The Road to Healthier & Longer Lives — with Andrew Scott

23:27But right now, people tend to leave the labor market from the age of 50. Age 50, about 80 % of Americans are working. By the age of 65, it's down to a third. And that's not really to do with people choosing to stop work. They either get ill, they have to look for someone, they have to care for someone who's ill, their skills are out of date, or just ageism in the workplace. So how we keep people working from 50 up to the state pension age, I think, is a really key thing. Peter Drucker, I think, said demographics are destiny. And it does feel like it's probably one of the biggest shifts in our society.

23:58I don't know if it's immigration, but this feels like it's right up there. And that is just economically in the U.S. about, we're about to get more than 50 % of our government spending is about to go to seniors. And also in the U.S., 70 % of Americans are obese or overweight. So let's first start. It strikes me that we're going to have to make seniors more productive. Let's just be very Darwinian about this. Seniors, quite frankly, are too expensive and not productive enough. I don't know if you agree with that thesis, but they're going to need to be less expensive and more productive if our society is going to maintain its economic vitality, if you will.

24:36So start with the economics. As an economist, I hear a lot about an aging society, which is there's more people aged over 65 than there's ever been. And that's a problem. Old people get ill, they need a pension, they don't work. But we underestimate the capacity of old people. And we've got to stop doing that. But I think the really big challenge is that, for me, we're focusing on the wrong thing. Because it's not an aging society with its focus on a change in the age structure of the population. The really, really big change is the young and middle age can now, for the first time ever in human history, expect to get old.

25:08And we fear getting old. We worry about outliving our health, our wealth, our finances, our relationships, our sense of purpose. So we have to act now to age well. So an aging society begins when you have lots of people aged over 65. A longevity society begins when you have lots of people who live to be over 65. So I think we've got to really think about this because if we're not productive for longer over our life and we live for longer, we see a fall in the standard of living. So you're right, we've got to be more productive for longer. And that will, of course, involve more people working as they're older.

25:40But it's more about a new map of life, I think. It's about thinking about a career that's going to last longer than before because you wouldn't need to be productive for longer. But right now we have this notion that people get old at 65 and they're incapable of working, which isn't true. And it's certainly not true for everyone. And for those of whom it is true, we've got to stop that happening for the next generation because as I say, if we're living a longer life, we want it to be a healthy one and we want it to be an engaged one. So let's go to the health side. I'll put out a thesis. Obesity.

26:10If we were to attack that, I mean, that would be a good start. How do you take healthcare from being a defensive industry to an offensive industry, what you were calling preventive? What are the two or three things you would want to see happen in terms of our approach to healthcare or wellness? So two or three things is where it gets tricky. First of all, we as individuals have to do a lot more. David Cutler from Harvard says that the most underused person in the health system today is the patient themselves. You know, you say you're ill, you turn up and you get treated. we have to take more responsibility for our own health that has issues about inequality which we can return to later but we just got to be more mindful of our own health in terms of the health system i think we're in a world where potentially we hear lots of things about how wonderful big data and ai is when it comes to health it could be truly phenomenal because we can now do genetic screening very cheaply we can find out the diseases that people are most susceptible to and we again start to target treatments so that we catch them early and keep them healthier for longer so that would be i think two of the major things there's big challenges the health system makes an awful lot of money from doing intervention so a question of how we actually switch to prevention is i think going to be interesting uh we perhaps need to have a system that's outside of the traditional health sector with its disease focus that provides cheaply uh access to the things that we need.

27:31Obesity is a very interesting one. I think what we need is a system that focuses upon certain key biomarkers, you know, things that say, look, if you've got this, this is a sign you're going to have disease problems later. And obesity clearly is a huge problem, particularly in the US and the UK, which stand out. So how do you change that? Some of it is around public health, and public health has been hugely effective in the past around smoking and drinking. We tend to be very cynical about it now, but I think we can do more in that area. Then you've got things like GLP-1 drugs, Ozenpik, and those things coming along, which although my heart sinks a little bit, because wouldn't it be great if we can get behavior change to happen?

28:10At least the early evidence on those suggests they really could be a game changer in terms of bringing about future improvements in health. Well, let me go personal. You're obviously one of the top domain experts in this world. What have you done personally? How do you approach your evergreen strategy, your longevity? What are the things you do that you think your neighbors and your colleagues and your peers are not doing? Yeah, no. Well, I think what's interesting about all of this stuff is that, you know, you can, you hear people out there doing these extreme lifestyle hacks. I haven't got the self-will or discipline to do that.

28:46So I tend to do the basic stuff. I try and eat better, I drink less, I sleep better. So all of the basic stuff. And although that's getting a bit of a scientific makeover, what's really changes my incentive to do it. And at 58, I have to do things differently from my father at 58 and my grandfather at 58, because I have more future out of me. So some of that is just taking care of the basic hygiene. As an economics professor, I've probably always been mindful about money. So I think that's something that I have been fortunate to be able to do something about. But, you know, Scott, one of the things I've heard a great deal about this topic, took me a while to get it, is we're living a longer life and what's the point of it?

29:29You know, you can sort of starve yourself at breakfast, you can do higher-intual training, etc. But there's a great quote by the Greek poet Pindar, which says, the point of life is to become who you are, having discovered what that is. And that notion of adult development, of using a longer life to change and become who you want to be or to try and shift and to say, who really am I? And I think that's the really interesting thing about longevity. You know, my father, born in 1925, was never a teenager. He went from being a child to an adult at 14. We rushed adult development. We're sort of extending adult development now.

30:06I look at my children in their 20s and 30s doing things very differently from me. But it's not just about that first stage, I think we've got scope to try and say, actually, what do I want to do and how do I spend my time? And we're so hardwired to think of aging as about to climb. We've medicalized old age. So I do hope that that's focused on adult development and saying, hey, I've always done this, but is that really what I want to try and do? So for me, that's the one I perhaps struggle with or focus on the most, the very human thing about longevity. I think, you know, the extreme supplements and stem cell stuff gets out of the real point of this is how do we spend that time?

30:45You know, obviously you want people to live long, happy lives. Societies go into decline when their birth rate drops. And I'm going to make a very reductive thesis that as more and more of our revenues go to supporting and caring for seniors, we lack the investment, the forward-leaning investments that grow the economy. The economy, and couple that with inequality, doesn't present a very optimistic future for young people. They stop having kids, and your society becomes less productive. You have sort of, you don't have, I don't know what's the term, it's not population decline, it's population denigration.

31:27And I always hear this notion that, okay, we have to make our seniors more productive. And this is going to sound ageist. I'm not sure they're interested in being more productive. Is that wrong? Well, I think, you know, one of the things is like, I'm not sure how useful it is to talk about people being old. Aging is a really diverse process and we have a rather monolithic concept of people after age 65. So I kind of agree with you. It's not that all old people need support. I think we need to be much more shrewd in thinking about, you know, for instance, in London, you get a free pass, travel pass if you're over 60.

31:59That's kind of daft when you're an investment banker cycling to the tube station to go to work. So we've got to think less of age is telling us something about people and think more of them as individual circumstances. So I think, you know, for me, you're right, though. I think the challenge in an aging society always becomes about care homes and adult diapers. But the people who have the longest life expectancy for whom the standard life course is no longer working is the young. You know, in the book, there's that great Coretta Scott King quote, The failure to invest in youth reflects a lack of compassion and a colossal failure of common sense.

32:38The young are the ones who have the longest life. And right now, that traditional lifestyle of raising a family, achieving financial security, and looking forward to retirement just isn't going to make sense for them. So I think we need some pretty profound changes. but that's all part of what I call the longevity agenda because if the young have a reasonable expectation of living to 100 my goodness how do they support that longer career but I do think we need institutions to support people doing what they want and your your point about the falling birth rate I'm not sure how much of that is choice versus circumstance it does seem that people around the world want to have fewer children now I've got three kids I think having kids is great but there does seem to be something about the world, the modern world, which is partly to do with expense.

33:26You know, it's expensive to raise a family, but people do seem to want to have fewer children. And I think that's a really part of this fundamental change has occurred to us as humans. We now have very long lives and we want to do things differently, but our social institutions are set up based upon old ways of behaving. 100 % agree with you on the kind of the looking at social programs through the lens of age is the right way to do it, that Social Security in the U.S. should be renamed if we were on a senior security, because it seems like we're not just basing criteria on who needs it, but based on age.

34:04Do you think there'll be significant changes in public policy that says, in the U.S., the wealthiest generation in history is seniors, and there's still a huge problem. A lot of seniors are retiring without money. But one, do you advocate for some sort of means test where they wouldn't, a wealthy banker in 70, 80 doesn't get social security. And also, what do you think of these plans to give kids$7 ,000 on birth, they can't touch it, you treat them like infants, and then when they're 65, based on previous market performance, they might end up with a million bucks or something. What do you think of these kind of, what economic ideas or what public policy ideas do you think we should be more seriously considering?

34:45Well, the only thing I'd say about giving kids money at that age, the asset management is would love it, but I'm not sure it solves the real problem. So I think we tend to think the aging society story is about a pension issue. It's really about how we create resources over our lifetime. And finances doesn't, you know, the rate of return you get on the stock market depends upon the underlying performance of the economy. Now, just to go back to some of the issues you talk about the economy, I don't know, a question I like to ask people is how much growth do you think in employment over the last 10 years has come from workers aged over 50?

35:18It's now the majority of employment growth in the rich countries. So in America, it's two thirds of employment growth the last 10 years as workers aged over 50. In my country, it's 75%. In Europe, it's over 100%. There's not much productivity growth these days. So all GDP growth is coming from employment growth. And all of that is coming from older workers. So I think for me, the key thing in all of this is how do we keep people active and engaged for longer? And of course, at 20, that might not seem important, but the thing that's changed is that 20-year-olds now can become a 50 - or 60-year-old.

35:52I was talking to some Chinese students the other day, and I was showing them China's demographics, which are horrific compared to America's. Population's falling. Number of people aged over 65 is going to be 45%. And I said to these 30-year-olds, how do you feel about all these 65-year-olds in the future? They said, it's terrible. All these old people, they get ill, they need a pension. I said, who are they? They said, what do you mean? I said, well, who are these old people? They said, well, they're old people. I said, no, they're you. They are you in 35 years' time. And that's the really tough change because for most of human history, the young haven't become old.

36:26So we've got to make sure the young age well in a way that is productive, healthy, and engaged. And there's, I think, no policies around that right now. Governments seem shocked when I tell them, hey, you know what? Of 50, four out of five people are working. 66 in America, only one in three are. If you could half that decline, that's a 4 % increase in GDP every single year. So that's a lot of money. It's the nearest thing to a macroeconomic free lunch that I can find. So that would be where I would absolutely laser focus on. How do I keep people working from 50 to 65? And of course, once you start thinking about that, you realize that someone who's 30 and in bad health with obesity, they are not going to be working at 50.

37:08So you're just storing up these really big problems. You had referenced China. And I read this crazy stat that I think when I was born, the average life expectancy in China was something like 45, and it's now surpassed the US. What has China done so right over the last generation? It has to have had the most remarkable increase in longevity likely registered in history, no? Yeah. And that's why China's got this dramatic aging society problem, because it's had this dramatic increase in life expectancy and a very big fall in the birth rate in a very short period of time. So it's got that huge change in the age structure, which America has got a much more modest version of.

37:52Kind of what's happening in America is that in the future, you're going to have the same number of people of all ages from 0 to 80, basically. That's kind of where we're going to. Whereas China, you know, you've got one child policies and you've got one kid, two parents and four grandparents, which is just very unusual. What do they do right? Well, they kind of did what everyone else did i mean one of the big things to do is to lower infant mortality uh and that's about nutritional intake of expectant and others it's a sanitation and hygiene all of that gives a really big improvement i think as you have fewer kids you spend more time nourishing and looking after them you know we know for instance that parents spend more time with children now than they used to whether that's a good or a bad thing i'm not sure but they do so you know there's they've done just very quickly what everyone else does i think the more challenging issue you raise is how does china with its gdp behead much less than america have higher life expectancy than america and america the gap between american life expectancy and what's called best practice the country with the highest has now increased to eight years and i think that's a staggering challenge you know as a macroeconomist if if us gdp declines it's over the headlines, there's policy initiatives to do something about it.

39:05But this eight-year gap now between U.S. life expectancy in countries such as Japan, that's a sign that things aren't right. But isn't it because it's poor people dying, so we don't really give a shit? Well, it's a lot about inequality, I agree. And I think if we could target, you know, we know aging is malleable. And if you have low income and stressful work and poor environment, you age more rapidly. So one of the things I think is so important is to have a target for healthy life expectancy in a country. At the moment, nowhere in government or the health system is there a target for healthy life expectancy.

39:40And I think if we did have one, we'd start to pay more attention to what would happen to inequality. We'll be right back. I'm Christian McCaffrey, pro running back, and Abercrombie is an official fashion partner of the NFL. I'm not kidding when I say NFL by Abercrombie broke the internet last year, and I think this season's lineup is even cooler. And so does my wife, who keeps stealing all my hoodies. Stay fit for the season and Abercrombie's newest arrivals. Shop NFL by Abercrombie in the app, online, and in store.

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41:02See a Lowe's Red Vest Associate or visit lowes.com slash holiday install to get started. Lowe's, we help you save. Basic install only, date restrictions apply, subject to availability. Install by independent contractors. See associate for details, contiguous US only. So I wanna pivot to another topic. Obviously you're known or you're getting a lot of press and warranted attention for your focus on longevity, but you're a professor of economics at LBS. And I'm fascinated after being in London for two years. Amazing culture, some of the best academic institutions in the world, fantastic, or what I call, institutions that typically lead to a very robust economy.

41:51Yet the UK hasn't grown in five years. Seven in 10 IPOs of the last decade are below their offering price. And one company in the U.S., Apple, is worth more than the entire FTSE. I realize it's a multidimensional problem, but what is it about the U.K. that it seems like it feels like it's doing something to snatch defeat from the jaws of victory, that it has all the underpinnings and the infrastructure of what should be a robust, you know, growing, if slow-growth economy? What does the U.K. get wrong? yeah so i mean i don't send us food parcels quite yet i mean we're still sort of all okay but yeah growth has disappeared as it has in much of europe and it's striking europe led the way with technology and telecoms and now is so far behind uh you know part of that i think in europe is the the sort of whole single currency project which has absorbed huge amounts of political focus on making that work.

42:50And of course, in the UK, we've had a Brexit, which has been, in a very British understated way, call it a distraction. And that's clearly not been very, very helpful. I would say the real challenge we've got around the world is that we've got innovation slowing. So, you know, even in the US, this sort of measure of innovation macroeconomists have, total factor productivity growth has slowed down. So, you know, there's not much productivity growth for all the hype about AI is going to take away all our jobs. Right now, the issue we've got is we've got lots of people working. Unemployment's very low, but productivity is very low.

43:22So there's a shared global problem. Then demographics on top of that mean that you've got less population growth and you've got more old people leaving the labor force. But I would say that Brexit for me, you know, as an economist, rightly or wrongly on the politics of Brexit, on the economics, it's not a good move to make it more difficult to trade with your richest neighbors on your doorstep. And at least that has short run costs. And then I would say that we're also seeing some issues around austerity from the financial crisis. We, you know, UK is kind of 25 % European and 75 % American these days.

44:01So we also have challenges around inequality. So we're seeing a lack of infrastructure investment, and we're seeing problems around inequality and health. And I don't want to make it look like I'm a person with a hammer who's going to hit everything, sees everything as a nail. But in the UK, we have 3 million people who are unemployed long-term because of health problems. And large numbers of those are aged 50 to 65. So that's one of our challenges. As you have an aging population, health has first-order macro consequences. In general, the UK has always been good at innovation. We're always good at inventing things.

44:37We're just not very good at then scaling them and implementing them. But no, What do you think, Scott? What do you see from being there? What do you find frustrating about British institutions if we've got enough time for that? My observation at London is that there's not a lot of organic value creation. It strikes me it's a lot of people servicing wealth that has been created elsewhere. Let's look at AI. Some of the most impressive intellectual property around AI was developed at Cambridge. I mean, it's literally as if they come up with ideas, and I don't know if they're not as risk aggressive.

45:10I don't know if the regulation is overdone. You know, it's hard for me to understand. It was a genuine question why the U.K. doesn't have a single company, really, that's worth over$50 billion in AI. And yet there are startups in AI that get valued at$10 or$20 billion in the United States. It's just odd that the UK doesn't seem to be able to commercialize some of the innovation that they come up with. I just can't put my finger on it. I find the business environment in the US is, can we make money together, yes or no? And in the UK, it's sort of like a very polite, definite maybe. Yeah, no, there's that cultural thing.

45:56that that's it's been a really long-standing problem in the uk that we've got you know an education system that is in some ways really unstructured which is great because you kind of have to learn things out yourself and that's kind of leads i think rather unequal education outcomes but it's great at the top in terms of innovation but it's never fed through and then with a focus on global capital markets you get you know what we call the windwarden effect which is that it's very rare that a Brit wins with the Wimbledon tennis tournament, but we kind of see it as globally one of the best in the world.

46:31And that's a little bit, I think, also the sort of the implication of having a global capital market based in your home country. Do you think there's, I read something that sort of struck my, captured my attention. I'm curious if you think there's any merit. The productivity per your comments is declining. And some economists are saying that the massive decrease in corporate tax rates, tax revenues from corporations in the U.S. used to account for 3.5 % of GDP. It's now 1%. Our corporate taxes are the lowest they've been since 1939, since the Trump tax cuts. And when you have taxes this low, corporations have a really good memory.

47:09They start returning more and more money to shareholders because there's less friction to get it out to them because it's taxed at a lower rate, and they invest less. And as a result, there isn't the same forward-leaning investments in plants, property and equipment, which reduces growth. Have we cut taxes beyond kind of the ultimate balance, if you will? Is that hurting productivity? So I think, you know, certainly I would say in the UK that some of the fiscal austerity that led to cuts in government expenditure around health and education has definitely hurt overall economic growth, for sure.

47:40On the corporate tax one, the reason given for that is that as we've made capital more mobile, as firms can just relocate anywhere around the world, you've had to lower the tax burden on it, which means that you either have to increase the tax burden on labor or you cut the welfare state and benefits. And, you know, I think that does risk losing inclusive growth. So I think that is a challenge. I see the returning of money to shareholders less around capital taxes and more around the thing you know there's not things to invest in that produce that tangible growth and i think that's you know the example of you know people always point to is uh you know when facebook bought whatsapp for what was it 17 billion dollars they could have bought sony for the same amount of money but rather than buy a company with 140 000 people they bought you know 35 mates getting together with a company And I think that's kind of one of the challenges we've got now, which is sort of investing in intangible capital isn't very labor or capital intensive.

48:42It's more IP intensive. And I think that's why we're seeing a lot of money in global capital markets, but not a great deal of productive places to invest it in, which is why we're seeing shareholder returns and low rates of return. So just as we wrap up here, I want to switch to parenting. You have three kids. Based on your research, has it impacted the way you father or any kind of habits you're trying to build in or any practices or lifestyle changes you're really trying to endorse and urge your three kids to adopt? I can barely manage my own life. So I kind of was reluctant to offer advice that other people's got.

49:21But it is an interesting motivation. I started writing Getting This World, where I wrote a book called The 100-Year Life, and I just lost my parents. So you start to think about mortality. And I was seeing my kids make very different decisions to me, particularly my middle child, who was just leaving university, good university, good degree. He said, Dad, I'm not going to get a job. And I was pissed. And I was trying to work out why. And there was a whole bunch of factors involved. One was I think I was jealous because at his age, I was working as an economist in an investment bank. And is my life in any way, shape or form better because of that?

49:56No. And, you know, here he was, good looking, young, going to travel around the world and have fun. I'd also was cross because, you know, I paid for him to get through college and I'd gone without holidays. And here he was going to have a two-year holiday. So that kind of annoyed me. And I was worried for him. But it made me realize that life is different. People are doing different things. And that got me thinking about changing the life course. So if that's an answer to your question, it's like, I can't judge what kids are going through. I think we define children by technology and all this Gen Z type stuff.

50:28But actually, one of the really big things that's changing is they're going to grow up with me and their grandparents around for a lot longer than past generations. So working on that intergenerational stuff is key and recognizing that hopefully they can learn from me. but I can learn a lot from them as well. Because if I want to be evergreen, I've got to think about things in a different way and learn it. And I'm unlikely to learn it from people who are my age doing what I do. I've got to be a bit more open-minded. Andrew J. Scott is a professor of economics at London Business School, having previously taught at Oxford and Harvard University.

50:59He is also the co-founder of Longevity Forum, a consulting scholar at the Stanford Center on Longevity, and co-author of the global bestseller, The Hundred Year Life. His latest book, The Longevity imperative, building a better society for healthier, longer lives is out now. He joins us from the great city of New York. In my opinion, always fighting for the top spot with London and a huge oversight. I didn't ask you what your club was. What football club do you support, Professor? It's private grief. I'm a Spurs fan. One of the reasons I'm... Spurs! Son! Absolutely. But one of the reasons I hope for a long life is I might eventually see us win something, but we're seeing.

51:39Yeah, my oldest is Spurs. I've probably been to a dozen Spurs games. The nicest venue in the UK. We got that going for us. Well, let me know. I've got three season tickets. I go with my two boys. They can't always make it. So if you... Done. Done and done. We love it. Well, anyways, Professor, really enjoyed the conversation. Me too. Pleasure to talk.

52:12Algebra of happiness, just a quick hack. I love this research showing that when mothers speak to their daughters, when they text them, their blood pressure would go up. And then when they call them, when mothers call their daughters and they hear their voice, their blood pressure goes down. And I've had some interactions recently professionally where I thought this just would have gone so much better if we just jumped on the phone with each other. And something I'm doing with my boys, I'm trying to do it every night, especially when I'm on the road, as I am now. I call them on FaceTime, and I just let them hear my voice for a few seconds.

52:45How are you doing? What did you do today? How are the dogs? I'm engaged in football, not because I like football. I'll stop watching it once they're out of the house, but it gives me common ground that I can ask them about stuff. And sometimes the calls are literally two minutes. Something I'm also doing, I'm working out with them. I'm kind of acting as a remote trainer just so I can, not a big deal, they're kids, they're 13 and 16, but just 7 or 12 minutes of exercise. But I'd like to think that my voice brings their blood pressure down. And it's sort of saying, I'm present, I'm here. I love the notion that one of the ways you give your kids confidence and security is to know that you're just always there for them.

53:23That if they get the heartbroken, if they lose their job, if they're feeling mentally unwell, or if they're just upset, they can just always come home. And home is not only a physical space It's someone who's living a virtuous life who hopefully is a good person maybe even an impressive person That is always there for them is always giving them four walls of love and comfort And for me the way I build that home with my boys when i'm on the road is for 60 seconds Maybe two maybe three minutes. I call them. I want them to hear my voice Sometimes they're not that nice to me. Sometimes they act like i'm bothering them, but that's okay They need to know that every day I will put up with that and I will call them because I am their home.

54:04They can always come home to me. I am that voice and it's worth it to me. I'm the four walls around them. This episode was produced by Caroline Chagrin. Jennifer Sanchez is our associate producer and Drew Burrows is our technical director. Thank you for listening to the Prop G Pod from the Vox Media Podcast Network. We will catch you on Saturday for No Mercy, No Malice as read by George Hahn. And please follow our Prop G Markets pod wherever you get your pods for new episodes every Monday and Thursday.

54:38Every once in a while, we got to go G just for the fans.