HEALTHSPAN IMPLEMENTATION: AN INTEGRATED APPROACH HEALTHSPAN WORKSHOP FEBRUARY 9, 2018 Brad Allenby President’s Professor, Sustainable Engineering/Law Lincoln Professor of Engineering and Ethics

Observations Much of healthspan work has been at genetic, metabolic pathway, and organelle level. At some point, if the discussion of healthspan is to be kept rational and pragmatic, broader biological and community implications must be considered. This cannot be done by industry and academic bio and medicine alone, but to rely on external domains (e.g., fundamentalist and environmental activists) to respond rationally and ethically may be questionable.

Healthspan as an Integrated Phenomenon https://www.ted.com/talks/susan_pinker_the_secret_to_living_longer_may_be_your_social_life?utm_source=twitter.com&utm_medium=social&utm_campaign=tedspread--b

Life/Health Patterns in Russia

Life/Health Patterns in Zimbabwe AIDs epidemic and economic collapse

Life/Health Patterns, US White Males, 45-54

Levels of Biological Systems Organelle (differentiated structures within cells), cells, tissues, metabolic pathways Organs and organ systems Focus of current healthspan research Advances in medical science generally; new bioprinting technologies; xenotransplants; challenges include cognitive decline and other degenerative diseases

Levels of Biological Systems Structural systems (not usually included) (joints, connective tissue, cartilage, etc.) organisms Some advances (e.g., joint replacement surgery), but not connected to healthspan discussions. Serious challenges. Whole organism healthspan management is new domain; must include psychology and other “designed humans” attributes.

Levels of Biological Systems populations and communities Significant conceptual challenges: Economic – who pays for healthspan enhancement; equity between rich and poor (e.g., dramatic gaps in life expectancy, cognitive capability, etc.); impact on current economic systems (pensions, employment, education, etc.)

Levels of Biological Systems Populations and communities, continued Social – as healthspan becomes extended, what sorts of community stresses and discontinuities can be anticipated and should be managed? How can community be designed to augment metabolic healthspan? Law and regulation issues Cultural: how will conservative religious institutions respond to the implications?

Levels of Biological Systems Ecosystems and biosphere Environment: in short term, may have significant impacts on resource and energy consumption patterns (e.g., even if demographic structures remain similar, healthspan advances could dramatically increase ecotourism and concomitant environmental degradation).

Levels of Biological Systems Ecosystems and biosphere Environment: in long term, healthspan is occurring in the context of the Anthropocene, where the planet, and the human, both become design spaces. Biology at all scales is becoming an engineering science; biological systems are technology systems; and ecosystems are shaped by deliberate design choices.

Ways Forward: Appreciating the Role of Context Widen remit of workshops, conferences, and other discussion venues to identify critical issues and challenges, and brainstorm responses. This will help community learn to automatically include context in activities. Form Healthspan Industry Association (alternatively, establish a Center at a neutral institution) to work on industry-wide issues, and to sponsor workshops, meetings, and publications to help shape dialog?

Ways Forward Informal efforts to include other intellectual domains, non-medical or regulatory policy wonks, and others in dialogs? Hold informational meetings with potential supporters of continued research and progress (e.g., AARP)? We are challenging aging, current design of humans, culture, religion, and much more. Appreciating that context is critical to success of healthspan enhancement technologies at all scales.