CHAPTER 1: If We Do Nothing

The year is 2050 and the average life expectancy at birth is 100. The oldest millennials are turning 70, with lower rates of savings and home ownership than any generation since the Great Depression. Social Security reached insolvency in 2035, imposing benefit reductions on an already stretched generation, and on all who retire from now on. Birth rates have cratered, a trend that began in the 20th century as economic opportunities for women expanded, while paid parental leave, affordable, high-quality childcare and preschool, and flexible employment options remained for most a mirage.

Yet the people most at risk remain uninsured, or dependent on Medicare, whose funding consumes an ever-larger share of GDP.

The youngest children spend ever more time indoors on screens, rather than playing and discovering nature, and are on a trajectory for poorer physical and emotional health than previous generations, as “nature deficit disorder,” identified by author Richard Louv in 2005, becomes the norm for children. Access to higher education is predetermined to an even higher degree by socioeconomic status and race in 2050, in an economy where automation and artificial intelligence have eliminated many of the occupations available to those without a college degree, still the singular, defining standard for most middle-class jobs. 

The “lost generation” of children who did not return to school or recover from learning losses during the COVID-19 pandemic of 2020-2022 are now un- or underemployed adults, with children of their own. Children living in poverty and underserved communities still fail at distressing rates to learn to read by 3rd grade, a precursor for dropping out and a higher likelihood of future incarceration.

Climate change shapes life everywhere for everyone, with disproportionate impacts falling on people of color and those who are low-income and older. American cities are hotter, suburbs are routinely ravaged by wildfires, and drought decimates rural communities. Climate refugees add pressure on strained housing and job markets. 

Racial inequities have deepened, especially for many Black Americans living in neighborhoods lacking clean air, safe water, stores to buy nutritious food, and access to green spaces where residents can play, exercise, and soothe stress. The median Black family has a net worth that is still around 12 percent of the median white household, due largely to the trillions of dollars in missing intergenerational wealth related to lower rates of home ownership for Black families, rooted in discriminatory government lending policies that persisted into the 1970s and in discriminatory banking practices that continue to the present.

This scenario of the “gray tsunami” washing over the land is a worst-case extrapolation of the “aging society” media narrative.

In suburbs, housing and transportation patterns have changed little since the 1950s. An increasing number of older adults no longer able to drive are marooned in neighborhoods designed and built a century ago for two-parent nuclear families with a stay-at-home mom to drive kids to school and swim practice, despite the fact that only a small minority of households reflect these assumptions. With mass transit scarce, the autonomous vehicle fleets that knocked Uber and Lyft out of business in the 2030s are too expensive for most retirees, and those unable to afford grocery delivery or a taxi are cut off from nearby sources of fresh, nutritious food. 

The Digital Divide has become a chasm, leaving poor and rural Americans cut off from education, jobs, and healthcare services in a digitized economy. Digital redlining and social isolation have further segregated Americans by income and age. Portrayals of intergenerational conflict proliferate in the media, driven by resentment, misinformation, and disconnection.

This scenario of the “gray tsunami” washing over the land is a worst-case extrapolation of the “aging society” media narrative. Such stories typically start with a cursory nod to the advances in science, medicine, and hygiene that led to the doubling of human life spans between 1900 and 2000 – after all, it’s hard to argue against reducing infant mortality. Then comes the twist: rather than regarding the advent of 100 year lives as more good news, longevity morphs into a demographic calamity that threatens the social and economic order. 

This genre inevitably caricatures older adults, whether 65 or 95, staring wistfully at the horizon or fretfully at their bank statements, sitting idly on benches, trading arthritis tips or being tended by smiling caretakers. A cover of The Economist from 2014 shows umbrella-toting pensioners raining from the sky onto rooftops, with the headline “Age Invaders.” Unlike Mary Poppins fluttering in to enchant the children in her care, this deluge of elders is presumably coming to siphon resources better dedicated to those children’s upbringing. While a recent counter-trend may feature pink-haired grandmothers on skateboards and garage band reunions of aging Boomer dads, the subtext of all of these caricatures is that older people, no matter how beloved or spunky, represent a net drain on society.

No wonder we are expected to take cover.

What if, instead, we developed a strategy to become a longevity-ready society?  A decade ago at Stanford, faculty were beginning to think of ways that Stanford could innovate transformative approaches for human aging, much as it did for communications technology in Silicon Valley. What began with a handful of faculty quickly expanded to include those from engineering, business, law, humanities and science, medicine, education, and earth sciences who saw a shifting population as an exciting challenge in search of solutions.

Laura Carstensen and her colleague, neurologist and stem cell biologist Thomas Rando, were deputized to establish what became the Stanford Center on Longevity and were given the mandate to apply science, technology, and behavioral and social change to improve longevity.  Carstensen had spent most of her career studying cognitive, emotional, and motivational changes that unfold across the life span, notably detailing ways that aging benefits emotional well-being and interests in helping others. Rando’s research was revealing ways to slow the biological processes that place people at increasingly greater risk for disease as they grow older.

Both held similar perspectives about the scientific aims, both stressing the important distinction between a Center on Longevity and for Longevity, meaning that the Center wasn’t going to advocate for extending life–a phenomenon already underway –but rather to apply science, technology, and policy to make longer lives better

By design, SCL came to include senior staff with deep expertise outside of academia and engaged a council of distinguished advisors who brought deep knowledge about how to make change at the societal level, how to distribute ideas and products, and how to bring to scale new ways of living. Given the aim of transformative cultural change, the center’s work focused squarely on impact. SCL forged relationships with businesses and corporations that were interested in collaborations to implement and evaluate novel solutions for the range of challenges they faced. 

Today the Center’s affiliated faculty includes as many pediatricians as geriatricians, along with economists, sociologists, and innovators in science, medicine, public health, technology, education, finance, transportation, design, culture, and media. As central to SCL’s mission as science and technology was, SCL recognized the need to change the narrative about coping with aging to one about discovering and pursuing new opportunities.

The New Map of Life is about much more than taking a different course from Point A to Point B; it is about changing the field of vision, the navigational tools, and modes of transportation to get us across entirely different terrain. Think Mars Rover instead of a steam ship or a train.

The New Map of Life is relentlessly forward facing, appreciating the flaws inherent in designing solutions for the future based on the problems of the past, and in coloring within the lines of today’s known facts rather than imagining new ones. A static view of what it means to age distorts our future perspectives about longevity, and our measure of the costs and benefits. As Carstensen wrote in 2011 in A Long Bright Future, “The danger that lies ahead for our society is that by failing to creatively and proactively adjust to life span changes, we will condemn the old people of the future to live like the old people of the past, even though they will be healthier, more mentally agile, and capable of doing much more.”

Meeting this challenge is not the sole responsibility of government, healthcare providers, or insurance companies; it is an all-hands, all-sector undertaking, requiring the best ideas from the private sector, government, medicine, academia, and philanthropy. For us, it is not enough to reimagine or rethink society to become longevity-ready; we intend to build it, and fast. Our collective challenge is to develop social innovations that will help people remain healthy and productive over the course of their longer lives. 

The New Map of Life is about much more than taking a different course from Point A to Point B; it is about changing the field of vision, the navigational tools, and modes of transportation to get us across entirely different terrain. Think Mars Rover instead of a steam ship or a train. Shoving off across terra incognita requires overcoming the psychic inertia that is part of human nature. “We are enmeshed in a collaboratively written life script that is intensely, but invisibly powerful,” Carstensen writes. “Even though it’s forcefully shaping our ideas about aging and where certain events should occur in our life span, we rarely realize it’s there.”

Another key design principle of the New Map of Life is flexibility. While the conventional life course is a one-way road through three life stages –education, work, and retirement – the New Map of Life features forks in the road that can take us in many directions. There are intersections, cloverleafs, curves, on-ramps, and off-ramps. Flexibility is the mantra and course corrections are the norm. Those who must veer at one point or make a U-turn at another deserve support for their resilience in the aftermath of a mistake, miscalculation, or misfortune. Adversity may be inevitable in life, but a central design feature of the New Map of Life is that it need not become indelible. For example, labels such as “dropout”, “unemployed,” “homeless” or “ex-con” are common yet derogatory shorthand for describing a person’s past experience that also serve to dismiss their potential for growth, or as an excuse to deny the societal resources to assist them in doing so. A recognition that adversity is more common –and less limiting– than the conventional narrative allows will make us more resilient as individuals and as a society. 

American culture values ingenuity, individual choice, responsibility, and virtues such as a strong work ethic. These qualities, along with making good decisions and having a supportive family, are assumed to propel us over the hurdles of life, and for many this is true. But the dominant cultural script makes few allowances for the hurdles at birth that hinder children born into poverty, racial discrimination, or the wrong zip code from even getting to the starting line, much less reaping the benefits of longevity.

In a democratic society with an advanced economy that depends on the participation and talents of all members, failing to create opportunities for each person to develop their full potential is an unconscionable waste. The policies and investments we undertake today will influence how the current young will become the future old, and what we choose –as individuals and as a society– to make of the thirty extra years of life gifted to us.



Chapter 2: ‘I Feel Needed’