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(upbeat music) (indistinct chatter) (bell chimes) - Good afternoon and welcome to the City Club of Cleveland, where we are devoted to conversations of consequence that help democracy thrive.

Today's Friday, September 9th.

And I'm Dan Moulthrop.

I'm chief executive here and a proud member.

And I'm really pleased to introduce our forum today.

It is part of both series, our Authors in Conversation series and our Health Innovation series.

If it seems to you like 50 is the new 30, or maybe 60 is the new 30, you might not be wrong.

Standard aging milestones once considered the norm in prior generations are now occurring later in life.

And perhaps it's because now there literally is more life to live.

With new scientific breakthroughs and cutting edge technology, the human lifespan is expected to continue to increase.

In the new book, "The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow," our guests today take a deep dive into the trends that have led to major medical breakthroughs.

Things like stem cell rejuvenation and gene editing.

The authors suggest that in the coming decades, living to 100 or even 120 will become more common.

This increased longevity is being called the next major societal disruptor.

Longer lifespans will change not only our own lives, but also our culture and dramatically shift views on aging.

So the big question is, are we ready?

Joining us to discuss whether or not we are ready and how to get ready is co-author Albert Ratner, the former CEO and chairman of Forest City Enterprises, a man who probably needs very little introduction here in this audience.

Also, Dr. Michael Roizen.

He's the chief wellness officer at the Cleveland Clinic.

Their co-author, Peter Linneman.

Dr. Peter Linneman is joining us virtually from his office.

And he's an economist and founding principal at Linneman Associates.

And moderating our conversation is Dr. Stephanie Brooks.

She's the dean of the College of Health at Cleveland State University and a newcomer to Cleveland.

Welcome Dr. Brooks.

Yes.

(all applauding) If you have questions for our panelists, you can text them to 330-541-5794.

The number again for our radio audience is 330-541-5794.

You can also tweet your questions @thecityclub and our team will work them into the second half of the program.

Members and friends of the City Club of Cleveland, please join me in welcoming our great panel today.

(audience applauding) - Okay, great.

So before we get started, I just wanna say congratulations on the book.

And I also wanna just say kudos on taking a topic that's so complex and technical and making it relatable and actually, quite frankly, kind of cool.

So with that- - [Dan] We have to say we have not been able to get books, but she got a book.

(laughs) (audience laughing) - Months ago.

So, but with that, I wanna just get the ball rolling.

And if you could just provide some history about the project, how you all got started on this, you began to collaborate, I think that's a good place for us to start telling the story.

- Well, I'll start out.

Michael and I have been friends for a long time.

And we played ping pong together.

And we've been doing this for seven or eight years.

Over time before we started to play ping pong, we would discuss what was happening in our lives, in our business lives.

- Let me really tell you what was happening.

He was trash talking me (audience laughing) and trying to get an advantage at the ping pong game.

(audience laughing) - I rest my case.

(audience laughing) So at any rate, so what happened, Michael started explaining to me all these tremendous things that were taking place in the research lab in every part of the body.

And I was saying to Michael that we as a company foresee the enterprises, we're all over the country in the inner cities.

And we were working in communities in the inner cities and finding out we had this very complex system.

But if you look at things in a simpler manner that you could really make change.

And there was an interconnection between what he was doing and the people in the lab we're doing and we were doing in inner the city.

So we started out to write this book.

We started out on the research end because the most important thing to remember is none of this happens if the research doesn't take place and come through.

And you'll learn how that's happening.

We got about halfway through the book when I said to Michael, it's obvious that if this research happens and we become healthier, that it has a lot of demographic opportunities.

So we then invited my dear friend Peter Linneman from the Wharton School, who's one of the world's really great economists, to help us figure out, what is the effect if the research works and we do our job?

So that's how we started out on our journey.

- That's what- - And what I'd throw in is that when they called me, I said, "I've written a book, I never wanna write another book in my life."

(audience laughing) And they convinced me that my life was going to be long enough that I could do this and still have a lot more life to live.

(audience laughing) - Peter, that's wonderful.

And so then one of the...

Since I've had the opportunity to read the book, there's a lot of passion in this book as well.

So what's your personal connection to this topic?

- Well, I'll take that, if you will.

So it actually started with a patient who I was trying to get to quit smoking.

And then through that process said, "How do I motivate him?"

And one of the ways was to say, what is his real age, his biologic age, as opposed to his calendar age?

When we started doing research in that to develop it in areas other than just cigarettes and tobacco... By the way, a pack of cigarettes makes you about eight years older.

Vaping makes you about 10 years older.

So get that, that's even worse for you.

But in fact, when we started to develop that, we found an amazing thing.

The science was much better known than we as general physicians were practicing it.

That is, in fact, two years ago, the American Heart Association caught up and said we should all have blood pressures under 125 and under 85.

That was known back in 1980, believe it or not.

I mean, when we started doing this work.

So we as physicians weren't, so I needed something to motivate patients.

And as I started doing the science, as my wife said, sometime in around 1993 was my last piece of red meat or processed red meat.

And believe it or not, there are 151 things we wrote about in 2000, 1999, actually.

And only one of them is even questionably reversed since then.

So there is a lot of data that you can do a whole group of things.

And people say, what do you do personally?

So my personal connection is I do 149 of them.

I don't get enough sleep and I have too much stress, but other than that, I do everything.

(Stephanie laughing) But as Albert and I started talking, we realized there are 14 areas of exponential growth in aging mechanisms, that is looking at the mechanism of why we get old and seeing if we can modify it.

And I'll get into it maybe a little later, but basically it says you all, every one of us, we predicted in 1998 when "Real Age" came out, and thank you for hosting me sometime after that to discuss it here, we said 60 was gonna be the new 40.

It is, if you look at the data in the nurses health study, the health professional study that's come to pass.

We now believe that with at least an 80% probability that 90 will be the new 40 within this 10-year period.

So, well, that... (audience applauding) (Stephanie laughing) No, that changes everything.

And it is a huge opportunity not only for financial planners to help people plan, but it is a huge opportunity for all of us to thrive.

And it actually is, we'll get into, I hope.

And Albert and Peter can talk about this more, it actually saves the country economically because, if you will, the CBO predicts that Medicare trust fund and the Social Security trust fund and every other trust fund will go belly up within the next decade.

That's not going to happen if we adopt longevity.

- Okay, Peter, do you have anything to add?

Wanna make sure you are included.

- Well, I don't even know if I ever mentioned this to Mike and Albert, but when they asked me, my father died at 49 and at that point I knew Albert, who I think, Albert, you were about 91 at the time.

(audience laughing) And I have a very dear friend, Lucille Ford, down in Ashland, who's 100 now.

And I've always been intrigued by why did my father die at 49?

What did he miss?

What did society miss that we got from Albert and people like Lucille?

And so that was kind of in the back of my mind when they reached out to me as a personal connection.

- Okay, great.

So there's a lot out here in terms of aging, research and wellness.

What makes "The Great Age Reboot" different?

Is it similar?

- So let me start up by saying what really makes us different is we took the research that was out there and was happening... We'd have a phone call every week and every week there were three more things.

And we realized that the change was taking place.

Well, you can have change, but the question is, what does it mean?

So what makes this book different is we have made a bunch of projections that nobody else has made.

So part of this is, I wanna take the stress away from everybody sitting here because what everybody wants to know is how long you are gonna live.

So let me tell you what we discovered, which really helped us figure out where we were going.

When we looked at the research, a number of people dying, what they were dying of, we came up with a following facts, that if you're 25 years old or younger today, that you had a life expectancy today, and the books of about 75- - [Michael] Nine.

- Maybe 79 years.

What we believe is if you are 25 or younger, you will live to 125 years.

- So- - Let me just take the other end.

If you're 75 years, you will live to 100.

So the range is, you can take whatever range you have and that's what the range is.

What I tried to do, Dick Pogue actually lobbied me to come up with a figure for people that were our age.

(audience laughing) And I wanna be clear about the fact he's much younger than I am.

(audience laughing) (Michael laughing) I wanna be clear.

But in Dick's and my case, what happens is we have a chance of living five more years until there are only five of us left.

So far, Dick, hi.

(audience laughing) (audience applauding) Now go ahead.

- Let me actually go.

And so I'm gonna go a little long on this answer- - Okay.

- But then none of the other...

I'll stay out of the other question.

So what's really different is the Human Genome Project started in 1992.

They expected to find 300,000 genes based on the amount of DNA in your nucleus.

They found both the Collins group at NIH and Vetner, privately, they found we have about 22,500.

They called the rest of that DNA junk DNA.

Eight years later it is known as epigenes.

What are epigenes?

They're switches that control whether your genes are on or not.

They're like rheostat.

So you have power over those, that's the next great thing.

So the point is, let me give you the example, if you walk fast or lift weights or do exercise, other physical activity that stresses a muscle, you change one of those epigenes that changes the gene in the muscle that turns on a small protein.

All genes are as protein factories, you get to turn them on or off.

You turn on a gene in the muscle by your action that creates a ricin.

A ricin goes to your brain and turn and releases brain-derived neurotrophic growth factor, which grows your hippocampus.

The hippocampus is the only organ in the body where size matters.

It is your memory center.

You're supposed to laugh at that.

(audience laughing) It is your memory center and it is if you grow your memory center, you decrease dementia.

So why does physical activity... We always said, "Well, physical activity must smooth, must help your circulation."

And that may be why your brain, it does that, but it does much more than that.

It actually turns on a gene.

And what we've learned is, for example, stress management.

Having six friends... Hello, Dick.

(audience laughing) Having six friends that you call once a week or once a month and are vulnerable to is the best stress management.

It changes 256 genes, from on to off or off to on.

So you have enormous power.

And what has happened lately in the research is not only knowing this and knowing a little more about it for what you can do in what we call self engineering, you are a genetic engineer better than anyone at MIT or Caltech ever was for you, but in addition, the medical research community is learning how to use that information to help change the ones that you don't already have the power to change.

And some of those are on the basic mechanism of aging.

So that the process, if you look at it in each of the 14 areas of research, at least two animal species have been rebooted back to the equivalent of 40 human years.

And what that does is it changes everything for society.

- [Albert] I'd like to- - Peter?

Oh, sorry.

- Well, when I was just....

It just struck me that if Albert gets booted back to 40, wow.

(laughs) (audience laughing) No, your comment about the self engineering, dean, one of the things you had asked the other day is what did each of us take away from all this effort?

The thing I took away that I didn't know as, I guess, a fairly educated member of society is just how much we control our own DNA.

We control about 80%, 80%.

And when you say we control 80% and science is working to help us control that 80% and to get to the 20% we don't control, how is this different than other breakthroughs like transistors or computers or electricity?

It gives us more of us and us is what created electricity.

Us is what created computers.

And when you start creating literally more time, more productive time to figure out and to interact, the growth prospects for individuals and society are just beyond imagination, really.

And they have huge changes on business.

The one we always joked about... And I'll give you a serious one.

The one we always joked about is if you could genetically engineer to control fat, WeightWatchers goes out of business and (indistinct) stock, I wanna own, right?

(audience laughing) I mean, there's that kind of... And you can go through all dimensions of society in that regard.

On a more serious level, one of the things we realized was that if you don't live very long, the mistakes you make don't last very long, but if you're gonna live a long time, the mistakes you make in life can haunt you a long time.

Careless driving, careless behaviors will last... Not saving, et cetera, will stay with you a long time.

The flip of that is the good that you do will reverberate much longer and you'll have much longer to implement that good.

- Yeah, there's so much to talk about and as I listen to both of you and your comments about rebooting and as a clinician, I'm thinking about, how do we motivate individuals to understand that they have the power to live longer, change their habits?

And so I'm wondering if you have any thoughts about that.

- Just before you go there, you had asked what made the book different?

I think the biggest thing that made the book different was the two of them sitting down and looking at the causes of death.

Looking at the research that was gonna take place and come to the conclusion that the death rate per 1000 was gonna go down from 92 or 93 to 22 or 23.

And that was a result of it.

That resulted in a set of numbers that said that in the three decades, the first of which we are living to 50, that we would have an increase in the population in the United States of 117.5 million more people.

We did that and what we discovered was the federal government at the same time that we said it was 117.5 and 19 said it was 55 million.

And in the last figure said we will only have 33 million more people in those three decades.

If we have only 33 million, that will be half of the decade percentage growth that we had during the Great Depression.

So one of the things that we learned that shocked us was that because you can only grow population by births over deaths and you can import people, but it doesn't make more people in the world.

So we look at that and the federal government's telling us our growth GDP is gonna grow in half from three to one and a half.

We can't allow that to happen.

So we then looked at the various ages and this is what we discovered.

Of the 117 and a half million people, there would be a 5% increase in people that were 40 and younger.

Over three decades, a 5% increase.

In 79 to 40, there would be a 25% increase.

And in 80 and over, there would be a 550%.

And what it means is if we take care of ourselves, everybody in this room is gonna be here.

So the difference is we're concerned about the practical effect of what happens to our people, our city and our country.

And Peter keeps saying, and he's right, this is not a choice, but the last comment I'll make on this is I hate to do everything.

I like to watch football, I like to do these things.

And Michael says to me, "You have to take 10,000 steps."

I don't like to walk.

(audience laughing) But here's what I discovered.

When I get on the floor and play with my grandkids, every minute I play is 100 steps.

(audience laughing) When I play ping pong with Michael for 20 minutes, it's 100 steps a minute.

So you don't have to walk.

Here's what you take away from this.

The beauty of this is the way you do this is you do what you love and what loves you back.

And that's what I learned from these two people.

(audience applauding) - I can't (indistinct) that.

(laughs) - If I might jump in, when we would tell people these numbers, and Michael would describe the science that is going to also help us get there, everybody we would talk to casually say, "We can't afford it.

How can we afford all these old people."

Right, all these old people, right?

And two really important insights.

One is Michael already made it.

What did you say, Michael?

90 is the new 40.

They're not old.

They're not old.

They're only old by a standard you have in your mind, but they'll be very different.

And the second is, human capital is all we've got.

You wanna produce as much of it and keep every ounce of it you can, as long as you can.

So we started looking at it and everybody's saying, can't afford it.

There are a bunch of studies saying, oh, medical costs are outta control.

Imagine that some of these genetic phenomena, whether they're medical in nature or self-engineered, took a hold.

You would see medical outlays fall by probably 7% of GDP.

7% of GDP is $1.5 trillion a year.

It's on the order of five to $6,000 per person that you would have additional to do something with.

It's a stunning number, not to mention you're healthier and happier and more productive.

And in fact, what we came to realize and the book lays out a lot of this, give you a simple, simple.

Michael said and Albert says that we find, let's say you're gonna live 25 to 30 years longer.

If you work 10 more years, because what else you gotta do during those time, right?

(audience laughing) You gotta pay for yourself, you gotta save.

If you work 10 more years, that's a 25 to 30% increase in your lifetime productivity.

Typical person works about 40 years.

And so suddenly if you work 10 more years, that's a 25 or more percent increase in every individual's lifetime productivity.

You say, "Well, I don't go to work work.

I don't get paid to work."

Yes, but you get paid to interface with society, with children, with grandchildren, with all kinds of things.

And we came to believe not only can we afford it, as Albert was implying, we can't afford not to have this kind of reboot brought about by self-engineering and by scientific engineering.

- [Stephanie] Yeah, so, go ahead.

- So let me go and just add one quick sentence.

So what is different in the book is that we go through, not only the science of what is likely to happen, but we go through the economics and political, and (clears throat) excuse me, that's where Albert and Peter are co-authors, if you will.

There's a huge amount of important information in policy, et cetera, that has to change.

- But the other- - Yeah, this is gonna be our last question before- - The other, this is important, half of the book... (audience laughing) (Stephanie laughs) Half of the book, one half of the book tells you what you have to do 'cause that's what it's all about.

It's not about us, it's about you.

That's one half.

Go ahead.

- And I just want you all before we go to the next segment of the program to talk a little bit more about what the implications are for education, for family, for healthcare providers.

Big questions, but really important to this topic.

- I'm gonna take just the first one.

Obviously, if you're gonna work 20 more years, if you're gonna live 30 years, you're not gonna wanna retire at 65 and do nothing till 115.

So we're gonna need our educational systems to change, provost, so that... (Stephanie laughs) In fact, Peter always says, since he's at Wharton, going to Wharton isn't any fun, or going to college isn't any fun.

I'm just riving him a little bit.

But in fact, going to Cleveland State is fun.

So the point is whether we think about a movie script of us going back and doing four more years at college, or whether in fact we change the way education is, there's going to be, have to be, there will be fewer kids.

So colleges won't have the young people on campus as much, but we're gonna have more older people getting reeducated and the system will need to change to do that.

And so they're huge changes in that.

- And those could be anything from traditional classes to YouTube clips, to books, to everything in between.

My only comment was, I don't think most people say, "Oh boy, I hope I get six more years of college," right?

And the challenge for the educational institutions is, how do we educate without, quote, "You have to get six more years of college."

And that's gonna be a fun challenge.

And the people who figure that out are gonna do really well.

And that's part of the joy of all this.

- And perhaps that's getting time for questions.

One of the questions will be asked is, what does this do about income inequality?

Because it makes an enormous difference in what happens.

It's really a great equalizer.

- And you asked about what it does for family.

I'm gonna use family in a broader sense.

- [Stephanie] Yes.

- Not literal family blood, but a broader sense.

Whenever somebody said to me, as I would talk to 'em about this, "Well, we can't afford the people to live," I would always say, "Well, you wanna start with your grandfather?

Do you wanna start with your grandmother?

We'll get rid of your grandmother, right?

She's a burden, right?"

And everybody said, "Well, I didn't mean grandma."

(audience laughing) - [Stephanie] Everyone but... (laughs) - Anybody but, and what it will do for families is children will get to know their great-grandparents.

They'll benefit from all that, whether it is blood great-grandparents or other modern family kind of.

And as Michael says, that is scientifically shown to improve health in and of itself.

And so what it does for society in that regard is quite wonderful.

- Thank you, Peter.

- You're with the City Club of Cleveland and on our special field trip to the Fountain of Youth.

Thank you for being along for this journey.

(audience laughing) We're about to begin the audience Q and A. I'm Dan Moulthrop, chief executive here.

Here with us on the panel is Albert Ratner, former CEO and chairman of Forest City Enterprises and co-author of this amazing book, "The Great Age Reboot," which we're discussing.

Also with us is co-authors Dr. Michael Roizen, the chief wellness officer at the Cleveland Clinic, and Peter Linneman who's joining us remotely.

He's an economist and founding principal at Linneman Associates.

Our moderator today is Dr. Stephanie Brooks, dean of the College of Health at Cleveland State University.

We do welcome questions from everyone, City Club members, guests and students, any students with us, as well as those of you joining us via our livestream at cityclub.org or radio broadcast on 89.7, WKSU, Ideastream Public Media.

If you'd like to tweet a question, please tweet it @thecityclub or you can text it to 330-541-5794.

The number again is 330-541-5794, and our team will work it into the program.

May we have our first question, please?

- [Peter] Thank you, Stephanie.

Welcome to Cleveland.

- Thank you.

- Al, Michael, Peter.

I'm Peter Whitehouse from the Intergenerational School.

Seated to the stable includes my 93-year old mother-in-law.

I wanna... (audience applauding) And my wife, but you can hold the applause (indistinct).

(audience laughing) But actually that illustrates I think what you guys have illustrated so well, being positive and a sense of humor is so important to longevity.

But I wanna add a little bit of a downer that builds among what we're just talking about.

Here we have three public intergenerational schools transforming education.

But Michael, to you as a physician, can I mention the word public health?

And the zip code that you live in makes a big difference in how long you live.

So how do you fit that into your framework?

And Al and Peter as economists, there's another eco word called ecology floating around.

And there's a lot going on in our environment that is gonna be really challenging to how long we live.

So apologies if that's a downer, but I think we have to take these issues seriously if we're gonna develop a comprehensive program around why we wanna live longer.

Thank you.

- You go.

- So let me take a whack at public health because in the work that we did in the inner cities, health became a big issue.

If the people weren't healthy, they couldn't perform.

We're blessed in Cleveland with one of the great medical systems in the world, in each of the hospitals, for example, and the school.

The fact that we have a school of health begins to tell you where our focus is going.

But it turns out that, I'll pick one, Metro General has put together a hope institute, which I believe actually is the best I've seen in the country in dealing with poverty.

It takes individuals, it finds out what's wrong with them, it assigns them to agencies to help them.

It's not hard to deal with these problems if we just ask the question, what's the problem and what do we do?

And forget about whether it's abortion or this or that.

Look at what the problem is.

We have the best institutions, we have sick people.

We know how to do it, we just have to get together to do it.

That would be my answer.

A year from now, I would bet this is gonna be a very different city than it is today because of everything that's happening.

- And let me take one of the issues that Peter covers.

And, Peter, maybe you'll get into it, but if you save... That's Peter Linneman rather than Peter Whitehouse.

What Peter taught me is if you save 3% of a $15 per hour income starting at age 22 and go to age 65 and it accumulates at 4% gain compound interest rate, you end up with around $250,000 at age 65.

But if you don't touch it till 95, it's 1.4 million in today's dollars.

And if you have a company like the Cleveland Clinic that matches that, it's 2.8 million in today's dollars.

And if you mandate that as Australia and Denmark and Singapore have done, you do a lot to deal to get away from wealth inequality.

Now believe it or not, while we were looking at the galleys to this book, all of a sudden it turned out the House of Representatives of the United States has passed that, and it's now sitting on the Senate.

We hear that the Senate is gonna act on it before the end of this, whatever you call, the session.

And so there may be the chance that our policy makers do...

It was bipartisan at the house.

So it may be the chance that our policy makers do this so that we get away from wealth inequality.

Now, that doesn't say what we need to do in the meantime is exactly what you put on, is how do we get rid of some of the health inequality?

That's a pretty tough problem if we can't motivate people to do things, if you will, in self engineering, but if we can motivate them, it becomes a much easier problem.

So the message is that things like the City Club, thank you, Dan, for doing this, is a really important venue to get this out to broad audiences.

- And let me, if I might, react to the other downer, the environmental and other challenges like that.

We know economically that Malthus was wrong, and we know that Eolake was wrong.

Empirically we know this.

And the reason they're wrong is because of human ingenuity.

And the phenomena here is the more longevity we create and the more productive longevity, that's how environmental problems get solved.

And there's a very interesting book by Marian Tupy recently that shows the solution to problems is people, not fewer people.

And it always has been.

And when you look at the big picture.

And so I want all this longevity to solve these issues.

I don't know how they're gonna solve it, right?

That person may not even be outta grade school yet.

But we want that longevity.

- Let me just add one more thing on that.

The genetic engineering revolution isn't just changing human health but biomanufacturing is occurring.

And how many of you here like beer?

How many?

Okay, there are few of you at least.

(Stephanie laughing) So beer comes in a bioreactor because they've got yeast that produces the beer.

Well, we can now genetic engineer the yeast to produce anything.

You want corn, the yeast can do it.

And hopefully you'll have this as a future thing here, bioengineering in...

If you put bioengineers in the city the size of Los Angeles, you'd have double the amount of food produced in the entire world now.

This is already solvable if you want and it will be solved, just as, if you will, longevity.

Again because of the genetic revolution, we can engineer, we can change...

The yeast stone object so far.

We can change what the yeast produced in proteins and in fact bio-engineer enough food for the world in a city half the size of LA.

- Okay.

- [Speaker] (faintly speaks) The City Club.

(audience laughing) - (laughs) (indistinct) The City Club.

(laughs) (speaker faintly speaks) - Dr. Roizen, you had mentioned about the House of Representatives, and I assume you're talking about when your comparison to the other countries was a mandated savings plan of some kind.

(clears throat) Every time that Congress has attempted to change Social Security or Medicare based on today.

Forget your book, about changing Social Security to 70 or 75 or using your book possibly 80 or if you wanna go back when they started Social Security, if you took the total morbidity rate, you were supposed to be dead by the time you collected because it was 62 and they made it 65.

If you eliminate a child morbidity, I think it was just like 69 or something.

So you're only supposed to live around four or five years afterwards.

So we've had 65 for Social Security and Medicare for 80, 90 years.

Do we have the political...

Assuming everything you say is true and believe me, I do believe it.

I own stock, I'm an investor in some of that stuff and love this stuff, don't get me wrong.

Do we have the political will to change something like Social Security, (speaker faintly speaks) something like Medicare, adding another 10, 15 years to it?

(speaker faintly speaks) - One, the House of Representatives bill was an add-on.

It didn't change Social Security or Medicare.

That's why it got huge bipartisan support.

- [Speaker] That was my assumption that it was an add-on.

- Yeah, but lemme go.

And Albert and then Peter are much better at this than I would be.

- So my lifetime, at least for the last 50 years, has been going to cities and states and changing things.

So I've spent my lifetime working with legislators, working with mayors, working with governors.

And this is what I find.

What I find is we expect them to change things.

And if you look at the way the country works, you can see how that dysfunctions when the communities themselves don't understand that this change can only take place in the communities.

And I will give you an example of this.

We started a company testing kids and we're in Appalachia, and we're now in 33 different counties.

The Appalachian counties got together and said, "We don't like our life.

It's not right and we wanna change it."

And they came to our company and said, "Can you change it?"

And we said, "No, we can't change it, but if you wanna change it, we can help you change it."

And we're now working with them.

We had a summer camp this year where we had 55 kids going, that graduated from high school that did not have a job, didn't want a job, they're all now being trained.

So this is the message, don't look to them.

Kirk Heuring's here, the best legislator I ever met.

But what he always says to me is, how can we do this?

The knowledge is in the communities, it's not in Washington.

If Cleveland got together, if Cleveland got together and said this is what we wanna do, and you sat down with the governor... For example, I've talked to the governor about longevity, and he said, "I'll put money in longevity, but what does Cleveland wanna do?"

So if there's anything you learn from this, don't depend on people outside this room to bail us out.

They can't.

They don't know how.

It's not why they're here.

Our job is to tell them how to solve problems.

So I'm really optimistic as this takes into place, when I see what's happening in Appalachia, when I see what's happening with things that the university is doing, the hospitals are doing.

So if you leave here with any idea, forget them, honestly.

Come up with an idea and go to them and let's get it done.

We've spent our whole life waiting for somebody to help us.

The takeaway of what we're talking about, this is all about us.

It's not about the legislature, it's not about all these other (indistinct).

It's about us.

If we want a better world, we can live longer to help people for a longer period of time.

And this isn't just philosophy, this is the way I've seen it worked in the worst parts of the country, in the worst housing parts of the country where people have lifted themselves up.

People don't wanna hand out, they wanna hand up.

So I'm really optimistic that we're gonna be forced to change, 'cause when you take a look at what's happening to employment, you can't get employees, well, what are you gonna do about it?

You're gonna start closing businesses down.

So I'm really optimistic and we will change those things.

And this is the group that can change 'em.

- Peter, do you wanna add anything before we take the next question?

(audience applauding) - I learned you don't follow Albert after he gets ovation.

(audience laughing) - Wanna be inclusive.

(laughs) - [Peter] Next question.

(audience laughing) - I'm still getting my mind around Albert, you transporting back to 40, but I think that'd be a good thing.

And as somebody who got a call from Albert before 8:00 in the morning, I think he's already there.

(audience laughing) But thank you for all you do, Albert, in our community.

I'm Chris Ronna and I just wanted to ask a question about the factors of isolation in our society and how much... Peter talked a little bit about the 80% factors within us, but what we just saw in terms of the two-year downturn in longevity, every attribute seemed to focus on the issues of mental health, addiction.

Not even just pandemic issues but just obviously related.

But people living now in a more remote environment, and suicide's up, mental health challenges.

So on a public policy level, pouring our money obviously into education has gotta be a first step.

But on the issues of meeting people where they're at in their communities and helping pull together a more social society, more active society, I mean, I'm convinced he's still going where he is going because he is purposeful, right?

How can we address from a public policy standpoint the issues that Metro, your colleagues, are telling us isolation is their biggest public health threat.

- So let me go and tell you what's been done in Britain and is now started in the United States, and it's actually a project of at least, I know of the three health systems, Metro, UH and Cleveland Clinic are all participating in it.

I don't know, there may be others as well.

I don't mean... Those are the only ones I know.

So the greatest agers, Chris, you're right, are stress and if you will, not having a posse and not having a purpose.

So in the Whitehall Studies way back in Great Britain, and I'm sorry, I'm a scientific nerd, in the Whitehall Studies way back in the '50s outta Great Britain, in the studies out of Alameda County, Berkman studies in the '60s in the United States and in recurrent studies now, isolation, not having six friends that you talk to once a month and not having a purpose are the greatest agers, are the greatest things we can do.

So the three health systems have started something that actually started in Great Britain called social prescribing.

So you have someone who is isolated, you hook them up with someone else.

So it's part of, if you will, a buddy system, but you get the buddy system to link them with five other people or five other things and to help them through volunteer eating choices, et cetera.

So all of that.

So Cleveland I think is the first place in the United States that has adopted this social prescribing and it is now going on.

(audience applauding) And I can tell you I got called from Great Britain.

I sent a patient, the first patient I sent, to social prescribing last Friday.

I see patients on Fridays and I sent... Other than today, obviously.

And I sent a patient there.

I got a call from Great Britain saying this is the ideal person to send to social prescribing.

So social prescribing is something that started in Great Britain and I think we're the second country and I think we're the first city in it.

So our health system is... (audience applauding) As Albert said, Metro actually has pointed this out as a major problem in our communities and we are working on it.

- And I would just- - The thing I might add in a different, the downturn in life expectancy is a great headline.

When you look at how it's actually technically calculated, it's not a very helpful statistic, never in and of itself.

And we don't have time to go into why, but part of the downturn clearly was COVID.

And if you think about it, the message of the book is science can be there to really help you a lot and is coming fast.

Imagine if mRNA had not been started, what, about 20 years ago, Mike?

Is that about right?

- [Michael] Yep.

- And was there.

How much more would... How many more deaths, how much more suffering?

And in a way it is a demonstration of this.

The other thing is that you think about problems that come from diabetes, et cetera, et cetera, even problems from cigarette smoking, et cetera.

Some of the genetic things that could happen either could interject themselves into that process or reverse that process.

And in so doing, we make huge changes that people have a hard time making for themselves.

And that's part of what good medicine I think is about, is to assist somebody make better decisions even when they're hard for them.

And mobilizing a hurt joint, for example, is to help what you can't do yourself.

(speaker faintly speaks) - I'm going to take one add-on to that.

So the mRNA vaccines got developed and all of you have been exposed or most of you have been exposed at least to the messaging about them.

But it also is used in another way in aging mechanisms.

So we developed senolytic, we developed senile cells.

We actually developed them when we're born.

Every year we get more and more, but we can't find them in people under the age of 30 'cause your body gets rid of them.

But they put out a specific protein.

So there's now a project, it has done it in two species, mice and another one, where you get a vaccine that knocks out your old cells.

Why is that important?

'Cause your old cells, one, don't function well and, two, they're like a piece of rotten fruit, they make all the cells around them old.

So there's now an mRNA vaccine in testing that knocks out your senolytic cells.

That happens, you're gonna get a lot younger from that way.

That again is a benefit of what's happened because of COVID-19.

So life expectancy, we can do the calculation.

It assumes that we're all going to die, that calculation, from COVID-19 at the same rates we did last year.

We're not going to.

- Correct.

- And hopefully the progress that that made is going to ricochet into aging mechanism research.

- Thank you, and I really appreciate the panel today and I actually had some conversations with Albert in the preceding months who gave me some preview of some of the work that you guys are presenting today.

So it's been very, very enlightening.

I will share with you up, just to be honest, my question was COVID related and life expectancy, and you've already dealt with that.

So let me pivot to an education question.

My youngest son is in Cleveland.

He is a high school chemistry teacher.

And what I'm wondering is, most of the time in the high school years and maybe in the first couple years of college, you first get aggressively exposed to the health sciences.

So my question is how do we take this work and start injecting it into our 13, 14, 15, and 60-year old use their learning processes, the curriculum at the high school level.

'Cause it seems to me that that's a generational opportunity that if we can take advantage of it, and by the way, if we can take advantage of it here in Northeast Ohio, maybe we create a model that could be replicated across the country or the world, but to me that I think is a great opportunity.

- I have an answer for that.

I have an answer for that.

"The Great Age Reboot," mandatory reading for everybody.

(audience laughing) (audience applauding) - So let me just make a comment about the educational system.

We've been trying for 50 years to figure out the educational system has become very complicated.

One of the things that we know, for example, if you take poverty.

According to this census, that if you take poverty, if you do three things, if you graduate from high school, if you have a job or go on to college and you don't have a child until you're 22 years of age, there's a 2% chance you'll end up in poverty.

If you do all of these things wrong, there's an 88% chance you'll end up in poverty.

If you look at the school agenda and you think of those three things and you ask yourself, how much are we teaching about those three things?

Well, it's the same thing with longevity.

And what we're doing in Appalachia is we're putting Appalachia into the high school programs.

This is a part of what you do.

So we have to rethink of the world as like, and we have to say, what are the life skills that people need?

We have a telephone that can teach me everything I learned in 16 years of education.

So I think what it is, if we're willing to say it doesn't work, we can figure out what to do.

If we accept the way it is, we're sunk.

- So the Great Lake Science Center people are here and in fact one of the things is they make learning science fun.

And so if you go there, you'll see what we should be doing in every high school class.

- [Dan] And in fact- - So I think (faintly speaks).

(audience applauding) - I'm informed on Twitter that they're actually already planning the exhibit about "The Great Age Reboot."

(audience laughing) So I'm Dan Moulthrop and today at the City Club we've been seriously enjoying a forum that is part of our Authors in Conversation series.

It was moderated by Dean Stephanie Brooks of Cleveland State University, and featuring Albert Ratner, Dr. Michael Roizen and Dr. Peter Linneman, co-authors, all of "The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow."

(audience applauding) I'm Dan Moulthrop, our forum is adjourned.

Have a wonderful weekend.

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