Why medical prevention is so important but (almost) no one seems to care
It was recently found that four simple healthy habits are associated with a 66% lower mortality risk. That’s about 12 extra years for someone in their early thirties, such as myself. Most people “know” that “an ounce of prevention is worth a pound of cure” and yet, about 80% of us don’t have those simple healthy habits. Why?
I’ve started a project to help people be healthier for longer and spent a long time thinking about the prevention problem. I’ve found seven key reasons:
1) We don’t know exactly what it is we should be doing — there’s loads of healthy advice out there, and more often than not, it is contradictory. Fat used to be bad and sugar was fine, now it seems sugar is bad and fat is OK again. But is it every type of sugar? Or is the sugar we get from fruit good? What about coffee? Is it good for your heart or bad? And exercise? Is 10k steps per day enough? Is more exercise better? How much is optimal? How about meat?
2) It is hard to get enough motivation — most people want to be healthy and say that prevention is important, but will generally tend to focus on more ‘urgent’ things, such as family, work, love, school, bills, etc. And there’s always the eternal myth of those ‘who drank a lot, smoked, and ate crappy food but lived until they were really old’. On top of this, we don’t really know what disease risks we have or what benefits we’ll get by adopting a healthier lifestyle. And when we do change our habits, we don’t usually know whether it is having any positive impact until much, much later.
3) We don’t always follow the best strategy when trying to change our habits — there’s actually science behind habit formation, and because we’re not familiar with it, we fail to change our habits. We don’t know that habits take on average 10–12 weeks to form and require daily repetition; that we should start with something easy we believe we can achieve, and associate it with a trigger (something we already do everyday) so that we don’t forget doing it; that we should reward ourselves after doing the new habit; that we should focus on just one at first and avoid trying to change multiple things at once. The list goes on.
4) Medicine is mostly reactive (and not preventive) — in the past, people had mostly acute health problems like infections that required a reactive approach. As in: you get an acute illness -> you get treatment for it. This reactive way of doing things is still the most common today, despite the fact that, at least in developed countries, we’re suffering mainly from chronic diseases. Even our med schools don’t teach our doctors enough about prevention. And let’s be honest, even if we had a more preventive approach, how would doctors make sure their patients are following the suggested preventive measures?
5) Some key players involved in healthcare have misaligned incentives — pharma companies make a lot more money if people have diabetes for a very long period, because they’ll have to buy drugs, rather than if people prevented diabetes by improving their lifestyles. Hospitals/doctors in certain healthcare systems also make a lot more money when someone does a coronary bypass due to heart disease rather than if people avoided these problems through prevention in the first place. How about the fact that companies selling sugary and other products we commonly eat, that might be bad for us, can influence the nutrition guidelines provided by government bodies/panels? Ever wondered why the WHO has for a long time recommended a limit in the intake of added sugar of 10% of daily calories but US panels had that limit at 25%? How about the fact that certain charities with health related mandates receive funding from those industry players, and also some pharmaceutical companies?
6) Hard to get good data and circulate good scientific research — it’s not easy to do good studies in this field as most data is self-reported by study participants (and who can remember exactly what they ate or did in the past?). Besides, trying to make sure the findings from these studies are due to the variable being studied (e.g. eating fruit and vegetables) and not due to other possible reasons is not trivial. It also isn’t easy to do random double-blind studies in this field (the gold standard in scientific research). There’s loads of new research being published every day, and not all is useful. But how can doctors have the time to go over all this new information and still treat patients, fill out paperwork and so on?
7) Prevention is not a (large) business — OK, so you found something that is associated with a 31% lower mortality risk? Awesome! Is that something you can patent, that people will be super excited to buy over and over again, and generate so much money that you’ll make the largest pharma company blush? No, it’s broccoli. Eating fruit and vegetables was associated with such benefit, but how do you make money by providing this information to people and helping them to eat more of it? Not to mention that while doing so, you’d also be disrupting all the massive businesses that benefit from the way things are done today.
Definitely not an easy problem to solve. But one that could have such a positive impact in the world! Time to look for solutions!
If you want to help, let us know how we can improve our prototype (here) or why you’d like to join us in this journey to help everyone be healthier for longer through prevention. Looking forward to hear from you!
