Will Joe Biden die in office? Actuaries review the survival prospects of the likely presidential nominees

When Joe Biden this week announced plans to seek re-election in 2024, he immediately triggered speculation as to whether he could serve a full second term.

Most political pundits agree that, at 80, age is one of Biden’s biggest political vulnerabilities. If re-elected, he would be 82 at the start of his next term and 86 at the end of it. Donald Trump, currently in pole position to win the Republican nomination, is not far behind: he would begin a second stint aged 78.

For US voters, a battle between the oldest candidates in history throws up all sorts of special considerations, from whether either has the stamina for another four years as commander-in-chief to what happens if their mental faculties fade.

Yet perhaps the biggest problem of all is the not insignificant chance of them dying in office. If Biden were to win, Kamala Harris, his unpopular vice-president, would be first in the line of succession, while Trump has yet to pick his running mate.

Nikki Haley, another Republican candidate, told Fox News this week: “I think that we can all be very clear and say with a matter of fact that if you vote for Joe Biden you really are counting on a President Harris, because the idea that he would make it until 86 years old is not something that I think is likely.”

Any predictions are by their nature uncertain, yet a longevity modelling firm has forecasted that both candidates are likely to live well beyond the end of the next presidency in 2029. According to Club Vita, actuarial data suggests both men could have more than another decade ahead of them.

The company, which offers analytical services to insurers, said its US model suggested Biden has a life expectancy of another 11 years, taking him to 91. Trump has 14 more years to look forward to, per the model, meaning he would die at 90.

The model’s inputs include affluence, marital status, and employment. These key demographics for both Biden and Trump put them in the same favourable categories for the main factors, including addresses in the top category for life expectancy: the analysts used Trump’s Palm Beach address and Biden’s Delaware home.

Erik Pickett, a New Jersey-based actuary for Club Vita, said a wide range of factors could prove its model wrong, from whether the candidates “are in significantly different health to the average of someone with the same characteristics” to the fact that presidents have “access to higher quality medical treatments” than the typical American.

A relatively high body mass index would probably trim a person’s life expectancy too, Pickett said. According to the final medical assessment conducted during Trump’s presidency in 2019, his BMI of 30.4 meant he was obese per the US government’s official yardstick.

The Club Vita model puts the candidates some way above the average. According to a life expectancy calculator provided by the US government’s Social Security Administration, the average American male born on the same day as Biden can expect to live for another 8.5 years. For Trump, that number rises to 10.7.

“I would say that both Biden and Trump are likely to have substantially higher life expectancy than the average, for their age, because they have high socio-economic status, access to the best healthcare in the US, and they do not smoke,” said Dana Glei, a senior research investigator at Georgetown University, who has authored papers on mortality.

The fact that neither smokes nor drinks alcohol is in both candidates’ favour, actuaries said, given these are proven risk factors in a multitude of illnesses from heart disease to cancer and some forms of dementia. “There is also some evidence to show that people who stay in work longer generally live longer lives, so this may also play a part,” Pickett said.

“The president will have access to the highest-quality medical care and will remain physically, mentally and socially active whilst in the job — all factors that improve lifespan,” Pickett added. But this will be “at least partially countered by a high-stress environment and possibly a greater exposure to external risk factors”, he said.

Al Klein, principal and consulting actuary at Illinois-based healthcare specialist Milliman, said the “biggest issues 1682845989 are health-related”, citing cardiovascular health, current or recent cancer and diseases affecting vital organs.

Age has loomed large in previous White House elections, most recently in 1984, when Ronald Reagan, then 73, was campaigning for a second term and managed to turn the issue to his advantage during a presidential debate.

“I am not going to exploit, for political purposes, my opponent’s youth and inexperience,” he retorted when a moderator raised the thorny question. He went on to defeat Democrat Walter Mondale in a landslide and held the record as the oldest US president until Biden’s victory in 2020.

Speaking to reporters at the White House this week, Biden said it would be up to voters “to judge whether or not I have it or don’t have it”, adding: “I respect them taking a hard look at it. I’d take a hard look at it as well. I took a hard look at it before I decided to run. And I feel good. I feel excited.”

Biden’s political aides in particular have gone to great lengths to portray their boss as unusually active for a man of his age. He is known to break into a vigorous jog when approaching groups of reporters and reportedly begins most mornings with a workout.

Longevity experts say exercise is crucial. Georgetown’s Glei said the best predictors of mortality for men aged 80 are physical function, whether the person is taking more than five medications, a diagnosis of heart disease, the number of hospital stays in the past year, and the frequency of exercise.

Important questions for older people include “can you walk a mile, can you walk several blocks, can you jog a short distance . . . do you have difficulty climbing stairs?” she said.

Trump is a self-professed lover of American fast food and is reportedly a proponent of the battery theory, which holds the body has a finite amount energy that exercise can only deplete. He has chided men of his age for engaging in strenuous physical activity and argues that his campaign schedule — which at its peak has him criss-crossing the US to appear at a series of hours-long rallies — shows he has more stamina than the norm.

“The age difference is quite meaningful actually,” said Samuel Preston, a professor of sociology at University of Pennsylvania. Trump being three-and-a-half years younger equates to a 30 per cent lower annual probability of death, he said. Though that advantage would be offset somewhat by Trump’s higher BMI, he added.

Meanwhile, attempting to present Biden as an octogenarian exercise junkie is not without its risks. Last year, a video clip of him falling off his bike went viral and was subsequently brought up by voters in a focus group, suggesting they are highly attuned to his age.

For some voters, it is not Biden’s physical fitness but rather his mental acuity that is the biggest source of concern. In his twilight years, a life-long stutter has become more noticeable in his tendency to mangle sentences.

“It’s not just surviving, dementia is a problem at older ages,” Glei said. For any older president, she added, people should “pay attention and look for signs of cognitive impairment”.

In an interview earlier this month, Trump questioned Biden’s ability to pursue a second term “from a physical or a mental standpoint”, but denied it was an “age thing”.

He added: “I think they do the age thing because I’m four or five years behind, they say, ‘this is a way of getting Trump’.”

Biden’s aides have batted back questions over his mental fitness. “We’ve heard these types of attacks or remarks before,” White House press secretary Karine Jean-Pierre said earlier this year. “If you go back to 2020, they said that the president couldn’t do it . . . and he beat them.”