“The first wealth is health.”
— Ralph Waldo Emerson
It’s easy to rank yourself for financial wealth these days. Just click on a news feed. Odds are you won’t scroll long before you’ll see a headline about how much you need to be average, well-off or just plain rich.
When I first started doing my “Wealth Scoreboard,” for instance, it was a lengthy and slow process. Today, a visit to a site like www.dqydj.com will provide several variations of the wealth or income information you seek.
Health Ranking Is Harder
Ranking yourself for your health wealth (where you stand compared to others) isn’t so easy.
To be sure, we have a plethora of health statistics.
- We have a good idea, for instance, of how fortunate we are to be alive and the probability of living another year, or more. (Thank you, U.S. Life Tables!)
- We have some figures on how many people report themselves to be in good health. What’s surprising in that data is that most of us seem to feel a lot healthier than our reported disability statistics indicate.
- We have reports on our disabilities measured two ways. Our ADLs, activities of daily living, and our IADLs, instrumental activities of daily living. There are also reports on our oral and mental health, though I have to say I think counting teeth is probably more accurate than assessments of how our heads are doing.
Hitting a Moving Target
These measurements are moving targets. They advance as the population of older people increases. Not that long ago you got to be 65. And that was the end. You were 65. Or 65-plus. Today, a few studies have moved the goal posts out to nonagenarians, the whole 90 years old and over crew.
Now let’s look at three age groups and note the decline of self-reported health that is good to excellent as the percentage with disabilities and without teeth rises.
- In the 65- to 74-year-old group, 80 percent report good to excellent health, while only 13.2 percent have disabilities and only 14.7 percent have no remaining natural teeth.
- In the 75- to 84-year-old group, 74 percent report good to excellent health, while 22 percent have disabilities and 20.1 percent have no remaining natural teeth.
- In the 85- and older group, 64 percent report good to excellent health, while 39.4 percent have disabilities and 27.4 percent have no remaining teeth.
Some (very) Rough Measures
So how are YOU doing? Here are some possible measures.
If you are 65 to 74, report good to excellent health and have no disabilities, you’re in the top 69 percent of your age group. But if you don’t report good to excellent health and have disabilities, you’re in the lowest 3 percent of your age group. (You could, of course, be reporting good to excellent health but have disabilities…)
If you are 85-plus, report good to excellent health and have no disabilities, you’re in the top 39 percent of your age group. But if you don’t report good to excellent health and have disabilities, you’re in the lowest 14 percent of your age group.
As a practical matter, I don’t think statistics like this are very meaningful. What matters is whether you self-report to be in good to excellent health. If you do that, you’ve adapted to whatever technically defined disability you have.
Adaptation Is Overlooked
Here’s a personal example. I have a condition called Dupuytren’s contracture in both hands. It’s a condition common in those of Scotch-Irish descent who work with their hands. It is bad enough in my left hand to be eligible for corrective surgery. But it has no material impact on my daily life. I remain the designated jar opener and heavy lifter in the Burns household, so there is no need to do anything about it.
Millions of people have some level of hearing impairment. It can be a real disability. But until the condition worsens beyond your ability to adapt with hearing aids and other changes in habits, life goes on as usual. Sadly, our ability to adapt is overlooked or not considered in many discussions of health conditions.
The Biggest Omission
But another, much more important, factor is missing. All these studies measure survivors, people living at the age they are being surveyed. As a practical matter, you’re doing much better than health statistics suggest if we account for “survivor bias” – the failure to start from the beginning numbers in the population sample. (There’s a column discussing this, “The Missing Bullet Holes Problem,” on my website at: https://scottburns.com/the-missing-bullet-holes-problem/ )
Here’s an example. Our life expectancy statistics are all based on the survival of a group of 100,000 individuals over time. The most recent U.S. life tables show that for all Americans, regardless of gender or race, 83.1 percent will still be alive at age 65.
But survivorship drops year by year. It sinks to 69 percent by age 75, 42.7 percent by age 85 and 9.6 percent by age 95. Since being alive is a rather crucial measure of well-being, every year of continued health puts you higher on the health wealth scoreboard.
It’s priceless, something to be grateful for every day – but I bet you already knew that.
Related columns:
Scott Burns, “Retirement 2.0: Another Life,” 10/10/25: https://scottburns.com/retirement-2-0-another-life/
Scott Burns, “The Many Stages of Retirement,” 10/4/25: https://scottburns.com/the-many-stages-of-retirement/
Scott Burns, “Smiles at 85,” 11/16/25: https://scottburns.com/smiles-at-85/
Scott Burns, collection of columns on the Wealth Scoreboard: https://scottburns.com/?s=Wealth+Scoreboard
Sources and References:
CDC infographic: “Disability Impacts All of Us”:
KFF, Non-institutionalized population who reported a disability by age:
2023 Profile of Older Americans: https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf
Changes in Elderly Disability Rates
“2024 Older Americans: Key Indicators of Well Being”
https://agingstats.gov/reports-and-tables.html
CDC U.S. Life Tables, 2023, 7/15/2025: https://www.cdc.gov/nchs/data/nvsr/nvsr74/nvsr74-06.pdf
This information is distributed for education purposes, and it is not to be construed as an offer, solicitation, recommendation, or endorsement of any particular security, product, or service.
Photo: Scott Burns, 6/17/2024 Another magnificent day walking the Frances route of the Camino de Santiago
(c) Scott Burns, 2025