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For decades, legacy planning has focused on transferring wealth efficiently across generations. Advisors help families structure trusts, optimize taxes, manage charitable giving and prepare heirs for stewardship. All of that matters. However, an increasingly material risk often sits outside the planning conversation: whether future generations will be healthy enough to fully benefit from the assets they inherit.
Recent research published in JAMA found broad declines in the health of U.S. children across multiple measures, including chronic disease, mental health, obesity, sleep quality, and mortality. Researchers reviewed 170 indicators and identified a troubling downward trend across much of pediatric health.
For advisors, the implication is straightforward: Preserving wealth without considering family health may be an incomplete strategy.
Health Is a Financial Variable
Poor health does not stay in the doctor’s office. It often shows up in household balance sheets, career trajectories, and estate outcomes.
Across generations, declining health can create:
- Higher healthcare and insurance costs;
- Reduced lifetime earnings;
- Caregiving disruptions that affect working-age family members;
- Greater reliance on emergency or reactive care;
- Increased stress, conflict and decision fatigue during family crises; and
- Faster erosion of inherited assets.
Families frequently plan for inflation, taxes, market volatility, and longevity. Yet many do little formal planning for chronic disease risk, mental health strain, or care-navigation complexity.
That may be changing.
A New Form of Capital
Financial capital compounds. So does health capital.
Healthy habits, preventive care, emotional resilience and sound healthcare decisions made early in life can generate returns for decades. The opposite is also true. Small risks left unaddressed in childhood or midlife can become expensive, disruptive problems later.
This does not mean advisors need to become clinicians. It means recognizing that health outcomes often influence financial outcomes.
Families that build strong health habits may reduce future costs while improving quality of life. Families that ignore them may eventually pay for it — financially and otherwise.
What Advisors Can Do
Advisors are increasingly asked to coordinate beyond investments. Health is a natural extension of that broader role.
Practical ways to incorporate the topic include:
1. Add healthcare readiness to annual reviews
Alongside tax and estate discussions, ask whether clients have:
- Appropriate insurance coverage;
- Access to needed specialists;
- Long-term care planning;
- Aging-parent contingency plans; and
- Updated healthcare directives.
2. Reframe prevention as risk management
Preventive care is often viewed as a personal matter. It can also be viewed as financial risk reduction.
Delayed screenings, unmanaged chronic conditions, and untreated mental health concerns frequently become larger expenses later.
3. Discuss caregiving exposure
Many affluent families underestimate how disruptive caregiving can be to adult children in their peak earning years. Time, travel, stress, and reduced work capacity can materially affect family finances.
4. Build a trusted network
Just as advisors coordinate with attorneys and CPAs, clients may benefit from vetted healthcare resources such as patient advocates, care navigators, geriatric specialists, or executive health providers.
- Include health in legacy conversations
Families often prepare heirs to inherit money. Fewer prepare them to inherit responsibility for health decisions, aging parents or navigating a fragmented medical system.
That gap can become costly.
The Next Frontier of Planning
Wealth transfer remains important. But wealth alone does not guarantee independence, vitality, or peace of mind.
The next generation may inherit substantial assets. Whether they inherit the health to enjoy them — or the burden of managing preventable family health crises — may matter just as much.
Advisors who broaden the definition of legacy planning may be better positioned to protect both.
John Samuels is founder and CEO of Wellworth, an independent healthcare advisory practice based out of New York City. He served as a senior healthcare leader in New York City’s top hospitals for over 20 years. John uses his extensive healthcare experience and wide network of medical professionals to achieve the best possible care for clients nationwide. He was recently honored by Forbes as one of the Next 1000 entrepreneurs and business leaders who are changing how businesses are run.
Read more articles by John Samuels
Advisor Perspectives welcomes guest contributions. The views presented here do not necessarily represent those of Advisor Perspectives.
