In 1999, a Belgian demographer, Michel Poulain, heard about an Italian island where people lived to be 100 and older while remaining mentally and physically active. Intrigued, Poulain visited Sardinia, where he validated people’s ages according to their birth records. Using a blue pen as he crossed the island, he marked on a map the spots where he found the oldest villagers. “From that time, it is called the blue zone,” he explained to me over the phone in June.

Four years after his first trip, Poulain published an academic paper on “blue zones,” as these sites became known, in the journal Experimental Gerontology. In the paper, he speculated about the factors that led to such long lives. Was it low levels of immigration plus high levels of inbreeding? More men than women lived longer; perhaps there was an environmental influence? Shortly after publication, Poulain got a call from Dan Buettner, a long-distance cyclist and National Geographic explorer. Buettner was chasing his own longevity hot spot—a city in Okinawa, Japan, where, he’d heard, people also lived to be very old. Buettner hoped to incorporate Poulain’s work and write about both locations; his National Geographic article on the blue zones ran in 2005.

In subsequent articles, books, a TED talk, and eventually a hit Netflix series, Buettner and Poulain expanded their research, naming three more blue zones in Ikaria, Greece; Nicoya, Costa Rica; and Loma Linda, California. Along the way, Buettner, who has a gravelly voice and an easy charisma, developed theories about what made the blue zones special. It wasn’t genetics, he suggested, but the environment. Physical movement was built into peoples’ daily routines, through their work, their commutes, and the surrounding geography. Plant-based foods dominated their diets, and they reported a sense of purpose and belonging. The conditions of their lives stood in stark contrast to those of most Americans, Buettner observed on the first episode of the Netflix show, which aired in 2023. And the consequences for the United States were grim. Life expectancy here was notably declining when compared to peer countries. In 2023, it dropped to 76.4 years, the shortest it had been in almost 20 years.

It probably isn’t a coincidence that, as life expectancy diminishes, we have grown fixated on living longer. Longevity has lately emerged as a wellness trend, if you can call it that, given how long humans have lusted after some version of a fountain of youth. In the first recorded story, the Epic of Gilgamesh, a king desperately searches for the secret to everlasting life. But there is undeniably a renewed focus in medicine on uncovering the secrets of long life. Billionaire Peter Thiel, a co-founder of PayPal, has spent millions on anti-aging research, and Google maintains a secretive life science company, Calico, to research the biology of aging. On TikTok and X, longevity gurus and influencers suggest that we can combine lifestyle interventions with biomedical advancements to keep our bodies going—and going, and going.

Buettner didn’t want to confine his and Poulain’s discoveries to written stories that might, at best, be recycled as fables. He wanted to effect real change in a world he saw becoming sicker around him. In 2009, he got a million-dollar grant from the AARP to see whether blue zones could be made, not just found. Buettner selected Albert Lea, Minnesota, near his home in Minneapolis, as the test city for a for-profit company he called the Blue Zones Project. “If you try to convince people to change their behavior, you fail,” he told me. “The whole idea was to change their environment so you’re setting them up for success instead of failure.” In the 15 years since it was established, the company, which Buettner eventually sold to the health care system Adventist Health, has enlisted more than 70 communities and more than four million people in the United States to participate.

But there are a few problems. The Blue Zones Project markets itself as a public health program, but it doesn’t measure its outcomes as rigorously as comparable initiatives run by academic institutions, so it’s hard to tell how effective it is. It’s also expensive. Largely for cost-related reasons, many of the participating towns and cities gave up their certifications as Blue Zones communities. And as the company grapples with how to help people live longer, healthier lives, the original blue zones are facing their own identity crisis. The data that shows concentrated populations of centenarians, some critics now allege, is flawed. Can you turn a U.S. city into a blue zone if the zones don’t exist in the first place?

In early June, I walked on the five-mile path that wraps around Fountain Lake in the center of Albert Lea. This was no ordinary sidewalk, but a “Blue Zones Walkway,” constructed as part of the city’s certification. Cathy Malakow-sky, the current head of Albert Lea’s Blue Zones Project, guided me through all the changes the town had made to transform itself. Malakowsky, who grew up in Iowa and moved to Albert Lea when she was a junior in high school, has an endearing Midwestern lilt to her voice. After going to college six miles away, she came back to marry her high school boyfriend and raise her children. She’s divorced now, but committed to Albert Lea. She began as a volunteer during the pilot project, and took over as the Blue Zones Project lead about two years ago.

Later that day, Malakowsky gave me a tour of downtown. To obtain certification, cities must agree that at least 20 percent of residents; 25 percent of grocery stores, locally owned restaurants, and public schools; and 50 percent of the top 20 employers will adhere to a “healthy-living plan.” For workplaces, this can include offering healthier snack options, a break room with yoga mats, or suggested routes for employees to take walk breaks during the day. Cities also receive assessments from Blue Zones consultants for how to improve the built environment. Malakowsky pointed out new crosswalks and sidewalk extensions, along with stop signs that slow traffic. As part of the project, Albert Lea added flowerpots, benches, and trash cans that double as bike racks. “We have invested millions of dollars in sidewalks and trails to make walking easier,” Malakowsky said. At the end of the initiative’s first year, the Blue Zones Project announced that residents of Albert Lea had gained an average of 2.9 years of life expectancy. The project was deemed a success.

As we got into Malakowsky’s car and drove to see more of Albert Lea’s trails, she told me about the Blue Zones Project’s True Vitality Test, which asks questions about diet, lifestyle, mental health, and social and work life. When she took it, the results said she would live until she was 88, but be healthy only until 80, unless she made changes to her diet. I noticed that the Blue Zones Project is replete with catchy—and trademarked—terminology. There’s the Life Radius, the Power 9, the 12 Pillars, and Vitality surveys, all borrowing lessons from the blue zones about how to eat, be active, and spend time in community.

Jargon aside, there’s no doubt that the Blue Zones Project’s suggestions are generically good: Make your cities more walkable, improve your connections to your neighbors and family, and eat healthier foods. Naomi Imatome-Yun, the executive vice president of the company, told me it was “the largest public health project in the country.” And the blue zones tap into a powerful truth: that despite how much Americans spend on health care, our overall health is only minimally related to medical care—about 10 to 20 percent, according to research on the social determinants of health. This helps explain how the United States can spend an exorbitant amount of money on individual treatments while Americans remain so sick. Countless studies show, for instance, how income influences health outcomes. A 40-year-old man in the poorest 1 percent of the U.S. population will die, on average, 14.6 years sooner than a man in the top 1 percent. For women, the gap is about 10 years. A study done in Baltimore found a 20-year disparity between a man’s lifespan in a poor neighborhood and........

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