It’s official: 1 out of every 2 Americans has a chronic health condition. Additionally, twenty-five percent have more than one chronic condition. In a new series initiated by the Centers for Disease Control (the first paper recently published in The Lancet), researchers note that chronic diseases have, in fact, overtaken the human health scene, with noncommunicable conditions causing two-thirds of global deaths. In the U.S., we likewise see the impact in terms of mortality but also in terms of personal disability as well as health care expenditures. Previous reports from the CDC claim a staggering 84% of health care costs go toward treatment of chronic conditions. Is there a way off of this sick merry-go-round? How about the old adage about prevention being worth a pound of cure? For all its seeming practicality, is the prevention mindset – and protocol – the best answer, let alone the panacea?
The State of Affairs
Authors of the CDC series share the “short list of risk factors” associated with the individual incidence (and societal prevalence) of these chronic conditions as “tobacco use, poor diet and physical activity…excessive alcohol consumption, uncontrolled high blood pressure, and hyperlipidaemia [high cholesterol].” While I have my own diverging and nuanced takes on the cholesterol issue in particular and would likely add chronic stress, I can’t argue much with the list itself. We suffer as the result of the most basic choices and deficits. It makes the premise of preventative medicine seems so elementary, but clearly we’re (collectively speaking anyhow) missing the boat. What does preventative medicine end up encompassing in the conventional scheme of things?
The CDC report authors cite, for instance, their organization’s four-pronged approach to prevention strategy: “(1) epidemiology and surveillance to monitor trends and inform programmes; (2) environmental approaches that promote health and support healthy behaviours; (3) health system interventions to improve the effective use of clinical and other preventive services; and (4) community resources linked to clinical services that sustain improved management of chronic conditions.”
While one hope of prevention strategy holds that additional contact with health providers can allow for essential nutrition and fitness counseling, surveys of actual doctors complicate this picture. Research shows that less than a quarter of doctors feel confident or particularly qualified offering diet and exercise advice to their patients. Surveys, in fact, have demonstrated that medical students continually receive inadequate nutrition training with a mere 22.3 hours of instruction on average. The results show. Less than one-eighth of physician visits include fitness or nutritional counseling. Given the prevalence of obesity and chronic illness, clearly one-eighth isn’t going to cut it.
Beyond the public health monitoring and the clinical intervention practices are the “self-management education” and the “supportive community environments.” (I think Primal folks have some experience with these concepts….) It’s another complex tier of incorporating and maintaining healthy behaviors that are the linchpin for prevention but may be at odds with conventional lifestyle practices, particularly in certain regions or population communities. Public health campaigns go out of their way to make healthy choices appear “normal,” but the reality can feel very different. It’s no surprise that people tell me time and again how embracing the Primal Blueprint as a counter-cultural lifestyle helped them adhere to the PB and actually enhance their investment in it.
The Paradigm of Prevention
The core issue of – or perhaps beyond – prevention is investment, I believe. Education – actually physiologically sound education – is key. People have to know the correct information to make positive change. (This is still a problem in CW society, but progress is being made here and there.) Nonetheless, after education (or with it), it’s about behavior. Are we going to make the choices we know are “right” for us? Are we going to complain about the costs and inconvenience, or are we going to see the trade-off as a bargain that we can take advantage of with planning that fits our personal budgets and needs.
Preventative medicine is about investment. Our health requires an investment of time and resources. People get impatient with the cost of real food. In truth, it’s not cheap. Yet, it’s a question of priority on a societal and individual level. We invest in our retirements – a worthy endeavor – but let our health go to pot, which means we’ll need more for retirement – often considerably more with the cost of an added private insurance policy to pick up what the first doesn’t cover, with the immense cost of prescription drugs, with the out-of-pocket expenses for various treatments, therapies and surgeries. We live with disabilities related to our medical conditions or a chronically impaired sense of general well-being. We end life never knowing what full capacity felt like.
This is my beef with conventional thinking or even the conventional paradigm of prevention. It’s about gingerly handling our unhealthy tendencies keeping us perpetually just shy of the disease threshold. It’s about assembling a collection of moderate messages and a barrage of outside resources to save people – but often just barely – from themselves. The goal becomes keeping something at bay rather than adopting a bigger picture of real wellness. Prevention is still about the disease: you’re “preventing” a disease. How about replacing the fixation on what to avoid with what to walk toward? What about setting the bar higher? If an ounce of prevention is worth a pound of cure, maybe an ounce of vision is worth a pound of prevention.
A View Beyond Prevention
Again, what kind of investment are you willing to make in your health? What kind of return do you think you’ll get on those efforts? (Can you imagine the responses you’d get from a cross-section of people with these questions?) How far is your doctor willing to push you in investing in yourself? How much truth, clarity and how many tools is he/she willing to offer? (I seriously cannot say this without feeling more gratitude for the new Primal Advantage service. It was truly a cause close to my convictions.)
While prevention is a step in the right direction, I believe in aligning myself with more optimistic intentions. I’m going to focus ahead on where I want to go, not live life looking behind me wondering when x, y, or z is going to catch up and nab me. I find I feel more personal authority and responsibility when I look at my health goals this way. I am choosing to walk toward a life I select. I am going to work toward the state of well-being I want. I am going to fuel my potential for vitality. I am going to build on my own vision for life. I am going to see each choice I make, every health/wellness related purchase I make, and every tool or program I use as a logical, positive investment in my ultimate goal and good. Pursuit can be much more inspiring than prevention.
Thanks for reading today, everyone. How do you see the message and measures of prevention in our current health care culture? How does it compare to how you conceptualize your approach to caring for your own health? Share your thoughts, and have a great end to the week.