Where is health in your priority list?

Say there is contrasted and peer-reviewed scientific evidence of a method that would extend your life a 10% but it comes with associated sacrifices. Would you take it? In other words, how much are you willing to sacrifice for a future better health and longer life to come? This seems like a straightforward question with an objective answer but you would be surprised at the general consensus.

In the field of economics similar questions have been formulated. Would you take $100 today or $200 in two weeks. Against all (economic) odds, Daniel Kahneman and Amos Tversky, showed that most of the people would fly with the immediate pocketing. Is this psychological myopia? It sure looks like it. What is worse is that, in general, the western world does have a much more sense for economics than for health, which makes the psychological myopia a much worse circumstance. In his book The innovators prescription Harvard professor Clayton Christensen claims employees are much more likely to care for their economic health than for their actual (physical) health. He puts a clear example of this fact by comparing a hypothetical corporate health scheme, confronted with a pension scheme increase, both of them with the same budget. When employees are faced with such a choice the likelihood of going for the economic improvement surpasses that of the health.

Such myopia becomes more relevant when we talk about patients (unhealthy) and not employees (presumably healthy). Patients are much more likely to be compliant with doctors prescriptions when their condition hurts than when it does not. When dealing with chronic conditions this makes for a big difference. Diabetic patients make up for a good example: there is a clear short loop-back when it comes to the treatment. Miss your medication target and you will quickly get the consequences in symptoms. Hypertension on the other hand, is the book example where skipping pill intake is not going to make subjective difference. The result: non-compliance in hypertension is huge. Different articles in scientific journals report non-adherence to medication rates between 40 and 60%!!

Just to frame this: you have been diagnosed with a chronic condition, for which you would need to take action, and you do not. This directly affects your risk of dying from a complication of the condition. But it does not stop here. I was recently shocked to read the article linked below recently.

So this is even more counter intuitive. You have two alternatives, change your diet or take a pill. You do not want to change your diet, because, hey you like tasty (salty) food. So you'd rather take a pill and not sacrifice your tasty food, so Doctor please prescribe this pill. The doctor does prescribe it, but guess what, statistically only about 50% of the population with such pill will actually take it. But this is even worse because for those which the pill takes effect limiting the blood pressure, not only they do not reduce or keep the same salt intake, they actually increase it!!!

All in all it says a lot about what place does health take in the priority list of the patients these days (definitively lower spot than either tasty food or the disturbance of setting a daily alarm for pill intake). Additionally it shows how the myopia actually blurs the lines between layers of the Maslow hierarchy of needs. It is clear that you should first think about your health and longevity than about how good your food tastes (or your financial health for that matter).

This response opens up lots of lines of action in the pharmaceutical and medical technology fields. It is key to be able to diagnose properly, and treat accordingly. It is also key to develop the drugs and devices able to support the treatments and to test in clinical trials that indeed interventions and treatments are effective. But all of the above just vanishes to thin air when the specific subject accurately diagnosed with a condition, gets the right treatment from the pharmacy but just does not follow the doctors indications and does not take the pill or changes the habit (food intake).

All in all, it might be more effective to work on the patients' habits and enforce some sort of compliance than to tweak their medication. What about, for instance, gamification of pill intake? (writing this I did realize how bad it sounded and how many bad ramifications it could have, but hey, still a valid point!) or technology enabling to check whether certain diet changes are effective? I am sure you can think of many dream scenarios in this direction that could change the situation for compliance.

Lack of compliance is nothing new (gyms even made a business model around it) but is something we should all become more aware of. To come back with the point at the beginning of the article, there is scientific evidence of methods to extend lifespan, but they come with challenging (some may say ultimate ) compliance action points : fasting.

To sum up, I hope this article speaks to your inner sense of compliance and makes you realize how non-nonsensical the order on our priority list is. It is up to you how to change that.

DISCLAIMER: This article presents my subjective view on a topic. This does not represent the thinking of my employer, previous employers, my customers or any other affiliation I might have or have had in the past.

#healthcare, #medicine, #medtech