In this conversation with Dawn M. Carpenter, distinguished ethicist, financial advisor, and author of The Longevity Equation, we explored how healthspan and wealthspan are deeply intertwined across the life course. Carpenter introduced her framework for understanding longevity as an outcome shaped not only by medical care, but by financial security, institutional design, and the responsible use of technology.
Drawing on personal experience and her professional work, Carpenter argued that health and wealth are not merely correlated but mutually reinforcing. She emphasized the role of contributive justice, framing longevity as a shared responsibility that requires institutions to enable individual agency through stable structures such as housing, employment, and education. The discussion highlighted innovative models, such as inclusive retirement design, and healthcare anchor investments, that address upstream drivers of health. The conversation ultimately reframed longevity as both a moral imperative and an economic opportunity, calling for cross-sector collaboration to support human flourishing at every stage of life.
Lecturer bio:
Dawn M. Carpenter, DLS, is a distinguished ethicist, financial advisor, and educator with a deep commitment to business ethics and social purpose corporations, particularly focusing on the welfare of the marginalized and working poor. She has extensive experience in financial advisory and advocacy, economic storytelling, and financial and business ethics education. Carpenter has held leadership positions at Georgetown University, City First Bank of DC, and JPMorgan Chase & Co., among others, where she has been responsible for strategic financial initiatives, mentoring, and community development. Her professional experience spans over two decades and includes roles in investment banking, asset management, corporate governance, and financial services. Carpenter is also an award-winning podcast host, an accomplished author, and a speaker, contributing to various publications and presenting at conferences on topics related to work, wealth, and social economy. She holds a doctorate in liberal studies from Georgetown University, in addition to graduate degrees in political science, finance, and theology. Carpenter is actively involved in several professional associations and serves as an advisor to the Vatican on solidarity economy issues.
Transcript:
Seth Green: Welcome all! We are so excited to have you here for the Longevity Equation. A conversation with Dawn Carpenter on how Healthspan and Wealthspan interact, and we are going to get right into it, because we are so excited to have Dawn with us, and we have a Power Half Hour with her, and so I want to make the most use of that time together. Hello, Dawn. Welcome to the University of Chicago virtually. We’re thrilled to have you here.
Dawn Carpenter: Oh, I’m more excited than you are.
Seth Green: Let me just start by saying Dawn has, even amidst the many people I introduce, a totally extraordinary biography. She is a distinguished ethicist, financial advisor, and educator, with a deep commitment to business ethics and social purpose corporations, particularly focusing on the welfare of the marginalized and working poor.
She’s held leadership positions at Georgetown, at City First Bank of DC, and JP Morgan, where she has been responsible for strategic headline initiatives in finance, venturing, and community development. She holds a doctorate in liberal studies from Georgetown University, actually a program that we see almost as our sister, in the lifelong liberal arts. And she also is an advisor to the Vatican on solidarity economy issues.
And so, Dawn, let me start there. You’ve spent your career across finance, ethics, community development, and now longevity research. Those Dawn’t always go together in every biography. Before we dive into the report that you are the author of, can you talk about what convinced you to engage in those, and that healthspan and wellness are inseparable?
Dawn Carpenter: Well, that’s, we can do an entire 30 minutes just on that question alone, but what I will say first off is thank you for inviting me here today, and again, as a sister institution in the liberal arts, you can’t address—and you probably recognize this—this audacious question without an interdisciplinary approach, and one, in my view, deep in the insights across a myriad of disciplines. So, here I am, and here we are, but you asked a different question, which was, how did I find myself looking at healthspan and wellspan?
So, if that’s the question you want, that’s the question I’ll answer. Right. So, before I was an ethicist, I was a mother. My two daughters began life as orphans in Russia, both with serious medical conditions, and at different points, each faced life-threatening illness. So I spent nights in intensive care, navigating not only clinical decisions, but also insurance coverage, flexibility, travel logistics, long-term financial insecurity, all of those things.
But in those moments, there was never a distinction between health and wealth, because access to care was never purely medical. It was always based on institutions. Labor markets, insurance systems, public programs, family resources. So the ability to secure time off and relocate for treatment or absorb financial stocks directly shapes and ultimately determines the health outcomes. So I saw this very clearly from a personal perspective.
And so, as a mother grounded in faith, we know when we look at our children—I’m sure fathers feel this way too—I came to see something very important: that each of us is unique and unrepeatable, and every human being, no matter how vulnerable, has an inherent dignity. Dignity requires something really important, which is structure. And so I saw the same pattern at scale as a banker. And so, when I was, surreptitiously, perhaps, introduced to Dr. Omar Lateef from Rush Medical Center in Chicago last spring, I was faced with a brother from another mother when he said, “healthcare is a human right.” And so I got to thinking about it, and I said, how can we understand this tension that I experienced as a mom? And so that’s what set me out on this quest.
Seth Green: Well, and Omar, of course, has been leading with Westside United and other aspects here, so we can talk about that toward the end. Let’s lay out the problem, and then, you know, where your report goes for a framework. So, you have a report, the Longevity Equation. It explores this deep interconnection between financial well-being and physical health. Can you walk us through the framework and what it reveals about how wealth and technology really are interconnected with our health and how we live?
Dawn Carpenter: Yes, I started thinking about this equation when I began to see a mismatch in the time horizon. How do you express this in a way where variables are not… oftentimes, scholars will look at this question as if variables are correlated. And I didn’t see that they were correlated so much as I saw them as interconnected. So, to describe this ethics phenomenon, which is, how do we express dignity and show the relationship of health and wealth, I thought a very simplistic way to do it is through an equation.
And so the equation itself is quite elegant. You take a healthspan, which is the expression of how we experience health from very poor and fragile to thriving. You can also express and understand wealth or financial well-being the same way. So I’m using my hands because, what we’ll talk about later is a visual representation of this equation. But, the equation itself says health span times wealth span, together, is impacted directionally by how we engage with technology. And what we’re really solving for in this equation is an understanding of a longevity outcome.
Seth Green: Yeah, tell us a little bit more. And then we’ll talk about the ethics of it all, but yeah, I mean, so what does that begin to illuminate?
Dawn Carpenter: Well, what it shows is that there is an interdependence, because when you take variables and put them in an equation using multiplication, what you’re saying is that if one diminishes—let’s say, ultimately to zero—it also diminishes the other variables. So you really cannot buy your way out of a lifetime of chronic illness. I mean, there are some people on the planet who you can say might be able to attempt at doing it, but ultimately that sense of well-being is diminished. So, it’s not as if you could have that trade-off.
So, if you had all of the health in the world, but absolutely no resources—and resources, not just monetary, but other types of resources. You can think of wealth as not just what’s in your bank account, or your pockets, or your app. It’s, you know, think about the virtues and values, like, how valuable is patience, for example. So, let’s say you had perfect health, but you didn’t have access to human connection. Well, those who study longevity say that interaction with other human beings is fundamental to longevity, so that’s another type of wealth.
So that gives you a sense. Now you may ask, what about this technology variable? Well, technology in a truly liberal sense. So we understand, as scholars of the liberal arts, that technology means not just your iPhone or your computer, or the latest device. It’s also all of those things in life that enable us to have more agency. So, for instance, technology could be something like literacy or an education from that perspective. And so, being more knowledgeable helps us use our capacities more, so it’s a type of technology.
So the equation says, alright, there’s this dynamic of technology, but do we do it well? So, if technology, for instance, a literacy program, if it kind of gives you knowledge but nothing actionable, how effective is it? So let’s say, it’s neither effective nor ineffective. That gives us a—if we have anybody out there who enjoys equations—the beta, that little exponent in the equation, is a 1, it’s okay, it’s kind of a “meh” in my view. From a layman’s perspective, it’s a dud. But if you see above one, you’re like, “wow, okay, this is super effective.” So the trend line goes up. But if it is negative, let’s say, it’s a really bad app that sends you to the wrong doctor, or, you know, some other way to measure it, that’s really bad.
So, that’s what this technology variable does. It tells us which trajectory we’re going, and it helps to describe and helps to give us a sense of movement through what visually, in my report, expresses as the ultimate tool of this equation, which is that matrix, which I’m sure we’ll talk about more. But, the idea is that we live life not as a kind of stagnant or fluid place of financial well-being or health well-being. We’re always moving through some type of continuum. Most of us fall in that, what we might say is “forgotten middle,” where there are scaffolds in society that help the most marginalized, and there are those in society who would never need any assistance beyond their own capacities. But most of us kind of fall in this middle area, and we want to design institutions and structural supports in society that move us to more health well-being and financial well-being.
Seth Green: Build on that, Dawn, because, you know, you are an ethicist, and so one of the pieces that I thought was so interesting is that this is not purely an economic analysis, this is also using, for example, contributive justice theory. And so, can you talk about how institutions play an essential role, and how, in your view, contributive justice theory means that, you know, we really have ethical demands on these institutions in practice to take the equation more seriously?
Dawn Carpenter: Yes, I guess where I’ll start is, for those who are not familiar with this concept of contributive justice, or really what ethicists do: ethicists look for a way to understand the good. And so we have ethicists that work in different domains, as we all know. Legal ethicists, bioethicists. I’m a financial ethicist, so I want to know what the good looks like in the world of finance and economics.
We’re all kind of going at it in our own way, but ultimately, the telos—if you take the theological language, because my training was, again, in the liberal arts, but through the view of moral and social teaching based in a religious tradition—we’re looking for human flourishing. And so, you asked a very important question. It’s like, how does that become real?
So, in contributive justice theory, this is just a dimension of justice, or a way we think about justice. So think about like a loaf of bread, and you have slices of a loaf of bread. One aspect of justice is this idea of contribution. So, as human beings, we have this inherent dignity that I talked about in your first question, but then we also have to deal with the world. And so, the way we deal with the world is how we get to interact with it. So, contributive justice says we as human beings should have the right to be able to contribute to our own development. And to do that, you need to live in a safe place. So at night, you get the rest that you need, you get the food you need, the access to education, and so forth. So when those aren’t available to you, it’s an injustice.
And on the other side of that, it’s a duty to contribute. We need, like at the beginning where I said we’re all unrepeatable, my contribution to the world, if I Dawn’t give it, diminishes your ability, for instance, to have this conversation today, because you miss out on talking to me. So, your question really was very practical. What does that have to do with institutions? Think about the institutions in society that benefit from people having long lives. You have longer times to pay your insurance premiums, right? So you keep making the payment. You have longer times to have an investment horizon. So there are institutions in society that think that it’s a good thing that we live longer. So why shouldn’t, then, those institutions be promoting the conditions in society so that people have a chance of doing that? Because we’re in it together. And so, that’s the idea of contributive justice as a way to think about what is the good. The good is the ability for all of the actors to participate. Those of us who are regular, everyday people, and those of us who are leading institutions in our society, whether they be financial institutions, or healthcare institutions, or governmental institutions. If you had that idea in mind, that we should privilege the ability to have agency to make choices, that means you’re looking at it from a contributive justice lens.
Seth Green: Well, so, that all, I think, is clear in theory. As you know, these worlds operate in silos, you know, so you have health, you have finance, and on sometimes short time horizons. So even an insurance company that might have a ethical and even business case for investing in preventive care, they Dawn’t know if they’re gonna still have that person on their patient roles in 5 years, so the equations break down in a certain sense, and the theory breaks down. Can you talk a little bit about—and this report does so—how would you think about the most important changes, whether in policy, in employer practices, in industry collaboration, that would have the greatest impact on aligning healthspan and wealth span, and getting us closer to that theory of contributive justice?
Dawn Carpenter: Well, I think we need to decide what it is we are going to measure. And so, if you were to ask me what is the biggest impact we could make, or the thing we could do today that would enable this equation to be informative on society, I’d say let’s think about what we’re measuring.
So, for instance, if you are a large employer, how many large employers are measuring how much emergency savings their employees have? That could be very useful to know, in terms of managing an employee and human resources capital. And so, also measuring things like when an employee goes out for caregiving, do they come back? You know, there is a tremendous expense to employers to find new employees. So if they were just measuring the right things, then they could realize what investments could we make, or what partnerships could we make, for instance, with financial services companies that provide tools or employee benefits that help manage some of those risks.
So that’s on the employer side, but what about on the healthcare side? So that’s kind of in the financial domain. As an example of measurement in the health domain, could you imagine if we were measuring the costs of, or the investments in upstream preventative solutions with hospital readmissions, or hospital readmissions and medical debt? You know, you start to see the cumulative impacts of how these issues interact, because right now we’re looking at them in silos. We’re not looking at what does a change in a labor dynamic, how does it impact the ability to perhaps stave off some of the harms from that by pairing it up with financial institutions. So, what I’m talking about is figuring out ways where each domain understands the relative impact of the other, and so that they can start looking at scaffolds or programs that can be effective.
Seth Green: And one thing that I thought was so interesting about the report, Dawn, is that you go into innovative models in, for example, inclusive retirement design, financial caregiving supports, innovation, as you were just talking about, and healthcare anchor investments. Do you want to share maybe a couple of those innovative models, maybe starting with the inclusive retirement design?
Dawn Carpenter: Well, one of the programs that I am very excited about—it’s not at scale yet, but it’s being tried in Washington state—is Washington Cares. This is a program that provides a mechanism for saving for long-term care as a state benefit program, a social program. It will not come nearly close enough to what it would cost an average family to take care of long-term care obligations, because we know from research that the average family will spend about $470,000 a year taking care of healthcare and long-term care costs. You know, that’s measuring at age 65, and about 70% of us will need some type of long-term care in our lifetime. So what Washington State has Dawne is said, let us think strategically to say that we understand this is a problem, and we should be able to begin thinking about this earlier in life, before the house is on fire.
And so that’s one. But my favorite, I’ll go back, is right there in Chicago, which is a model that has been 10 years in the making on the west side of Chicago. We call it—it started by Dr. David Ansell at Rush Medical Center—but he recognized the longevity gap right in your own city, and he said, we need to do something about it, and we know that when communities are financially healthier, their populations have a clinical health profile that’s better. And so let’s invest in increasing the financial well-being of those communities, and they’re doing it by measuring something as simple as cardiovascular health. And we know that there’s tremendous stress when you live in distressed neighborhoods, and it brings forward chronic diseases that you might not expect later in life. Dr. Ansell shares with me that, you know, he’s prescribing blood pressure medicine to 20-year-olds. That’s insane. And so by investing upstream, and lessening the causes of stress, it can marketably change health outcomes. And so those are examples of innovative, forward-thinking work that really has to be Dawne, because in many ways, we’re facing, you know, a very serious health and longevity crisis in marginalized communities. So, the west side of Chicago was just one of those illustrations.
Seth Green: Tina asked, can you share any research or resources on the lack of housing, or unaffordable housing, and how that’s linked to longevity?
Dawn Carpenter: Oh, well, that’s interesting. Housing is an issue that is faced all throughout the lifespan, and so, when I sit in the Center for the Future of Aging at the Milken Institute, and we see aging as the entire life course. So, we see an affordability crisis for younger people. And we know that the home is one of the principal wealth-building assets that a family has. And so, when a younger generation doesn’t have access to the primary builder of wealth, it then compounds in later life, because you have less financial resources to choose from when you need a different type of housing later in life. And so we’re starting to see multi-generational living, for not necessarily those good, you know, family closeness reasons, it’s just out of economic necessity. So, I think it was Tina who asked that question. I think that is probably the question of the conversation. Because long-term care housing on the latter part of life is the most critical and urgent issue that we have.
Seth Green: Dawn, when you think about the ethics, and you think about some of the very, high-cost pieces of the equation—so, you know, you mentioned long-term care might be $470,000 in a year—how do you think ethically about the distribution? Meaning, you know, society has a certain level of resources possible; you have many demands, including young people who have developmental needs and, you know, there may be ways in which missing investments there come back to be haunting long-term, in the sense of health and other outcomes. And so, I’m curious how you think about inevitable trade-offs in the system, as well as obviously doing more, and how the ethical framework allows you to think about those trade-offs.
Dawn Carpenter: Yeah. So, I mean, there are different ethical approaches. It’s sometimes thought, you know, we should be putting resources that give the broadest opportunity for positive impact to the largest number of people.
Seth Green: Like, a utilitarian approach, or…
Dawn Carpenter: Very much so, yeah. And what contributive justice says is that is very important, but we shouldn’t lose the notion that everyone has the right and the duty to contribute. So, how would I answer that question? I would say, let’s look at the things that are preventative. The things that Dawn’t cost as much. So, having access to—excuse me—fresh and healthy foods. That is one of the key drivers in population health. Having access to preventative care, those are things that are a lot less expensive than the bleeding-edge medical technology that helps you in your last weeks of care. And so, you know, I would argue that we should be looking at holistic solutions that help on the health side, but also on the financial side. There are basic things that we can do so that young people begin to have a better start in life. You know, look at the cost of obtaining an education, and what burden that can put on many young people, and that those shocks at the beginning of life stay with you and amplify throughout the rest of your life, so I think that the best things we can do are on the front end.
Seth Green: A final question here is from Ben. He asks, can you suggest a sensible structure of how to hand off financial control to children when aging parents’ dementia increases to the point where their wealth is at risk of fraud and inability to make sensible decisions? Can you just talk about some of those family dynamics embedded in this?
Dawn Carpenter: Oh, that is a very good question, and I heard a financial talk show host years ago say, “older people never want to get financial advice from someone who has changed their—whose diaper you have changed.” And I think there’s still some of that mentality, but the truth of the matter is we all need to plan. And so we need to plan when we are well.
And so, I think the person who asked that question was asking what could you do when there’s maybe a fear of diminishment, or there is a diminishing trajectory on the horizon. I would say have those very difficult questions, very candidly, and financial power of attorney is an important tool, and just as you think of a healthcare power of attorney. So, making sure that both of those dimensions are in place, but you’re right, one of the most egregious and difficult things for me to imagine is that someone would exploit someone elderly financially. It is one of those crimes against humanity if you were to ask me, and so that is a very important question, particularly when we see that family finances are sometimes the first way we see signs of cognitive decline.
And so when you have trouble—we Dawn’t so much balance our checkbooks anymore, but keeping track of passwords and where you bought things and registered for things, you know, is super important, along with maybe just working with the older generation on how to access technology, because sometimes it’s just… you think you’re logging on and doing one thing, and you swear you’ve Dawne the right thing, but in actuality, you’re being scammed. And so protection is always key, so whoever you’re asking that question for, I’m sure you’re going to do a good job taking care of them.
Seth Green: Well, Dawn, we are out of time. This has been a fascinating conversation. Thank you for sharing the report. Thank you for the broader work that Milken does in healthy aging, and we look forward to seeing many of you back as we continue these conversations about longevity and how we navigate it. Have a great day, everyone.
Dawn Carpenter: Thank you for having me.
