Host: She’s a senior fellow at the California-based Pacific Research Institute, a New York Times and Wall Street Journal contributor, and the author of three books. She’s also an instructor at California’s Command College, and serves on the board of trustees for Singularity University. Her new book, “100 Plus”, observes that humanity is on the cusp of an exciting longevity revolution. She examines the social, economic, and cultural impact of a 100-plus-year lifespan, and argues that society should rally to support and embrace longevity science and technology. Please welcome Sonia Arrison.
[applause]
Sonia Arrison: This is a copy of my new book. Hopefully most of you have managed to grab a copy. They’re out there, and I think the Thiel Foundation is giving them away complimentary, but I’ve been told they don’t have enough. If you don’t have one, and you want one, you should probably pick one up before they all go.
Dr. Badylak is one of my heros. I go over his work, and the work of other people, in chapter two of the book. The book takes a look at how science and technology are going to allow us to live longer and healthier lives. I try to put the emphasis on healthier, because it’s not just about radical life extension, it’s about heath extension. We want to be healthier longer, we don’t want just to live longer, and that’s what should be able to happen through a revolution in biotechnology and regenerative medicine.
The premise of the book is that we might be able to double our life expectancy, our health expectancy, to 150 years during my lifetime. I’m 39-years-old right now. That’s roughly a doubling of current life expectancy. We’re around 80 today. But so what? Other people have said things like this before. This is not new. I’m not the first person to say this. That’s what the rest of the book is about, the “So what?” part.
So what if we can we live longer and healthier lives? How does that change the world? What does that even mean for us? How does it affect the economy, our family lives, even religion? These are some of the topics that I cover in the book, and I’m going to go over them, but before I do, let me go over some history.
This is the life expectancy chart. Ray had a great chart earlier with all the international life expectancies, and how they bounced up and down. This is a smaller graph, but you can see in the Cro-Magnon era we were only living to around 18 years. The time of the European Renaissance it was only around 30. By 1850, life expectancy was 43. Today we’re up near 80 in America. It of course is higher than that in other countries. Monaco is around 90 years.
Some people will look at this chart and say, “Oh, yes, but the only reason why we’ve got that nice line is because we’ve taken all the low-hanging fruit. We’ve tackled all the easy things. Right? Like nutrition helped us life longer. Fighting infectious disease, germ theory, antibiotics.”
That’s all true. Those are reasons why we’re living longer. We tackled things that were killing us early on, and that makes sense of course for us to deal with those things first. But, the reason why the chart continues to go up in the second half of the 20th century – the reason why that line continues to go up is because of advances that have been made after age 65. We’re now starting to work on the things that kill us at the end of life. That’s the exciting part. This is really just the beginning of the story.
What’s going to take us there? Dr. Badylak told us a little bit about some of the exciting things that are happening in regenerative medicine, the ability to grow back muscle, the ability to grow brand new organs, windpipes, and bladders. In the lab, hearts and lungs have been done for rats. That’s very exciting.
Gene therapy is another thing that’s incredibly exciting, because that allows us to hack the human code. Just like computers are built on ones and zeroes, humans also have a code – the A, C, T and G of DNA. We’ve sequenced the human genome, as Ray pointed out earlier. Now we’re trying to reverse engineer it. Biology has become an engineering project. The engineers are involved now, and that’s very exciting. That’s really going to change things.
How did I tackle some of the largest societal issues, say the economy or family? I tried to do it in a number of different ways. One of the ways I worked on doing it is looking back in time, and saying, OK, what happened the last time we roughly doubled life expectancy, when we went from 43 to around 80? What kinds of things changed in society?
I went through all the different disciplines, and looked to see if scholars had noticed this and if they’ve worked on it, and it turns out that they have. If you look at economics, a number of economists have written on how life expectancy affects the economy. We’ve become richer over time. You can see some of the figures here. The gains in life expectancy just in the last century, which were around 30 years, are worth about 1.2 million to the current population today. That’s how much we value them at. From 1970 to 2000, gains in life expectancy added 3.2 trillion to national wealth.
Other studies have done a comparative basis where they’ve shown that if you have two economies that are relatively similar, and one country has a five-year life expectancy advantage, their economy will grow at half a percentage point quicker. Real incomes will grow in that economy.
That’s interesting, right? If you start to think about radical health extension, you could say, “Wow. What if a country had a 10-year advantage? What if it had a 20-year advantage? How would that change things?” It might be really important. By the way, the reason for why we get richer as we can live longer has to do with health. For a long time, scholars understood that wealth usually begat health. If you’re wealthy, you can usually afford to be healthy. They didn’t look at the other part of the equation until fairly recently, that health actually begets wealth. The reason for that is because you can’t be productive if you’re not healthy. If you’re sick, you’re not working as well, you’re not innovating. Health really does help produce wealth because you’re productive.
So what else. I’ve got the Mona Lisa here, and the reason for that is when we can have longer-lived, healthier populations, innovation has the potential to grow. The reason for that is something I didn’t realize until I started doing research for the book, and that’s because innovation is a late-peak field. I live in Silicon Valley where we’re used to seeing a lot of young people starting new companies, and so you tend to start to think “Oh, it was always the young 20-year-olds who were making all these discoveries and doing great things and changing the world.” It turns out that that’s actually not true.
Da Vinci for instance was 51 when he painted the Mona Lisa. The person who discovered the X-ray was in his 50s. Benjamin Franklin was 46 when he did his famous kite experiment, and then he went on to continue with innovations for the rest of his life. When he was 78 he invented bifocals, maybe an example of how necessity is the mother of invention. That’s exciting, right? Because around 40 or 50 is when some people’s health starts to decline, so if we can pick that up, we might have so much more innovation, and that’s exciting.
Education. We become more educated over time, and in fact the longer we live, the more education becomes valuable to us. That’s because once you get educated, if you live another 20 years that’s great, but if you live another 40 years that’s even better, so you’re getting more bang out of your education buck so to speak. And of course if you’re around and healthy for a longer period of time, you might want to change your career, you might go back and get re-educated. Education is going to be a growth market. It might not be the traditional type of education that we think of today, and I know that the Thiel folks think that that’s not the best way to go, but it will be some sort of education. The education market is going to be so exciting to watch, I think there’s going to be a lot of different things happening, and because people will be living longer and healthier lives, there will be more opportunity.
Marriage. Of course as we’ve been living longer and healthier, we’ve been getting married later. I think that trend will probably continue, and new phases of life might come along. Adolescence didn’t used to exist. It’s a new phase of life. We used to go straight from childhood to being an adult, and then when we lived longer and healthier, adolescence came around. Now scholars are starting to see something that they’re calling “adultlescence.” You’re not an adolescent but you’re not really an adult, you’re sort of this 30-something living in an urban area, not married, and that new phase some people are calling adultlescence. So we’re going to see more new phases of life come along, and probably more diversity in different choices.
The era of the 70-year-old mother, is it on it’s way? Right now we’re in the era of the 40-year-old mother, age at first birth has been going up steadily. And because of the advances in fertility technologies, I think it will be possible, and I detail why in the book, I won’t go into it now because I don’t want to take too much time, or maybe we can discuss it in the Q&A. But it will be possible, I think, for women to extend their fertility longer. We’ve already seen that the uterus still works around 70-years-old, it’s the eggs that go bad.
Religion, right? So what about religion? Maybe a lot of folks in this crowd don’t think too much about it, but I wanted to make sure to include it because it’s important to a lot of people around the world. If you look at the data, around 90% of the world is religious, and there are pockets of the world that aren’t, but they’re in the minority. This was actually the most interesting part of the book for me to write, because I started out with the premise that as we can live longer and healthier lives, and get further away from death, then maybe we’ll be less interested in religion, because we won’t be thinking about the afterlife.
That was the premise that I started out with, and everything that I found when I was doing it, everything kept showing me that that was wrong. As we’ve doubled our life expectancy, religion has not tanked, has not declined. In fact some people have made the argument that it’s even gotten stronger, since communism outlawed religion in some countries, and as soon as that fell, religion popped back up in those communities, and it tends to stay steady around 90% around of the world.
So the question is why? There’s a number of explanations. One explanation is simply that we’re wired for it. Another explanation is that religion is about more than the afterlife, it’s about purpose. What’s the best way to live my life? What is good and evil? How should I live my life? Religion purports to answer those questions. And you could actually make the argument that the longer you live, the more guidance you’ll need at figuring out how to live your life. So there’s a market opportunity for religions here, but they’re going to have to change. They can’t have more of their focus on the afterlife. The ones that focus more on the afterlife won’t do very well. The ones that will do better will be the ones that focus on purpose and how to live your life.
Population. Usually the first question, or knee-jerk reaction of longer health expectancies is a worry about population. If people don’t die as quickly as we’re used to them dying today, won’t the world become overpopulated, is the worry. And I think that’s a legitimate concern, because if people die at a slower rate, population could increase. If you look at the chart I’ve got here, these are the world population growth rates, from 1950 projected out to 2050. As you can see, world population growth rates are declining. At the same time that this is happening of course, fertility rates are declining. The U.N. has predicted that by 2050 fertility will be under 2.1, which is under replacement value. So population is projected to shrink by 2050. Now of course that might not happen, projections can be wrong, and fertility rates could very well increase if 70-year-old women are having children. We don’t actually know what’s going to happen. Population could increase a little bit.
The thing that makes this not quite as scary as it could be is the fact that really heavy population growth comes from births, not from fewer deaths. The reason for that is when you have births, you can have multiple births and it can be exponential. When you have one person not dying, that’s only one person. So population may well grow, but it might not be quite as catastrophic as some people might think initially.
So then we have the question of resources and pollution, essentially. Because if there are more people around – let’s grant that maybe population will grow. There are two things here. One is will we run out of resources? This is the Malthusian argument. At some point we’re just going to have just too many people, and the Earth won’t be able to handle it anymore. We’ll run out of water, and minerals, and metals.
That’s wrong. Malthus was wrong. The reason why Malthus was wrong is that he forgot something, he forgot one of the resources. One of the resources is humans, human capital. The great thing about humans is that they come up with ideas, and new ways to provide things that we need, and this is why we have not run out of things as population has grown, and in fact we have more food now than we ever did before, and so on when you look at the data.
So that addresses the resource question, and then there’s the question of pollution, which is what this slide is about. There’s the concern that, if you look at the Industrial Revolution for example, when we started burning coal, the skies got black. In Britain, bronchitis was known as the British disease, because everybody was coughing because they were burning so much coal that it was just visibly polluted and disgusting.
But they let it go until they reached a certain income. You can see the Kuznets curve here, this is called the environmental Kuznets curve. You can use this to explain how pollution will happen. We hit a point of income where society feels it can afford to start taking care of the pollution problem. Then you start to see the environment getting better over time. You can have a different Kuznets curve for different types of pollution problems, and scholars typically argue over what’s the number, what turning-point income do you have to get to before we’ll finally address X issue?
But very few people argue that this happens. This happens. You could argue that, OK, well as nanotechnology comes along, and the next Industrial Revolution, or synthetic biology, maybe there’ll be some type of pollution problems that we don’t know about yet, and it’s going to be terrible. And it might well be the case that there’s some sort of pollution that comes out of it. But the question is, what is the trade off? That’s what we always have to be asking ourselves, and maybe we put up with it for a little while, and then we fix it, and we move along, and we progress. So that’s a way to think about pollution and environmental issues in a longer-lived world.
Of course I have to get to some potentially negative things. I’ve been called an optimist, but I’m not all optimistic. There are some potential things that could be a problem in this world when we can live longer and healthier lives, which in general I think is good. But let’s think about the longevity divide for a minute, and inequality in the world.
Here I’ve got a chart of the top 10 countries in life expectancy. Monaco is at the top of course, around 90 years, south of France. People there live quite well, it’s a small community, and they’re wealthy. So that’s great for them. Notice that the U.S. is not in the top 10, we’re down somewhere around 70, which is not so great.
Here are the bottom 10 countries. Angola is down around 38 years. A difference internationally between 38 years and around 90. That’s over 50 years. That’s an entire lifetime. I mean, Steve Jobs lived to 56. So that’s a really big starting point, a really big divide that we’re starting from in the first place.
Within the United States, there are divides as well, not quite as big, but still bigger than I had expected to find before I did the research. An Asian-American woman in New Jersey has a life expectancy of around 91 years, which is great. But a Native-American man in South Dakota has a life expectancy of 58 years. We’re looking at a 33-year difference, which is pretty significant.
When longevity technologies do finally hit the market, when some of Dr. Badylak’s work gets widespread, when we manage to hack the genome in effective ways to cure diseases using gene therapy, that will be expensive probably at first. The first people to use that are going to be the wealthy people, because wealthy people always get access to new innovations first. And in some ways that’s good because they put up a lot of capital for things that don’t work really well in the beginning.
Think about cell phones. What did cell phones look like in the beginning? These big suitcases, and then they were big bricks, and everybody thought they were crazy for carrying these things around. But they were pumping money into it because they wanted to be able to use these things, and then eventually development got better and we have these small amazing cell phones, and places like Africa got to completely skip landlines, and went straight to cell phones.
So the question is, how big will the lag be between the wealthy and the poor getting access to longevity technologies? Because as we’ve seen, health is incredibly important to wealth, so the healthier you are, the richer you are. So you can imagine how, if there’s a long period of time between different segments of society getting access to these technologies, we could see serious, serious divides and potentially unrest. We’ve got protesters out in the streets today, protesting in front of people’s offices and houses over economics, but what about when it comes to their life? What if they think that they’re literally fighting for their life? We could have trouble.
I want to make you feel not so bad about this, so here’s some data on how the distribution of technology is actually speeding up over time. To the extent that biology is becoming an information technology, perhaps it will fit in with this list. It took 46 years for a quarter of the population to get access to electricity, 35 for the telephone, 16 for the personal computer, 13 for the cell phone, 7 for internet access. That’s going in the right direction, and we can hope that biotechnology will follow that trajectory, but it’s not guaranteed.
This is the last slide. One of the other things I typically hear when I’m speaking about this subject is, “Well, even if everything could be great and we could extend our health expectancy to 150 years, maybe we shouldn’t do it. Maybe it’s just unnatural, it’s this weird crazy thing that we’re trying to do, we’re trying to play God.” My response to that is, why is an 80-year lifespan natural? If we talked to somebody back in 1850 it would have been 43, right, and we go all along the line.
At what point do you decide what is natural? Back when this guy was around [picture of caveman on slide], fur was the only fashion option, right? Now we have clothes, and glasses, and laser eye surgery, and we keep improving ourselves. My response is that it’s entirely natural for humans to want to improve themselves, and for humans to make themselves healthier and better, and that’s what’s natural. So following and pushing for greater health extension is really the natural thing to do, the human thing to do. I have a chapter in the book that addresses all the different questions surrounding that.
The one thing I want to end with is the idea of aging being set in stone. For the longest time... and in fact, demographers have constantly been saying “Oh we’ll never pass this number in life expectancy, and we’ll never pass this number,” and on and on. And of course we keep doing it. There’s this idea that lifespan is set in stone. There’s a ceiling and we can never pass it. The oldest person to have ever lived is 122, and we are never going to pass that. That’s what some people say.
But what we’ve learned recently is that aging is plastic, it is not set in stone. Just like the brain is plastic, we’ve learned that people can still keep learning as they get older, older brains are plastic, aging is plastic too. There’s research that’s been done all over the world where you can show that by doing gene tweaks on lab animals you can slow down aging. For instance Cynthia Kenyon at UCSF does experiments on worms where she makes a couple of tweaks, and they live six times longer than they would have lived otherwise. But not just longer, healthier, they’re younger, and the reason they’re younger and they get disease at a slower rate than the normal worms, is because she has slowed down aging by hacking their code.
We’re on the cusp of a revolution where we’re going to be able to hack our code in different ways to do different things. That’s exciting, and it’s something that we should really be pushing for. Because we do want to be healthier for longer periods of time because there are all sorts of good things associated with it. But this kind of stuff doesn’t happen just on its own. I can stand up here and tell you that look, this is going to happen, Dr. Badylak’s work is amazing, and Ray Kurzweil is doing great things, and there are all these other scientists who are doing incredible things, and engineers in Silicon Valley who are working on reverse-engineering biology.
But they shouldn’t be alone. I actually make the call in my book, and I’m going to make it right now, that we need to support these people. Not only do they need financial support from governments and private industry and philanthropists, but they also need social support. For the longest time, working on anything related to aging was a death wish really if you were in academia, because that sounded flaky, it sounded like snake oil. But now, people who are working in that field are starting to gain respect, and they should because they’re making great advances.
We have to support them as a society. Journalists and policy-makers and educators and all sorts of different types of people who think about these things, and who care about being healthy longer, should get involved, because if we’re not, this stuff will still happen, but it will happen more slowly, and we might not be around to take advantage of it. So I’m hoping that everyone here will get involved and do something, do whatever you can. If you’re a graphic designer, maybe you can help some of these people explain their ideas better to the public, and so on.
That’s the final thing that I’ll say, and then we have three minutes for questions. Thank you. [applause]
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[Q&A begins]
Man 1: How much of the advances in life expectancy come from adults living longer, and how much of it comes from people just not dying in childhood?
Sonia: Right, so I tried to make that point earlier. Most of the gains, when you look at that chart, most of the gains early on in the first part of that curve were made from things that were done earlier on in life, like infant mortality declining, and better nutrition, and better ways to treat infectious disease that would kill a lot of people early on in life.
But in the second half of the 20th century, we’ve been making progress. Because chronic disease didn’t come along until more of us made it to be older, so we didn’t even start thinking about those things until cancer and heart disease and Alzheimer’s even entered our lexicon. That wasn’t even part of our world until relatively recently. Now we’re starting to tackle those things.
Obviously we’re not there yet. We haven’t cured heart disease or Alzheimer’s. We’ve had some great progress on cancer. Not completely curing it of course, but in certain cases we’ve managed to save people, and we’re getting better at it. Chronic disease also is setting in at later and later ages than it used to before, which goes to show that some of the things we did to help people at the beginning of life are also helping through life.
[next question]
Man 2: Currently there’s a big controversy in the nation about the increase of health costs, Medicare’s exponential growing, a lot of people are trying to put a cap on it. So you’re accounting for the economic boon or positivity of a longer life, but how do you account for the fact that all these technologies that keep people alive longer cost a lot of money?
Host: The question, just to repeat quickly is, how do you think about the growth in life expectancy, but also the rising cost of healthcare, and how will that play out?
Sonia: So one of the things I often hear is, “Can we even afford to live longer?” And that’s because healthcare costs are so expensive, and we know that the majority of costs occur near the end of life, when we’re trying to save people. That’s a difficult question to answer, because we don’t know which technologies are going to come along at what time and in what order.
The way I like think about it is that there is the potential for healthcare to become more expensive depending on how expensive repairs are, but there’s also the potential for healthcare to actually become cheaper.
Here’s how you can think about it. Imagine somebody today who has heart disease. They’re put on a lot of expensive drugs. They typically have many emergency trips to the hospital, and all the costs that are associated with that. They might have heart surgery, but it doesn’t really fix them, it just patches them up for a little while and gives them some extra years.
Or, we could think about the future, when tissue engineers are successful in growing a brand-new heart. Suppose somebody has heart disease. They go to the doctor, the doctor says “Oh, you know what? You’re going to need a new heart,” and they grow a brand-new heart for that person out of their own adult stem cells and replace it. And guess what, they’re not on any of those expensive drugs, they’re not taking all those trips to the hospital, and they’re only having one surgery instead of potentially more. So there’s a potential for health care costs to come down.
[End of Q&A]
Transcript; 100 Plus: How the Coming Age of Longevity Will Change Everything, from Careers and Relationships to Family and Faith
https://docs.google.com/document/pub?id=1qDYiTefNKuqsE6R5rxXZAHiuC8phVFQraJgLXB3MttY
