The future of healthcare: your health, your responsibility
Understanding our risk factors, monitoring vital health indicators, and making informed lifestyle choices gives us the power to prevent and manage diseases in the second half of our lives.
None of us like to admit it, but the second half of our lives is the part often marred by the discovery and management of disease and the worry and treatments associated. And through this process we are completely dependent on the health system. The GPs and the institutions in our health system are our key to detection and treatment and in Australia they do a very good job. But we are at a turning point and both the health system and the attitudes of individuals has to change. The greatest opportunity to create longer, better lives now lies in each of us taking more responsibility for our health, understanding our own risk factors as individuals, and monitoring ourselves more personally and more regularly. And that is not something ingrained in our culture among average over-50s or our health system ... yet.
Healthcare systems have been through a rather amazing transformation over the last 30 years. They have moved from being a place to treat primarily communicable diseases, injury, childbirth and neonatal health, to being the centre of our fight to treat non-communicable diseases, like cancer, heart disease and diabetes related issues. People have been trained to seek medical attention when they notice significant symptoms of a health issue or concern, and are then sent off for testing, get a diagnosis, and then doctors try to fix it. In an effort to avoid dying early we have been trained by the modern health industry to check our bodies for the larger and more obvious signs of disease, like lumps, cancers and heightened blood pressure. And when we find something significant, we seek diagnosis and treatment.
We all understand it. If you find a lump in your breast, a lesion on your skin or have a pain in your chest, you go and see your GP for further investigation. If they find cancer or heart disease, you then start the long, slow and often debilitating treatments to make yourself well again, if you caught it in time. We also understand that we should, from the age of 50, do our bowel-screening test every two years, have a mammogram every second year (for women), and have a PSA test for prostate cancer (for men) every other year from 50-69. We learn these ‘rules’ and follow them so we can ‘discover’ disease lurking inside our bodies that might be undetectable by symptoms.
To some extent, this approach has been successful in extending life spans by catching early signs of diseases like breast and bowel cancer, and implementing treatments to remove or slow their progression.
But the world is changing again, and with it, the health sector will have to. Managing our risk factors is now the key to the next stage of healthcare in the second half of life.
The Global Burden of Disease Study 2019, published in The Lancet, identifies poor risk factor management as responsible for over half of the lost years of life expectancy worldwide. Four of the largest risk factors, which have experienced a dramatic increase, include:
High Body Mass Index (BMI): A significant indicator for various health issues affecting quality of life, including cardiovascular disease, type 2 diabetes, sleep apnea, joint problems, and certain cancers.
Ambient particulate matter pollution: Caused by exposure to fine particulate matter, including smoking and second-hand tobacco smoke, it poses a significant risk to respiratory health and premature death.
High fasting glucose levels: An important symptom of metabolic disorders like insulin resistance, pre-diabetes, and diabetes.
High systolic blood pressure: An essential indicator of hypertension, which can strain the heart and blood vessels over time, leading to heart attacks, strokes, and other cardiovascular complications.
How many of us truly understand how our bodies function until we face a major health scare? How many of us comprehend the significance of blood pressure and cholesterol readings, know our target levels for HDL (good cholesterol) and LDL (bad cholesterol), systolic blood pressure, fasting blood sugar levels, and understand how certain foods affect our insulin levels?
These highly preventable risk factors are on the rise in the Western world at a rate that our medical system is not adequately prepared or equipped to handle. Moreover, they contribute to four out of the five leading causes of death in the latter half of life:
Cardiovascular diseases: Many cardiovascular diseases, including heart disease and stroke, can be prevented or mitigated by adopting a healthier lifestyle. This includes consuming a balanced diet, engaging in regular physical activity, avoiding smoking, managing stress, and controlling high blood pressure, cholesterol levels, and diabetes.
Cancer: Although not all cancers are preventable, a significant portion of cancer cases is linked to modifiable risk factors. Lifestyle changes, such as avoiding smoking and excessive alcohol consumption, maintaining a healthy weight, engaging in regular physical activity, practicing sun protection, and receiving vaccinations for HPV, can help reduce the risk of developing various types of cancer.
Respiratory diseases: Many respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and lung cancer, are closely tied to smoking. By avoiding or quitting smoking and minimising exposure to secondhand smoke and other respiratory irritants (such as air pollution or occupational hazards), the risk of developing these diseases can be significantly reduced.
Diabetes: Type 2 diabetes, often associated with poor diet and lack of physical activity, can be prevented or delayed through adopting a healthier lifestyle. This includes consuming a balanced diet, engaging in regular physical activity, achieving and maintaining a healthy weight, and managing stress.
Most medical professionals in prevention agree, the only way to turn this wave of non-communicable diseases around is to give people more information and better tools to manage their own risk factors and teach them just how important this is.
The knowledge in the medical industry has now progressed to such an advanced level that we could monitor and evaluate these things in almost real time on our own personal dashboards.
We could learn, and take responsibility for our own ‘good health’, looking for ways to make lifestyle and situational changes to our numbers if they were suboptimal. And then, when we require treatment, that treatment could be personalised to the data we have collected about how our body reacts to a variety of stimuli, but that’s another conversation.
It would be a complete ‘script change’ for the medical industry and for consumers, so I expect it will take some brave medical experts, entrepreneurs, bureaucrats and politicians for our country to go there. But the benefits to all of us would be phenomenal, and it would reap rewards for the health sector for many decades to come.
But the big questions I want to ask you are twofold:
Who has to move first for this to become a reality - the health leaders and health system, or the motivations of the consumers? Will it be a slow change or a more rapid shift led by governments in response to these diseases of ageing and poor risk factor management flooding our health systems?
Do you want to manage your health and risk factors more proactively and would you if the technology and information was more readily available and supported by governments or health funds?
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And until next week, make it epic! And don’t forget to email me with your ideas and insights on bec@epicretirement.com.au.
Bec Wilson Xx
(Sources are below if you’re curious).
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Article sources
The Global Burden of Disease Study 2020, The Lancet, 2020, https://www.thelancet.com/gbd
Health Literacy Survey 2018, Australian Institute of Health and Welfare, 2022, https://www.aihw.gov.au/reports/australias-health/health-literacy
Mathur S and Mathur S: Personalized medicine could transform healthcare (Review). Biomed Rep 7: 3-5, 2017 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5492710/
Measuring HRV is easy and tells me a lot. I absolutely believe wearables with data sent to primary care can alert well before symptoms manifest. It’s a no brainer and many functional medics are already running that way.