How can we repair the life expectancy curve in Europe?

How can we repair the life expectancy curve in Europe? I was reading a report, recently, from the London School of Economics on premature death due to cardiovascular disease when I was confronted with this question.

Since the 1960s, life expectancy in Europe followed a steep upward trend. With an increase in modern medicines, screening and preventive care, people were living longer, healthier lives. In fact, with every passing decade since the 1960s, life expectancy has increased more than two years. But recently, something curious has happened. Even before the COVID-19 pandemic, which triggered life expectancy losses not seen since World War II, experts observed life expectancy stagnating or declining across Europe.

In November 2019, the King's Fund and the Organisation for Economic Cooperation and Development (OECD) brought together a small group of health experts from around the world for a workshop in Paris to discuss a perplexing paradox: What was slowing improvements in life expectancy in Europe?

One thing was clear for that group of health experts at that Paris workshop: cardiovascular disease (CVD) was the main suspect. They believe, as do I, that CVD is one of the most significant contributors to slowing improvements in life expectancy.

Today, CVD mortality is about half of what it was in 1995. We have seen people live longer, healthier lives thanks, in part, to life-saving innovations in medical procedures and innovative pharmaceutical interventions. But most of that reduction occurred before 2010, and CVD mortality has plateaued or increased across Europe since then.

Today, CVD remains the EU's leading cause of death, accounting for 37% of all deaths and 22% of premature deaths.

Have CVD mortality rates plateaued or increased due to a lack of innovation, implementation or imagination? If the answer is yes, then we have a responsibility to act and act soon.

Moving from a “sick care” to a “preventive care” model

In the EU, more than 60 million people are living with CVD, with close to 13 million new cases diagnosed every year. That’s more people than the population of most European nations. Because of a lack of adequate education and preventive care, we have created an invisible nation of people who go undiagnosed or undertreated until they experience a major cardiovascular event.

That’s due in large part to a mid-century model of healthcare, one which focuses on taking care of the sick – or the “SICK care model”. In this model, we are concentrated on reacting to illness and disease rather than proactively focusing on promoting HEALTH, wellness, early detection and prevention.

However, to be ready for the future and to tackle future disease curves, we need to reimagine how our healthcare systems across Europe treat patients. We must move from a system that takes care of the sick to one that preserves wellness, because a reactive approach to healthcare will always cost us more in terms of access, system burdens, care delays and inequalities. And as our understanding of health – and our ability to improve outcomes through innovative medicines – continues to evolve, we have an opportunity to save more lives lost due to CVD through population health approaches.

We already have the medical innovations to do this. Eighty percent of CVD-related deaths are preventable with interventions that exist today. New therapies and therapy access models to treat CVD are still needed, but we have not used what we already have to its fullest potential.

For patient care to improve, we must focus on changing care delivery, payment and funding, and even the regulatory framework in a coordinated way. We must be as innovative in delivering medical innovation to patients as we are in creating therapies. We must prioritise screening and early detection programmes and improve adherence to treatment guidelines to help patients access innovative medicines. Building data and digital capabilities can also help us change CVD care delivery, allowing us to monitor outcomes and interventions in a meaningful way and identify the right interventions for patients.

The health inequities we see across European countries must also be addressed. Not all countries are affected by CVD in the same ways; there is a greater than six-fold variation in mortality between Member States. A coordinated and harmonised approach is crucial to ensure all EU citizens have equitable access to prevention tools and to close the inequality gap across Member States.

?I see so much potential for the future of European health systems, and the path forward has never been clearer.

Partnering to bend the life expectancy curve

I am acutely aware that there is no one-size-fits-all solution to improving CVD care delivery for European patients. But I firmly believe that collectively we must change what we do to drive health system behaviour change. We must be partners with health systems to address the burden of CVD, overcome access barriers and improve population health. Partnerships will be the common thread in our solutions for these diverse challenges affecting life expectancy.

We are also continuing our legacy of transformative collaboration with public-private partnerships, including one with the Ministry of Health in Belgium, which aims to lower rates of atherosclerotic cardiovascular disease (ASCVD) by improving access to life-saving medicines. Additionally, we have partnered with the Global Heart Hub to raise awareness among policymakers and healthcare leaders and encourage them to act on cardiovascular health.

But these initiatives are just the tip of the iceberg. If we can pool our strengths across private and public sectors to prevent diseases like CVD, we could make a monumental difference in European heart health and life expectancy.

I see so many opportunities to leverage our collective strengths to enhance and extend lives across Europe. But, to do so, we must think differently – we must think bigger.

How else can organisations work together to increase life expectancy in Europe? I challenge those in the private and public sectors to consider how their strengths play into our industry's shared goal: to improve and extend lives.

Let's address the CVD public health crisis together.

Let's live longer together.