Immortality is the gift we might secretly desire but know would be an abominable curse to receive. To truly live forever would mean watching our loved ones die, generations at a time around us, and looking on while the natural world we value withers and falls into decay.

But while eternal life may be a fantasy, the prospect of us living longer lives than our predecessors is very real. The global Covid-19 pandemic might have interrupted proceedings, but the evidence clearly shows that over the long term the longevity of the worlds populations is unstoppably on the rise.

Even over relatively recent periods, the statistics are striking. In 1960, for example, the average life expectancy for men was 50.7 years, according to data from the World Bank, and for women it was 54.6.

Fast forward six decades to 2019, and World Bank figures show that the average life expectancy for men had grown to 70.6 years, and for women had edged past 75 years.

Looking into the future, the Hamburg, Germany-based market and consumer data firm Statista projects that, by 2050, the average life expectancy globally will reach 76.7 years and, by 2100, an impressive 81.7 years.

Given that these figures are averaged out across societies worldwide with wildly differing economic fortunes, that must surely mean that some people will be living considerably longer still.

Therein, of course, lies part of the explanation. The worlds populations are becoming wealthier, bringing with it improvements in diet and lifestyle and more advanced medical treatments and healthcare provision.

It seems hardly surprising that, according to World Bank figures, the 2019 average life expectancy of someone on a low income was 66 years, while for an upper-middle-income earner, it was a full 13 years longer, at 79.

The pace of developments in technology and in the provision of infrastructure such as roads, rail, schools and hospitals also means that as the worlds populations grow they are also urbanising more quickly. In short, our lives are better, from the moment we are born often in sanitised maternity units at the hands of trained experts to the moment we die, perhaps in a quality long-term care home.

Part of the deal, unfortunately, is that as we age, we tend to become more infirm and more vulnerable to diseases including conditions such as cancer, diabetes and heart disease.

Health and longevity make up one of the six themes that we have identified within the social and demographic change megatrend. And the more than 1,340 companies captured by the Fix the Future database strongly reflect some of the factors that are fuelling our longer lifespans.

By business line, they range from diagnostics and research firms to drug manufacturers, medical device makers, healthcare information providers and pharmaceuticals retailers.

The history of drug research and discovery is littered with casualties in the form of companies that believed theyd found a blockbuster treatment only to crash and burn in late-stage trials or founder when their medicine reached the market.

But there are plenty of established players, many of which have the backing of the worlds most skilled fund managers and are included in the Fix the Future database.

Among them is Novo Nordisk, a Denmark-based multinational that researches, develops and produces treatments for people with serious chronic diseases, including diabetes, obesity and rare blood and endocrine problems. (The endocrine system essentially regulates all of the bodys biological processes, including metabolism and blood sugar.)

Novo Nordisk is listed on the Nasdaq Copenhagen stock exchange with a market value of DKK 1.2tn (138bn). It produces half of the worlds supply of insulin for people with diabetes and says its aim is to prevent more than 100 million people from getting type 2 diabetes (often diet-related) by 2045. The company also carries out clinical trials in more than 50 countries.

From an investment perspective, this means that not only does Novo Nordisk have established, recurring and resilient sales, but it is also locked into long-term developments in demographics and growing healthcare needs.

There are numerous other routes into health and longevity as an investment theme, however. There are the manufacturers of medical equipment, for example, including Smith & Nephew, the UK-listed group most well known for its hip and knee replacements.

Listed on the London Stock Exchange with a market value of 10.6bn, Smith & Nephew also makes products to help stabilise fractures and correct bone deformities and has sports medicine and ear, nose and throat divisions, along with a unit that specialises in advanced wound management.

Crucially, the group describes itself as a medical technology company, signposting that it has its eye on the need to keep pace with modern treatments. In practice, that has meant building up its capabilities in robotics and digital surgery, and increasing its investment in research and development from 4.7% of sales in 2017 to more than 6% in 2021. With sales of just over $5.2bn (4bn) last year, that equates to about $312m.

Hospital operators such as HCA Healthcare provide the bricks and mortar of healthcare. This is a US business listed on the New York Stock Exchange, valued at just under $79bn, and which runs private hospitals and other centres in 20 American states as well as in the UK.

All told, HCA Healthcare manages more than 2,000 facilities, including hospitals and surgeries, emergency rooms and urgent care centres, as well as diagnostic and imaging units and walk-in physician clinics.

For an investor, that means HCA Healthcare is exposed to the structural growth of the private provision of healthcare and the harsh reality that well need more medical treatment in our old age.

And, of course, there are the insurers and sellers of healthcare plans, whose policies help cover medical bills and, in turn, help to underwrite the growth of private provision. Just one example is Fairfax Financial, a Canada-based business that also operates in parts of Asia, Europe and the Americas and is the owner of Brit Insurance in the UK.

Fairfax Financial is listed on the Toronto Stock Exchange and has a market value of just under C$14.6bn.

The company sells life cover and health insurance, among other financial services, so in this regard is positively plugged into the dynamics of ageing populations and their medical needs. However, it is also in the business of expanding opportunistically in regions where insurance penetration is low, which adds to its potential interest and ability to increase revenues.

Fairfax Financial has a solid foothold in high-growth Asian markets such as Indonesia, Thailand and Vietnam, where the populations are growing rapidly, wealth is on the up, and the safety nets of a welfare state are all but non-existent.

Like the rest of us, no company is immortal, but some of the smartest investors are working on the assumption that these and other businesses will be with us for some time to come.

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The companies leading the drive for longer, healthier lives - citywireselector.com