For decades, healthcare has measured success by how long people live. But longevity without health tells only half the story.
Today, the average American spends nearly 15 years managing chronic illness, disability, or preventable decline—a period often described as sickspan. This is not just a personal burden. It is a systemic one, affecting families, clinicians, health systems, and economies alike.
This system burden costs the US over $4 Trillion per year—90% of the $5.7 Trillion we present in 2025 was spent treating people stuck in “sickpspan”
Dr. Larry Brilliant has long argued that the real challenge is not extending life with sickness, but extending healthy life:
“The real challenge before us is not how to help people live longer, but how to help them live longer lives in good health, wth dignity and purpose.”
Despite decades of research demonstrating the effectiveness of prevention, uptake remains remarkably low. In the U.S., only about 8% of adults aged 35 and older receive all recommended preventive services, even though those services are proven to reduce chronic disease, disability, and premature death.¹
Extended sickspan fuels rising healthcare costs, caregiver burnout, and diminished quality of life. It pulls clinicians into a perpetual cycle of late-stage intervention, where the opportunity to prevent disease has already passed.
This is not a failure of intent. It is a failure of systems.
Healthcare excels at responding to illness once it appears, but struggles to deliver preventive care early and consistently. Structural barriers like time constraints, workforce shortages, fragmented data, payment models, and uneven access, make prevention difficult to operationalize at scale.²
Even when strong evidence exists, it takes an average of 17 years for new clinical knowledge to be adopted into routine care.³ During that lag, millions of people remain exposed to avoidable decline.
Meanwhile, studies estimate that providing all recommended preventive services to a typical primary care panel would require more hours per day than clinicians actually have, underscoring the impossibility of prevention under current workflows.⁴
Scientific discovery is accelerating, but translation into everyday care remains slow and uneven. Research is siloed. Medical education struggles to stay current. Preventive insights are difficult to personalize and even harder to sustain over time.
As Dr. Brilliant has noted:
“We have built healthcare systems that excel at treating disease after it appears, yet we continue to underinvest in the knowledge, tools, and time required to prevent illness before it takes hold.”
Clinicians want to act earlier. Patients want to stay healthier longer. The system has simply not made that easy.
Reducing sickspan requires a shift from episodic, reactive care to continuous, informed prevention. That means:
Sickspan is not inevitable. In many cases, it is the result of delayed insight and missed opportunity. Fixing it starts by valuing prevention as much as treatment—and by designing systems that help people live not just longer lives, but healthier ones.
