Experts say that if you want to age healthily, you should plan for it.

That’s what I’ve tried to do: I played in a soccer league well into my 60s, and I was a regular runner. Those activities kept me fit and active at the time. Now, in my 70s, I hope they continue to pay dividends.

Healthy aging is something the Milken Institute, a nonprofit, nonpartisan think tank, has long focused on.

Ten years ago, it published a series of essays from thought leaders on the subject. Now, a decade later, the health and finance research organization has assembled a new collection of essays, expert commentaries and interviews, featuring many of the original authors along with some new voices. The publication, available to the public tomorrow, explores another dimension of healthy aging: the importance of closing the gap between lifespan and health span.

Milken is calling for a new way of thinking about aging at a time when people are living longer – but not necessarily better – lives. It involves building and scaling infrastructure to support our aging population, shifting outdated thinking and policies, and connecting people across generations.

I spoke with Diane Ty, managing director of the Milken Institute’s newly rebranded Future of Aging and Longevity, for an exclusive look at the essays and what they reveal about the challenges of living longer.

You’ve mentioned there’s been a decade of progress in approaching aging differently but more needs to be done. Can you talk more about that?
Absolutely, though I think the nature of the work will need to change. So much of the progress that we’ve seen is more of an awareness, it’s in the conversation about how we need to prepare. But I think now the pressing questions are really, ‘how do we design our institutions and our systems for these longer lives?’ Businesses, policies, all the institutions, they need to catch up with the reality of this aging population.

And how do we extend health span? We have a 12.4-year gap between how long people live and how long they are in good health. So how do we make sure we’re closing that gap through prevention, earlier detection, healthy lifestyles all the way around? And then with the scientific progress we’re seeing, the innovations we’re seeing, let’s make sure that they’re accessible to all, not just the few who can afford some of these treatments and innovations. Our educational systems, retirement systems, financial systems, workplaces, they were all built for shorter lives.

Some industries have adapted: financial services, travel, housing. But public policy is still somewhat stuck in a time warp on this issue, right?
We have seen change in the past decade with health systems, employers, technology, although I would say still through more pilots, some states that are leading promising innovations, but they’re poised to scale. But I think in all cases, we see innovation does outpace policy. There does seem to be a natural lag.

We’ve been trying to elevate the role of employers, which we think is undertapped as a platform for supporting family caregivers. When you think about the 63 million family caregivers, 70% have paid jobs apart from their caregiving. So we’re lacking that infrastructure on how to scale some of the good ideas, the good models that we’ve seen.

The disproportionate burden of caregiving nowadays seems to fall on younger people and particularly on women who often interrupt their career development or their lives. What is the level of burden and sacrifice that goes along with that?

Actually, I wouldn’t say that caregiving is falling mostly on younger people. The actual average age of the caregiver is 51. But I don’t want to overlook the fact that there is a huge increase in young people. You imagine a 50-year-old woman needing to care for her mom or dad, taking them to the doctor in between meetings, or spending time during the workday to navigate an insurance claim. These women are often in their peak earning years. About half say their employer is unaware of the caregiving duties that they carry alongside their job responsibilities. People are spending on average more than 25 hours a week in caregiving.

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