Americans are living longer than ever before, but gains in longevity are not distributed evenly throughout the country.  The gaps, which in some cases span decades, have the potential to either get better or worse depending upon longevity technology adoption patterns, making this the right time to start thinking about the issue.

To be sure, there has never been real equality in life expectancy which on average, is almost 80 years in the United States.  Some people take on dangerous jobs, others have detrimental personal habits like smoking, and some get unlucky when it comes to genetics.  Race and education also play a big role.  Today’s disparities are surprisingly stark. 

For instance, in the county of San Mateo in California, there is a big divide within just a few miles. In Atherton and Belmont, the current average age of death is 80 years. In East Palo Alto, it is 61.8.  Big gaps can be found in other states as well.  In Fairfax Virginia, women have a life expectancy of 84.1, but women in Greensville and Sussex can only expect 75.9 years.  The key question here is whether new longevity technologies can change the situation.  There is both a pessimistic and an optimistic view.

The pessimistic view sees biology as it has been in the past: a slow moving, heavily regulated area that relies a good deal on accidents and luck to come up with fundamental discoveries.  In an era where getting a drug to market takes years and millions of dollars (and sometimes billions), it’s hard to imagine prices dropping.  Indeed, today there is no shortage of stories about people both in developing and developed countries who can’t afford life-extending medication and sadly wind up suffering. 

In an interview with the Economist Magazine, Severin Schwan, the chief executive of Roche, said: “The starting point always is, what is the right price for a medicine? And there is no objective answer…At the end you are discussing, what is the price of life?” 

If new technologies do not dramatically change the game and humanity remains stuck in the current model where the investment and risk for developing new therapies are so high that companies must charge hefty fees that only few can afford, then there will likely be massive revolt, maybe even all-out war. 

Imagine if only the wealthy can afford to live in good health well past 100 years while the poor remain stuck for the foreseeable future in the double digits.  Literally fighting for one’s life will likely be something that will draw committed support, making the Occupy Wall Street movement seem like a love-fest.  Fortunately, new technologies often do change the game and now that biology is becoming more of an engineering project, there is greater reason to be optimistic.

The optimistic view looks at longevity technologies as moving at a pace comparable to the computer industry, which sees rapid advances that then translate into lower costs and wider distribution of technology throughout society. Consider that, in the future, doctors may be able to use stem cell therapy or tissue engineering to repair a heart instead of the current standard of prescribing medications that only slow down the damage but don’t actually fix the problem. 

Fixing a health problem rather than simply delaying progression of disease is a first step in reducing costs, but will such a procedure be extremely costly?  If biotechnology follows the curve of Moore’s Law, or even better, the rapidly falling prices involved in genomics, then longevity technologies should be available to almost everyone very quickly.  Inventor and Singularity University co-founder Ray Kurzweil argues that biotech is very much like information technology and, because of that, we have reason to be optimistic.

“Biology is a software process,” he says. “Our bodies are made up of trillions of cells, each governed by this process. You and I are walking around with outdated software running in our bodies, which evolved in a very different era... We’re now able to reprogram health and medicine as software, and that [pace is] going to continue to accelerate.”  That is the engineer’s viewpoint, and to the extent that biology is part of that realm, it’s true that things are moving very quickly. 

While longevity technologies are advancing at an impressive speed, the path of their distribution is still unclear.  Reading and writing DNA are epic feats that are rocketing forward, but those abilities alone may not be enough.  Time will tell how quickly other longevity technologies will move, and in the meantime societal leaders should be considering all potential outcomes.