We’re living longer on average, but the number of years we’re healthy hasn’t kept up. This lagging “health span” translates into more time living with serious illness and disabilities at the end of our lives.

This can have significant repercussions for our retirements. Some of us will have our working lives cut short by ill health, reducing how much money we can save for our futures. Others will face big bills for medical and nursing home care.

Then there is the emotional toll of struggling with poor health rather than traveling, visiting the grandkids and engaging in all the other activities we’d planned for our golden years.

It doesn’t necessarily have to be this way. Many of the biggest risk factors for poor health are within our power to modify, prevent or control, says R. Dale Hall, managing director of the Society of Actuaries Research Institute, which provides research on managing risks. But as with retirement saving, the earlier we get started, the better.

5 health span risk factors

The institute commissioned Vitality, a company that partners with insurers and employers to promote healthier living, to conduct a study that identified five lifestyle risk factors with the largest impact on health span: Tobacco use, obesity, high blood sugar, poor diet and high blood pressure.

The researchers also highlighted ways to modify those risks, which include quitting smoking, engaging in physical activity, eating a healthy diet and taking medications as prescribed.

The study relied on data from the Global Burden of Disease, a resource maintained by the University of Washington’s Institute for Health Metrics and Evaluation that tracks the prevalence of diseases and risk factors worldwide, along with the relative harm they cause.

The GBD shows average remaining life expectancy at age 65 in the U.S. rose from 17.6 years in 1990 to 19.6 years in 2019 – a two-year gain. Healthy life expectancy, on the other hand, rose less than one year, from 12.2 years to 13.1 years.

That echoes similar statistics from the World Health Organization, which found that U.S. life expectancy at age 60 rose nearly 8% between 2000 and 2019, but healthy life expectancy rose less than 5%.

Other barriers

The GBD has some limitations: It doesn’t track the impact of well-established prevention strategies such as immunizations and screenings, or account for risk factors such as stress, depression, lack of sleep, loneliness and lack of purpose, Vitality researchers report.

It’s also important to acknowledge there can be huge systemic barriers to healthier living:

• If you live in an area with limited access to fresh fruits and vegetables, it’s harder to eat well.

• If you live in crowded housing in an unsafe neighborhood, getting enough exercise can be tough.

• If you must choose between buying medication and food, you’re unlikely to fill the prescription your doctor wrote for you – assuming you can afford to visit a doctor.

• The more money you have, the better access you have to the key health interventions that help people live a longer life in good health. Even when we have enough money, our behavioral biases can get in the way — particularly our tendency to value present gratification over future gain.

“I’d honestly rather sit on the couch and eat the bag of crisps rather than go for the run,” says Tanya Little, Vitality’s chief growth officer. “And yet future me would thank me for going for the run now.”

Identify 1 area for change

Similarly, we may choose inaction over action if we’re asked to change too much, Little says. Instead, Vitality’s programs identify one change that would have the biggest impact based on each person’s health and lifestyle profile.

“This idea of an endless list is totally overwhelming and demotivating,” Little says. “Whereas if I say to you, ‘If you just did this one thing’ ... you are much more likely to do it.”

Once people make progress on a single goal, they’re often inspired to change others, Little says. People who get more exercise often start to eat healthier, for example.

Healthy habits don’t make us immune to illness and disability, of course. But minding our health improves the odds we’ll have many more years to enjoy.

If you’d like to see what Vitality recommends for you, as well as its estimate of your life and health spans, you can visit the company’s calculator.

Liz Weston is a columnist at NerdWallet, a certified financial planner and author of “Your Credit Score.” Email: [email protected]. Twitter: @lizweston.