Health-Cost Averaging
In 2017 I swapped the safety of a PAYE pay check for the roller-coaster of self-employment. Overnight my financial situation changed. No automatic pension contributions, no tax taken at source, or monthly student loan repayments—just whatever landed in my account to juggle invoices, bills, and, by 2018, a newborn daughter who could vaporise any monthly surplus created by my wife and I with one unexpected growth spurt.
That pressure of the first few years self-employed forced a crash-course in long-term thinking. I dived into learning the alphabet of ISAs and SIPPs, began to research what an index fund is, and asked Google multiple times., “How much does a self-employed individual need to retire?”
Around our second house move in 2020—trading a two-bed home for something more practical to grow into, and this time with Lego-proof floors—I found Morgan Housel’s The Psychology of Money. His story-first style felt like financial first aid; I binged (and still continue to this day…) every blog, podcast, and footnote he had written to that point.
Fast-forward a few years around 2023, and Peter Attia’s Outlive became my latest read for the month and the puzzle clicked: everything Housel wrote about money maps onto the concept of health-span near perfectly. Pound-cost averaging has a biological twin—call it health-cost averaging. The steady pension and ISA contributions we make that secure our family’s future have a mirror image in the steady deposits of sweat, sleep, and quality food that will secure our future bodies. The earlier and more automatic those deposits begin, the cheaper tomorrow gets.
Skip a decade ahead and the maths - whether financial or physical - take a turn. Start investing £200 a month at 25 and let even modest compounding do its thing, you arrive at roughly £300 k by age 65. Wait until 35 and you’re likely closer to £160 k. Ten years lost, and half the resulting outcome gone. We all nod along. Yet most of us treat our bodies like we plan on winning some type of lottery at 60, banking on late-life fitness windfall that may never come.
Welcome to the concept of health-cost averaging: small, automatic deposits - workouts, eight-hour sleep nights, real whole food - paid in today, compounding into mobility, independence, and a hopefully lower medical requirement tomorrow. The sooner the standing order or automated investments start, the cheaper the future becomes.
Your Balance Sheet of Biology
Think of health as an asset that pays back dividends you actually feel - increased energy on a Wednesday afternoon during the midweek slump, knees that don’t complain going up and down the stairs, a resting heart rate that whispers rather than shouts. The line items:
Cardiorespiratory Fitness (VO₂ max): Peaks in your late 20’s, then declines around 1% a year. Above average at the 60? About 32mL/kg/min.
Muscle Mass and Strength: Enter the realm of sarcopenia: 3-8% muscle loss each decade after 30; strength slips 10-15% each decade once you cross 50.
Balance and Stability: Falls often aren’t clumsy accidents; they’re predictable balance-sheet failures. Balance scores drop ~20% each decade after 40.
Resting Heart Rate & Blood Pressure: Every extra 10 beats per minute equates to ~20% higher mortality. A 60 bpm ceiling target at 60 buys you margin.
Metabolic Markers: Blood glucose, LDL, inflammation - sound boring, until they’re not…
Reverse-Engineering 60
Retirement planners calculate how much you should hide away today to hit a number decades out. We can do the same for health. Aim to be “above average” at 60 and back-date the requirements to today.
* (Decline rates: VO₂ max ≈ 1 %/yr; strength ≈ 1 %/yr after 50; balance ≈ 20 %/decade; RHR +3 bpm/decade.)
Notice the numbers aren’t heroic. They’re just ahead of average—the same way a boring index fund such as the Vanguard S&P 500 quietly beats most individual stock-pickers over time.
The High Price of Procrastination
Present-bias - the itch for comfort in the now over a greater payoff later - makes the gym easy to skip and Netflix easy to binge. But biology still runs the books, and there’s no free lunch.
VO₂ max Reality Check: Sit at 30 mL/kg/min at 35 and ride that −1 % slope; you arrive at ~22 mL/kg/min by 60—borderline for climbing a flight of stairs without gasping.
Strength Slide: Ignore resistance training until 50 and you hit the frailty on-ramp just when your kids ask you to lift the grand-kids off the ground.
Balance Sheet Risk: A single fall after 60 can wipe out more wealth—and freedom—than any recession or financial collapse could.
It’s the same compounding curve, just inverted. Delay costs more than it looks.
Monthly Health Contributions
In its simplest form, what can we start contributing today to reap the compound rewards decades into the future?
The return isn’t six-pack abs; it’s optionality. The ability to chase your kids around a garden, hike hills at 70, change a tire independently without calling roadside assistance. Freedom, in other words.
Behavioural Hacks to Keep the Direct Debit Running
Make it Automatic: Schedule workouts like rent or mortgage payments. If calendar invites rule your career—which for most of us they do—let them rule your daily activity too.
Shrink the Stakes: “I’ll just do ten minutes” is financial-speak for the £50 starter investment. Momentum > perfection.
Create Social Escrow: Commit in public. A friend, or coach, waiting for you at 6 a.m. is the late-fee you’d rather avoid.
Gamify Streaks, Not Outcome: Track deposits (sessions, meals cooked) instead of share-price (weight, VO₂ number). You can’t bully a graph into moving faster, but you can show up again tomorrow.
Closing the Books
No rational investor would wait until 60 to start saving, hoping compound interest takes pity on them arriving late to the party. Yet we delay the same principle when the currency is heartbeats rather than banknotes. Small, boring deposits—paid consistently—compound into something money can’t buy: health independence.
So audit your personal balance sheet. Pick one metric that’s below par—maybe your resting heart rate, maybe your single-leg balance. Set up a health-cost averaging plan for it, measured not in heroics but in direct debits of effort. Thirty years from now, when your age-peers are paying hefty interest on early-life neglect, you’ll be living off dividends you barely notice you’re still collecting.
The best time to start was when you opened your pension. The second-best time is before dinner tonight.
AK.