Preventive health interventions can increase health span

Traditionally, healthcare professionals and policymakers have viewed the increase in life expectancy as a positive thing, an indication of successful care outcomes.

But since the gap between life expectancy and health span has grown larger, people are mostly extending the part of their lives lived in poor health.

The healthcare system faces a ticking time bomb in the years ahead as it will struggle to cope with ever-increasing demand for diagnosis and treatment, partly driven by the growing prevalence of unhealthy lifestyles, even among the younger generations.

Consider that 48% of the Dutch population do not exercise sufficiently, 20% smoke, 16% suffer from burn-out complaints, and less than 10% follow the public health institute (RIVM) recommended diet. The average individual spends three hours a day watching television, with teenagers spending an additional three hours daily playing computer games and using social media channels.

As a result of these behavior patterns, the increasing need for treatment is having a direct impact on the cost of healthcare in the Netherlands, widening the gap between and the young and the old, and the rich and the poor in our society.

One of the solutions to rising costs is for policymakers to start to communicate to the public about how individuals can take action to avoid preventable illnesses while they are still in good health.

While the health literacy of the general public is limited, citizens’ general interest in health has been heightened as a result of the global pandemic, as it illustrates the fact that people with chronic illness or pre-existing conditions are more vulnerable to suffer long-term complications, such as chronic fatigue. Therefore, all stakeholders have a rare window of opportunity to capitalize on a highly engaged public.

Rather than making incremental changes to the existing healthcare model, what would happen if policymakers pivoted towards prevention?

In response to the challenges facing healthcare delivery, many organizations such as the World Health Organization, the Dutch government and the Eurostat commission are making ‘healthy life years’ a strategic priority.

Healthy life years can be defined as years lived without longstanding illnesses such as diabetes or heart disease.

At Ancora Health, our ambition is to add 5 million healthy life years to the society by 2030, working with multiple stakeholders to dampen down the rise in health costs and ultimately bring a better quality of life to citizens as they grow older.

Thanks to the rapid advancement of data collection methods, our research team has been able to quantify the benefits of good behavioral health choices on the number of healthy life years lived.

In collaboration with the University Medical Center Groningen, we used machine learning, a branch of artificial intelligence, to examine the relationships between people’s genetics, diet, behavior and the resulting health outcomes as they grow older.

The main conclusion from our research is not surprising. People with unhealthy lifestyles are more likely to live their later years in an unhealthy state, translating into fewer healthy life years.

Highlights from the dataset analysis:

• Individuals that have a poor lifestyle on average live only 4 years in a healthy state between the ages of 40 and 70, rather than the full 30 years one would hope for.
• The healthiest group of individuals – i.e. those who score well in terms of healthy behaviors – live on average 25 healthy life years between the ages of 40 and 70.
• People in the unhealthiest group (5% unhealthiest) have 6 BMI points more than those in the healthiest group (5% healthiest).

Since doctors are likely to become even more occupied in the future, with more patients and more possible treatments, it is important to transfer the burden of choosing and execution of interventions to other experts, such as health coaches, or even to individuals themselves, where possible.

If people could become aware of possible treatment alternatives, such as remitting type-2 diabetes through lifestyle interventions, they could take control of their health themselves and solve a complaint before it becomes chronic, rather than maintaining a permanent state of disease.

At Ancora, this is the approach we are pioneering. We are developing tools that allow not only doctors, but also individuals, to have access to information about their health risks, in an easily interpretable manner.

We strongly believe that if citizens can better understand the potential benefits of preventive health, such as remitting type-2 diabetes through lifestyle interventions, that could increase their likelihood of enjoying a longer health span.

To help drive the change, government policy can also play its role in empowering people to make better health choices. For example, subsidies for healthy goods such as fruit and vegetables could be offset by the introduction of taxes on unhealthy goods such as sugar.

While the benefits of preventive health interventions are starting to be better understood, the cost to the user remains a key consideration. Our experience shows that only a small percentage of individuals are willing to invest their own money in preventive health.

What are the possible solutions? One could be a scheme whereby either insurance providers or government makes a commitment to invest in preventive health programs.

This is much more likely to happen if the long-term financial gain for the payer is clear.

In summary

• To tackle the root causes of poor health span, policymakers should create the conditions that empower individuals to take control of their own health. Only then will we keep healthcare affordable and make sure people enjoy a high quality of life as they grow older.

• People have the chance to extend their health span if they improve the lifestyle factors within their personal control, such as diet and physical activity. Even simple changes, such as spending less time sitting on the sofa, could tip the balance towards a person enjoying significantly more healthy life years.

• Nevertheless, the pursuit of longer health span is not a one-size-fits-all endeavor. It relies upon identifying key risk factors for each individual and translating this into realistic lifestyle improvement actions aligned with the person’s needs, goals and preferences.