On average, women now live five years longer than men. That statistic gets repeated as if it’s automatically good news. But it isn’t.
Women may be living longer, but they’re spending more of those years in poorer health, according to the Global Burden of Disease. Women experience more years of disability or chronic illness across nearly every region.
A longer life is only good news when more of those years are lived with health, independence, cognitive function, and quality of life. Women have the advantage in lifespan. We don’t have the same advantage in healthspan, or what I think we should start calling wellspan: the years we’re alive and able to live well.
I’ve spent more than 25 years in medtech. Longevity is the word I often hear at health conferences and in investor meetings. But I rarely hear anyone ask what those extra years will cost or who will carry that cost.
Alzheimer’s Makes the Gap Impossible to Ignore
Nearly two-thirds of Americans living with Alzheimer’s are women, according to the Alzheimer’s Association. A woman’s estimated lifetime risk at 65 is 1 in 5, while a man’s is roughly 1 in 10. Age drives most of that risk, but longevity isn’t the only driver. Researchers are looking at biology, hormones, genetics, and immune function to understand the rest.
Globally, more than 55 million people live with dementia today. An analysis published in The Lancet projects that number will top 150 million by 2050.
Yet most people don’t think of Alzheimer’s as a women’s health issue, and that’s a problem. I’ve said this many times and I’ll keep saying it: women’s health is whole-body health across the lifespan. A woman doesn’t stop having sex-specific health risks when she leaves the gynecologist’s office. As I discuss in Undervalued to Unavoidable, once a woman passes childbearing age, she all but disappears from the data, yet the majority of health problems she’ll face emerge after her reproductive years.
We Need to Stop Measuring Success in Birthdays
There is a real opportunity in the economy of longevity. AARP puts the 2024 economic output of Americans 50 and older at $12.5 trillion, with a projection of $24 trillion by 2060. Globally, that same age group generated $45 trillion in GDP in 2020, and is projected to reach $118 trillion by 2050.
Based on those numbers, it’s clear that older adults are valuable. But what’s unclear is what it will take to increase their wellspan. Cognitive decline is a big piece of the gap, and it falls disproportionately on women, both as patients and as caregivers (women are more than 60% of Alzheimer’s and dementia caregivers).
Adding years to life while ignoring what determines how those years are lived is an incomplete strategy. We need to focus on wellspan: preserving cognition, mobility, independence, social connection, and the ability to participate economically and personally for as long as possible. And that’s where AgeTech becomes much more interesting to me than longevity as a concept on its own.
AgeTech Is Infrastructure
Most people still think of AgeTech as wearables, fall detectors, medication reminders, remote monitoring, and smart homes. That definition is too small.
We should think of AgeTech as infrastructure for the aging population. That includes earlier cognitive diagnostics, remote monitoring that helps people age in place, tools designed for caregivers, and clinical AI trained on data that’s disaggregated by sex instead of defaulting to male physiology.
With HERhealthEQ, we’ve placed diagnostic and medical equipment across 12 countries, with the understanding that technology alone doesn’t improve outcomes. It also takes infrastructure: training, service contracts, and integration into health systems on the ground.
Innovation matters, but the infrastructure around the innovation determines whether it changes lives.
Build for the Woman at 75, Not Only 35
Historically, women’s health investment went to the reproductive years. That’s starting to shift, as menopause becomes its own health and investment category. That’s real progress, but it’s the entry point to a 30-year risk curve.
The hormonal changes of menopause don’t end when the transition does. They may shape cardiovascular, metabolic, bone, and brain health for the decades that follow. Yet most menopause-focused investment only covers the transition itself. The years post-menopause, when Alzheimer’s risk, mobility loss, and caregiving costs build up, need to become part of the conversation.
That means investors should ask how AgeTech performs for women. Employers should treat caregiving flexibility as a way to keep their most experienced people. Healthcare systems should build earlier pathways for cognitive health instead of waiting for a crisis or diagnosis. Researchers should study sex differences across the lifespan and across countries. Innovators should design alongside older women rather than designing for an imagined version of them.
Adding Life to Longevity
Women living longer should be one of medicine’s great success stories. But lifespan alone is the wrong metric.
The next generation of women’s health infrastructure has to help women stay healthy enough to use those added years: to work if they choose, care for the people they love, stay independent, take part in their communities, and recognize the people sitting across the table from them.
The data to make this case is already public, and the opportunity is still wide open.
We’ve spent enormous energy trying to add years to life. Now we need to build the infrastructure that adds life to those years.