The Longevity Landscape: Value Creation for Healthy Aging

Abstract

Background: The global aging population underscores a critical need to tackle accompanying health and economic challenges, at all levels of society. This All-of-Society approach emphasizes the involvement of various stakeholders - governments, NGOs, researcher centers, private companies, local communities, and opinion leaders - to collectively promote healthy aging. However, how stakeholders enable healthy longevity remains unclear.
Objective: This study examines how global stakeholders (governments, NGOs, researcher centers, private companies, local communities, and opinion leaders) create value towards healthy longevity. We identify the healthy longevity dimension of stakeholders' value propositions and examine alignment between their propositions as an indicator of shared goals.
Methods: Following the All-of-Society approach, we analyzed the healthy longevity aspects of value propositions among the six classes of stakeholders (N=128). We (1) employed semantic topic modeling to identify the primary value proposition topics as related to healthy longevity and (2) computed proposition alignment using similarity networks.
Results: Our analysis revealed varying degrees of alignment between stakeholders' healthy longevity propositions, with the lowest alignment observed for local communities and researcher centers.
Conclusions: Findings underscore a key need to strengthen synergies between academic and community-based initiatives to promote translational science and highlight opportunities for strategic partnerships in the evolving healthy longevity field.

Full text

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The Longevity Landscape: Value Creation for Healthy Aging
Wasu Mekniran1, 2, Odile-Florence Giger2, Elgar Fleisch1, 2,
Tobias Kowatsch2,3,4, Mia Jovanova3
1Centre for Digital Health Interventions, Institute of Technology Management,
University of St. Gallen, Switzerland
2Centre for Digital Health Interventions, Department of Management, Technology, and
Economics, ETH Zurich, Switzerland
3Centre for Digital Health Interventions, School of Medicine,
University of St. Gallen, Switzerland
4Centre for Digital Health Interventions, Institute for Implementation Science in Health Care,
University of Zurich, Switzerland
ORCID:
Wasu Mekniran (0000-0001-5184-0438)
Odile-Florence Giger (0009-0005-7660-864X)
Elgar Fleisch (0000-0002-4842-1117)
Tobias Kowatsch (0000-0001-5939-4145)
Mia Jovanova (0000-0003-3634-4449)

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ABSTRACT
Background: The global aging population underscores a critical need to tackle accompanying
health and economic challenges, at all levels of society. This All-of-Society approach emphasizes
the involvement of various stakeholders—governments, NGOs, researcher centers, private
companies, local communities, and opinion leaders—to collectively promote healthy aging.
However, how stakeholders enable healthy longevity remains unclear.
Objective: This study examines how global stakeholders (governments, NGOs, researcher
centers, private companies, local communities, and opinion leaders) create value towards healthy
longevity. We identify the healthy longevity dimension of stakeholders' value propositions and
examine alignment between their propositions as an indicator of shared goals.
Methods: Following the All-of-Society approach, we analyzed the healthy longevity aspects of
value propositions among the six classes of stakeholders (N=128). We (1) employed semantic topic
modeling to identify the primary value proposition topics as related to healthy longevity and (2)
computed proposition alignment using similarity networks.
Results: Our analysis revealed varying degrees of alignment between stakeholders' healthy
longevity propositions, with the lowest alignment observed for local communities and researcher
centers.
Conclusions: Findings underscore a key need to strengthen synergies between academic and
community-based initiatives to promote translational science and highlight opportunities for
strategic partnerships in the evolving healthy longevity field.

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What is already known on this topic
The National Academy of Medicine's All-of-Society approach advocates for multi-stakeholder
engagement towards healthy longevity, but specific stakeholder contributions, and their alignment
toward shared goals, are poorly understood.
What this study adds
To our knowledge, this study is the first to provide empirical evidence into the value propositions
of healthy longevity stakeholders on a societal scale. It highlights key areas where multi-
stakeholder collaboration can be strengthened—particularly between academic and local
community initiatives—and proposes five strategies to strengthen collaboration.
How this study might affect research, practice, or policy
Prioritizing (1) community-based participatory research, (2) translating healthy aging-related
research findings into accessible resources, (3) prioritizing equity in intervention delivery, (4)
establishing community advisory boards, and (5) developing knowledge translation and training
programs, could potentially better align academic and community efforts towards more aligned,
equitable and effective healthy longevity initiatives.

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INTRODUCTION
The global demographic change toward an aging population, combined with the surge of non-
communicable diseases (NCDs), presents key challenges in our healthcare systems (WHO, 2020).
This challenge is two-fold: on an individual scale, older adults increasingly contend with NCDs as
they age, while at a societal level, healthcare systems face escalating costs. Notably, 74% (41 out
of 55.4 million) global deaths in 2019 were attributed to NCDs (WHO, 2023). In parallel, global
healthcare expenditure is projected to surge from $9.1 trillion in 2020 to $11 trillion by 2026
(IHME, 2023). These alarming numbers underscore the need to prioritize healthy aging.
Addressing these complex challenges calls for healthy longevity initiatives, ensuring
individuals maintain their functional health as they age (Bautmans et al., 2022). Recognizing this
urgency, WHO (2020) designated 2021–2030 as the Decade of Healthy Aging, and the National
Academy of Medicine (NAM) proposed the All-of-Society approach, with different sectors coming
together to tackle healthy aging, at a societal level (WHO, 2020; National Academy of Medicine,
2022). Yet, implementing a multi-stakeholder approach is complex; and no prior work has
evaluated stakeholder roles. This study aims to address this gap and identify opportunities to build
stakeholder synergies.
Drawing from public health and business research, a helpful method to understand a
stakeholder's role is by analyzing their value proposition (Payne and Frow, 2014; Gassmann,
Frankenberger and Choudury, 2020). A value proposition captures what a stakeholder offers and
to whom (Steinhöfel, Kohl and Orth, 2016) and serves as a foundation for multi-stakeholder
collaboration. Theoretically, stronger value alignment between stakeholders suggests shared
objectives and fosters partnerships to address complex challenges like global aging, ensuring that
all stakeholders are working towards the same objectives. This shared focus from a complementary

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value proposition could enhance cooperation, and support a unified approach to tackling issues,
thereby increasing the likelihood of sustainability of outcomes (Cozzolino and Geiger, 2024).
However, no work to date has examined the value propositions of stakeholders in the longevity
landscape, which is crucial to understanding their individual roles and collaborative dynamics
(Lingens, Seeholzer and Gassmann, 2022). Thus, this study aims to (a) identify the healthy
longevity value propositions of key stakeholders and (b) analyze their alignment as an index of
potential collaboration. We examine the following questions:
RQ1: What are the value propositions of healthy longevity stakeholders?
RQ2: How aligned are the value propositions of healthy longevity stakeholders?
By addressing these questions, we aim to identify potential gaps in value alignment and discuss
recommendations towards more collaborative healthy longevity efforts.
METHODS
To identify and analyze the value propositions of key classes of stakeholders (governments, NGOs,
researcher centers, private companies, local communities, and opinion leaders) in healthy
longevity, we conducted a content analysis and applied computational social science tools. We
identified academic and non-academic stakeholders (N=128) using pre-defined search terms and
extracted their value propositions using a combination of databases (i.e., Web of Science,
PitchBook, and Crunchbase). For details on the search strategy, data inclusion, methods details,
and analysis plan, refer to Appendix S1. Next, we applied semantic topic modeling, a data-driven
text analyses technique (Valdez, Pickett and Goodson, 2018) to identify the primary themes in the
healthy longevity value propositions (RQ1) and network analysis (Wasserman and Faust, 1994) to
assess alignment between stakeholders' value propositions (RQ2). Building on these analyses, we
propose recommendations to strengthen stakeholders' value alignment. No ethics approval was

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required for this study, as it involves the analysis of publicly available data and no human subjects
or personally identifiable information.
RESULTS
Value creation among stakeholders in the healthy longevity landscape
Using semantic topic modeling, we categorized the main themes of the healthy longevity aspects
of the value propositions of the six classes of stakeholders (RQ1):
In our sample, governmental organizations focus on developing policies that create
supportive environments for older adults and establish evaluation guidelines for standardized
program evaluation. NGOs focus on allocating longevity-focused resources among stakeholders
and developing healthy aging programs. Research centers investigate aging biology and develop
interventions for NCD prevention and management. Private companies in the longevity sector
focus on personalized, digital health analytics to prevent and treat age-related diseases. Local
community supports equitable aging through targeted education, family support initiatives, and
advocates for aging-specific healthcare services for diverse populations. Opinion leaders promote
longevity innovations through outreach activities, including disseminating research on age reversal
methods. See Figure S2 for main themes per stakeholder.
Value alignment among stakeholders in the longevity landscape.
To examine how likely are stakeholders to share common healthy longevity related values,
we analyzed the similarity of their value propositions. We created an undirected network where
stakeholders are represented as nodes, and the connections, or edges, between them are based on
how similar their value propositions are to each other (Figure 1, A). Similarity was measured using
a widely used pairwise-cosine similarity score (Valdez, Pickett and Goodson, 2018). By summing
up these similarity values for each stakeholder across the network, we calculated their "node

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strength," which indicates how closely their values align with those of other stakeholders. Higher
node strength indicates stronger alignment with the overall values of the network. For more
detailed information on the measurement process, refer to Appendix S1.
We observed wide variability in stakeholders' healthy longevity value proposition
alignment (normalized node strength range: 0.59-1) (Figure 2, B). Opinion leaders, private
companies, NGOs, and government organizational, showed high to medium alignment with all
other stakeholders, with shared overarching goals to fund, develop, implement, evaluate, and
disseminate healthy aging programs, while local communities and research centers displayed
lower levels of alignment (relative to all other stakeholders), with normalized node strengths of
0.63 and 0.59, respectively, implying lower alignment with other stakeholders' goals (Figure 2, B).
Researcher centers focus on innovative aging-disease related research, while local communities
focus on equitable healthy aging advocacy and reducing disparities in healthy aging.
Figure 1. Healthy longevity value proposition network, where nodes are stakeholders and edges
present pairwise cosine similarity scores (A). Node strength distribution for stakeholders in healthy
longevity (B). Note: node strength is normalized (0-1).

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DISCUSSION
This report analyzes how global stakeholders create value towards healthy longevity with a
systematic approach. We identified the healthy longevity-related value propositions of 128
stakeholders—government organizations, NGOs, research centers, private companies, local
communities, and opinion leaders, through semantic topic modeling and network analyses and
examined their alignment. Our findings uncovered both consistent and inconsistent values.
Specifically, we observed stronger value alignment among opinion leaders, private companies,
NGOs and government organizations, in funding, developing, implementing, evaluating, and
disseminate healthy aging programs, but weaker alignment for local communities and research
centers relative to all other stakeholders.
Importantly, our findings suggest that while research centers may drive biological and
behavioral innovations and advancements to promote healthy aging, conflicts may arise over
accessibility, affordability, and equity in delivering these innovations to individuals and
communities who need them most (Fernandez-Moure, 2016). Thus, strengthening the alignment
between local and academic stakeholders is a first step to foster more coordinated initiatives that
do not exacerbate existing health inequalities; and are better suited to the needs of local
communities. To this end, we propose five strategies for value alignment—particularly to
strengthen accessibility, affordability, and equity in developing and delivering scientific
advancements for healthy longevity:
1. Community-Based Participatory Research: Actively involving community members in
longevity research development processes.

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2. Translating Healthy Aging-related Research Findings into Accessible Resources:
Ensuring research findings are accessible and tailored to community needs and address
specific concerns or interests within the community.
3. Prioritizing Equity in Healthy Aging Intervention Delivery: Tailoring interventions to
address specific barriers: i.e., socioeconomic, or cultural factors that may affect
intervention access.
4. Establishing Community Advisory Boards: Creating longevity council boards where
residents provide input on healthy aging research initiatives.
5. Developing Knowledge Translation and Training Programs: Empowering community
members with information related to healthy aging, i.e., online training modules or
workshops designed to promote healthy aging behaviors.
These proposed strategies reshape current stakeholder priorities with a focus on equity in healthy
aging and aim to ensure that scientific progress from research centers reaches diverse populations
outside the lab. Together, while our analysis of healthy longevity value propositions contributes to
new opportunities for stakeholder partnerships, it is also important to acknowledge that our
sampling may not capture all emerging stakeholders in the longevity landscape and does not focus
on payers and payees. The novelty of the healthy longevity field means that scientific publications
and financial data are limited and may omit additional relevant sources. Future work could address
these limitations by employing more systematic sampling approaches at scale and conducting
expert interviews.
Overall, this work improves our understanding of stakeholder values and collaboration
dynamics in the healthy longevity landscape and underscores and opportunity to create synergies
between local communities and research centers to address healthy aging. We emphasize the

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importance of community-based participatory research, accessible delivery of aging interventions,
establishment of healthy aging community advisory boards, and implementation of knowledge
translation programs as key steps towards healthy longevity equity.
Conflicts of Interest
WM, OFG, EF, TK and MJ are affiliated with the Centre for Digital Health Interventions, a joint
initiative of the Institute for Implementation Science in Health Care, University of Zurich, the
Department of Management, Technology, and Economics at ETH Zurich, and the Institute of
Technology Management and School of Medicine at the University of St.Gallen. CDHI is funded
in part by CSS, a Swiss health insurer and MavieNext (UNIQA), an Austrian healthcare provider,
and MTIP, a Swiss investor company. EF and TK are also a co-founder of Pathmate Technologies,
a university spin-off company that creates and delivers digital clinical pathways. However, neither
CSS nor Pathmate Technologies, MavieNext or MTIP were involved in the design, analysis, or
writing of this research.
Contributions
WM, TK and MJ contributed to the conceptualization of this research. WM and OFG conducted
the qualitative data collection and content analysis. MJ conducted the quantitative analyses. WM
wrote the research protocol and the first version of the manuscript. MJ, EF, and TK provided
feedback on the manuscript. All authors reviewed and edited the manuscript and approved the final
version.
Patients and Public Involvement
This research did not involve patients or the public directly.

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