Between 2000 and 2016, life expectancy at birth in France increased by 4.1 years for men and 2.5 years for women, according to the Human Mortality Database. However, there remains an unanswered concern, an issue that is central to both individual and collective levels: in what state of health and dependence will we experience these “bonus years”? Indeed, when it comes to life expectancy in good health, the picture is not so rosy: according to Eurostat, a woman born in France in 2016 has a healthy life expectancy of 64.1 years, while for a man this figure stands at 62.6 years.
The role of Marine Habart, AXA Group Life, Savings and Health Chief Risk Officer, is to consider these issues and to interpret the corresponding risks. In the field of aging, she is responsible for “calculating the future”, i.e. establishing probable scenarios that determine the life expectancies of AXA policyholders, as well as their life expectancies in good health. However, her role also involves consideration of the best way to support people on the road to a better end of life. To do so, she works alongside renowned experts and scientists; particularly those financed by the AXA Research Fund.
We spoke to Marine Habart as part of the launch of the “Silver Age: Aging better” AXA Research Guide, in which experts and scientists share their perspectives and knowledge on this subject.
Why do you think it is necessary today to publish a guide to advance knowledge on healthy aging issues?
Marine Habart: The fact is that for a century we have been gaining three months of life expectancy at birth each year. This statistic has been confirmed over the long term. In the future, we will probably live even longer. The question that is therefore essential to address is: will we live these extra years in good or bad health? Depending on a patient’s state of health, end-of-life costs can vary significantly for families, insurers, health systems, and society in general. From a global perspective, Europe is preparing for what some people are calling a “silver tsunami”. This expression refers to the wave of octogenarians that will need looking after in a context of populations with low fertility rates. It is therefore essential that every effort is made to provide the right conditions to foster healthy aging, at a time when profound changes are underway in demographics and care facilities. For example, these days we often refer to the “sandwich generation”: the generation of people, many of whom are themselves elderly, who care for their (adult) children and also their parents who have become dependent...
The objective of this guide is to highlight a pressing problem and provide pathways with which it can be addressed. We must remember that while population aging can be a problem on the social scale, primarily the issue is about gaining extra years of life, something that is precious to us all as individuals.
How can we promote healthy aging?
Marine Habart: Good health is simple to define: it is to live independently and free from disease. It is however more difficult to obtain and maintain. From an individual point of view, there are two new phenomena.
The first phenomenon: the chronization of previously fatal diseases. Due to better prevention and new treatments, it is now possible to live for many years after experiencing cancer or stroke.
The second phenomenon, which is related to the first, is multimorbidity: as the chances of surviving diseases like cancer increase, so too does the likelihood of contracting another disease afterwards, and thus living with several consecutive pathologies. All of this has an impact in terms of costs and quality of life. At the societal and health system level, rising costs and changing treatments imply new approaches and perspectives.
This is our principle role as an insurer: to help our policyholders with such expenses and to promote the right conditions for healthier aging. Because in some cases, small changes can have a big impact on an individual’s aging pathway. The scientific literature evokes the “zone of fragility”: an age of life during which small simple improvements (support, better care, etc.) can have major impacts on life expectancy. I am convinced of this, as an academic (I am also a Doctor and Associate Researcher at IMT Atlantique Laboratory) but also as an AXA collaborator: we have a role to play in this critical period of our lives; today we must determine the best ways to support senior citizens. And such support already takes several forms (teleconsultations, alternative medicine, etc.), as Didier Weckner, AXA France CEO Health & Employee Benefits, reminds us in the Guide.
Were you inspired by any of the Guide’s contributors? What in particular did you learn?
Marine Habart: In my job, I work regularly with researchers. It is these researchers, their expertise and particularly their conclusions that guide us in the definition of our models. My team and I have had the opportunity to collaborate with several researchers in the Guide, such as Carol Jagger, whose work deals with life expectancy in good health – an area in which she is an internationally renowned expert.
It is difficult for me to mention only a few projects here, since they are all exciting. Nevertheless, I was particularly interested in the initial conclusions of Peter Joshi’s work. He studies the genetic determination of longevity. And contrary to what some believe, it seems that the key to longevity is not contained within our genes; it is our behavior and habits that largely determine our lifespans. Another project that comes to mind is Abdul Barakat’s “stents” which, by taking the laws of fluid mechanics into account, look set to revolutionize the success of these implants.
Beyond these projects and all the others, I maintain a general feeling of confidence in the future, and in the ongoing research that will improve our lives. But we must remember the following: work on this subject is being carried out in many different disciplines: demography, economics, epidemiology, genetics... If these fields become isolated, the knowledge they provide will be insufficient. It is only when considering all of these fields together that their findings become complementary, and we can achieve real progress.