We need to place greater emphasis on wellness and preventive medicine in our lives and healthcare system (see: Wellness, Preventive Medicine, and the Classic Disease Model). The goal of such an approach is to prevent diseases before they strike and thus both improve the quality of life of Americans and also reduce our healthcare costs. Luckily, the recent healthcare reform legislation funds various preventive medicine initiatives (see: Some Encouraging News About New Federal Funding for Preventive Medicine Initiatives).
It is commonly stated that we are in the midst of a chronic disease epidemic (see: Seeking Solutions to the Chronic Disease Epidemic) with increasing incidence of obesity (see: Obesity as a Cause of Death Recorded on Death Certificates) and diabetes (see: The Staggering Cost of Treating Diabetes). Increasing attention is being paid to the lifestyle diseases (see: Seeking the Correct Definition for a "Lifestyle Disease") that are the result of both choices made by individuals such as diet or lack of exercise. On a larger population basis, lifestyle diseases can also be defined to include diseases of old-age as well as exposure to pollutants in a particular country. Needless to say, there are various conditions embedded in our chronic disease epidemic such as hypertension and abnormal lipid profiles that can be easily screened for and are amenable to medical treatment.
One of the ways in which to understand the effects the preventive medicine and wellness movement is to measure changes in the number of preventable deaths. A recent article in the NEJM by Drs. Murray and Frenk included the following passage about this topic (see: Ranking 37th — Measuring the Performance of the U.S. Health Care System):
Given the vast number of preventable deaths associated with smoking (465,000 per year), hypertension (395,000), obesity (216,000), physical inactivity (191,000), high blood glucose levels (190,000), high levels of low-density lipoprotein cholesterol (113,000), and other dietary risk factors, there are huge opportunities to enact policies that could make a substantial difference in health system performance — and in the population's health. More investments that are targeted at promoting proven strategies — including tobacco taxation and smoking-cessation programs, screening and treatment for high cholesterol and blood pressure, banning of trans fat, creating incentives for people to engage in physical activity, and subsidizing the cost of consumption of n–3 fatty acids — could dramatically reduce mortality and enhance the performance of the U.S. health care system.
If we add up the numbers above for preventable deaths per year in the U.S., we arrive at the staggering number of 1,570,000. Assuming that the U.S. population is about 309,500,000, this constitutes about .5% of the population dying each year of preventable causes. We all know how to address some of these problems: better and broader health screening programs; enhanced public health education programs; sin taxes such as those on cigarettes, liquor, and even soda pop (see: State Taxes on Soda Pop Gain Momentum; Does the End Justify the Means?); and greater access to our health system to promote earlier treatment of disease. We also certainly need to pay more attention to the dietary habits of most Americans (see: Proposed Dietary Guidelines Take Aim at Obesity, registration required).
For me, one of the key question in this discussion is how much involvement in the lives of Americans can be justified in the pursuit of the certainly appropriate goal of reducing the number of preventable deaths in this country?