Healthspan vs. Lifespan: What's the Difference?

Written by David Roberts, MPH

Key Takeaways

What is the difference between healthspan and lifespan?

Lifespan is the number of years a person lives. Healthspan is the number of those years spent free of significant disease and disability.

The two numbers used to move together. They no longer do. US life expectancy reached 79.0 years in 2024, 81.4 years for women and 76.5 for men. [8]

The years being added at the end of that span are not arriving in good condition. A 2024 analysis in JAMA Network Open put the global average distance between lifespan and healthspan at 9.6 years, a 13 percent widening since 2000. [1]

Why is the healthspan-lifespan gap widest in the United States?

The United States has the largest gap of the 183 World Health Organization member states in that analysis: 12.4 years, up from 10.9 years in 2000. [1]

The gap is also not distributed evenly between the sexes. Across all 183 countries, the gap for women ran 2.4 years wider than the gap for men. [1]

Can you measure your own healthspan?

Not directly. No single test yields a healthspan number, but five physical measures have large-cohort studies linking them to how long people live and remain independent.

None of the five is a diagnosis. They are population-level associations, which describe what happens across tens of thousands of people rather than what will happen to any one of them.

What makes them worth knowing is that every one of them responds to training.

What does grip strength predict?

Grip strength predicts all-cause mortality more accurately than systolic blood pressure does.

The PURE study followed roughly 140,000 adults across 17 countries. Each 5 kilogram drop in grip strength came with 16 percent higher all-cause mortality and 17 percent higher cardiovascular mortality. [3]

Grip is read with a hand dynamometer. The European clinical thresholds for low muscle strength are 27 kg for men and 16 kg for women, though those numbers were set to identify sarcopenia in a clinical setting rather than to grade healthspan. [4]

What does the sitting-rising test measure?

The sitting-rising test measures whether a person can lower to the floor and stand back up without support. It is scored out of 10, five points down and five points up, with a point deducted for each use of a hand, forearm, knee, or the side of a leg. [2]

A 2025 study in the European Journal of Preventive Cardiology followed 4,282 adults with a mean age of 59 for 12.3 years. Among those scoring a perfect 10, 3.7 percent died during follow-up. Among those scoring 4 or below, 42.1 percent did. [2]

After adjustment, the low scorers carried 3.8 times the risk of death from natural causes and six times the risk of cardiovascular death. [2]

What does walking speed predict?

Usual walking speed tracks survival closely enough that researchers have used it to estimate life expectancy.

A 2011 JAMA pooled analysis followed 34,485 adults aged 65 and older for a median of 13.8 years. Each additional 0.1 meters per second was associated with a 12 percent lower risk of death. [5]

The reference points from that analysis: 0.8 meters per second corresponds to median life expectancy for a person's age and sex, 1.0 or faster with survival longer than expected, and below 0.6 with a higher likelihood of poor health and function. [5]

Measuring it takes a hallway, a tape measure, and a phone timer. Time a 4-meter walk at a normal pace, then divide 4 by the seconds elapsed.

What does heart-rate recovery show?

Heart rate recovery shows how quickly the pulse returns to baseline in the first minute after exercise stops. That drop reflects how fast the nervous system shifts out of exertion.

A 1999 New England Journal of Medicine study set 12 beats per minute or fewer at one minute as the abnormal threshold. It carried roughly double the risk of death over six years, after adjustment for other risk factors. [6]

The calculation is peak heart rate minus heart rate one minute later. Any chest strap or watch recording continuously produces both numbers.

How much does cardiorespiratory fitness matter?

More than most of the risk factors that get clinical attention. A 2018 JAMA Network Open analysis of 122,007 patients who underwent treadmill testing, followed for a median of 8.4 years, found low fitness carried an adjusted hazard ratio of 5.04 against elite fitness. [7]

For scale, in the same analysis smoking carried a hazard ratio of 1.41 and diabetes 1.40. [7]

The researchers found no upper limit to the benefit. Fitness kept tracking with lower mortality at every level measured, including the highest. [7]

What does a poor result on one of these tests mean?

About what a single high blood pressure reading means. It is one data point, not a verdict, and it describes a population average rather than an individual future.

All five respond to training. Grip strength and sitting-rising scores improve with resistance work. Walking speed improves with both strength and aerobic conditioning. Heart-rate recovery and cardiorespiratory fitness improve with conditioning.

The reason to run them is to establish a baseline. A number recorded this year is what gives next year's number meaning, and a trend across three years says considerably more than any single result.

Anyone with a cardiac history, a mobility limitation, or a recent injury should speak with a clinician before attempting the floor test or a maximal effort.

Frequently Asked Questions

Sources