. Ah, was there a micron there? Yeah. Ok.


I'm interested to know if your research has any, um, indicators on how people.


Are doing with regards to estate planning or the lack thereof, and how that.


Impacts them in this case of longevity.


Yeah, very important question, and I would say there are two levels to it. The first is, do they access a financial planner, even to begin with, before they have more sophisticated conversations around estate planning? Uh, and, um, the younger you are, the less likely in terms of access, and also it changes by demographic group. And one of the points that's missed is sometimes, in most of the cases, employers provide advice as well, and being able to take advantage of advice, both offered by the employer and outside, becomes very important.

But the numbers are substantially low and there's a lot of education that we can do to help people access financial advice, including estate planning.


I think if memory serves me correctly, more than 70% of americans die without a will. So it's something that we should take seriously, because that creates a lot of anxiety throughout the whole family ecosystem. Um, um, and it would alleviate a lot of things, um, that need to be addressed. Um, that's one part of having, if you will, a good, solid financial foundation is having a will, right?

So you can make sure that you have an orderly financial disposal of all of your assets. That's a huge problem in this country.


I just spoke to a 70 year old woman whose 50 something year old son had died unexpectedly. Small business owner, no will. Um, and she said, if I give you one bit of advice, get that will going. It's been a family nightmare.

I think there's another microphone over here. The question. Yep. Hi.

Um, what is the future, um, for us humans? Being able to get scanned earlier, because going once a year, uh, for your annual, and getting scanned for cancer, scares the shit out of me. But there's no, uh, everyone says you have to get scanned. How do you do it?


Well, there are longevity centers that have emerged that are doing, um, and maybe some who have participated can talk about this, but, uh, who are doing full body scans, uh, anticipating, you know, the kind of history, um, uh, helping you to have more of a proactive lifespan approach to health. Uh, and, ah, really targeting, you know, at age twenties and thirties, what it is that you can expect to develop, um, in terms of problems, conditions, diseases going forward, and how to position yourself through all of the lifestyle choices that you're making to be able to prevent or mitigate that. So I don't know if that's answering your question, but that is an industry that is fast growing, but once again, it's accessible to people who can afford that kind of investment. It's a huge personal, ah, investment, um, and it's not something that our traditional programs, insurance programs, are at all paying for.


I always wanted that thing in Star Trek where they just run the machine over you and the person is healed. I think that would be a real, you guys should work on that. That's right. Um, any other.

There's somebody here with a hand up. Oops.


So actually, the Star Trek thing is an interesting thing, like about how so often, like, the future is defined by the Sci-Fi stuff we see. How come there's no financial stuff in Sci-FI are we missing something there? I don't know. Is that an opportunity?


Yeah. We should get to work. Yeah, absolutely. Um, especially if you compounded from
now, right?

You know, you'd be great in 3080. There's one there.


Hi, Mike Carter, um, strategy officer at Nationwide Financial. Appreciate all the help, uh, and guidance you guys are showing us on, um, retirement income. My, um, question is around future products. So have you explored anything around benefits or long term care to help solve some of the chronic conditions?


Um, I think, look, as a financial person, I think you can do all the math to come up with something that works, but I think it ultimately revolves around participation. I think the biggest thing that I would like to see from a
legislative perspective, um, two things. One, require everyone to participate in a plan, um, either a private plan or a state sponsored plan. I think that is first.

And then two, introduce the notion of optionality in terms of how you want your funds invested. Do you want them invested in a liquid form so you can take out money? Or do you want to say, you know what, I have enough discipline and wherewithal that I will leave that money untouched for 30 years and get that 100, 150 basis points point illiquidity premium. Um, products are only as good as the ability, um, to use them and use them to their fullest value so that they can actually get you to realize what your goals are.

Um, I don't think there's a magic. Um. Um, uh, if you will, solution. I think insurance companies are battered by a lot of things.

There's climate change. People are living longer. If you look at rates across all different asset classes, whether it's car, auto, home, those numbers have skyrocketed. Right.

And so I think we have to think about, okay, well, what do we do? And to me, it's much more on the public policy side. And insurance companies know that they can manage money for 30 years as opposed to five years. That's much better.

That's a much better system. Um, I think that's one that we should think about and look at other places that are doing it better than us and say, how do we incorporate that into our models? And so you look in Europe, they're doing a lot of things better. I'm not making a statement around tax policy, because that is different, but around requirements, you get a much better result, if you will, over time.


Unfortunately, uh, we are pretty much out of time ourselves. Um, but real quick, I've got a call in a Barron's position, as I come from Barron's, which is to ask each panelist for an actionable idea. Um, and you're prepared for this, so I'll start with you, Surya. Um, but we've got to make it quick.


Yeah, we've talked about finances already, so I'll make this point. As I make this point, think about your situation, which is, uh, what is your social life when you're done with the work? So right now, we are working. We have off sites, we have team meetings, we have colleagues.

But when you finish working, what's your social life? Because that drives health and mortality. So I ask you to think about a socialization plan. In addition, financial plan.


That's fantastic advice. We didn't touch on that, Mary.


I would say, first of all, if you have a parent, um, um, I would sit them down and talk to them about what matters to them, what their goals are in life, what's important to them, um, and how it is that you can assist them. And if you're a young person, I would really make sure that you're thinking about a role as a caregiver in your future.


Colbert, take us out.


If your early career, start thinking about life in five year increments, prepare real world budget. Real life budget. Where can I save? How should I start?

When can I start? That's what I would focus on.


Well, with that, but a warm round of applause. Thank you, guys.

Surya Kolluri

TIAA Institute

TIAA Institute is a division of Teachers Insurance and Annuity Association of America (TIAA), New York, NY.

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