Public health and prevention: don’t wait until it’s too late!

Who wants to live forever? A tough question, we have to admit. Whatever your very personal answer to this question, we believe the majority of people would only agree to live forever if it would mean to do so in the right conditions: with a certain quality of life and —often taken for granted— in good health.

Now, looking at the so-called blue zones of the world, where a very high number of centenarians live, what would you say if we told you that you could (almost) live forever? And more importantly: what would you be willing to do for it?

According to Eurostat, the current life expectancy at birth in Luxembourg is 80 for men and 84.5 for women. However, when it comes to years spent in good health, things look very different: in Luxembourg, you get 63 years in good health on average.

That means around 15 to 20 years living with cardiovascular diseases, cancer, chronic respiratory diseases and diabetes, to name only the most common in Europe. It also means taking 13 medications daily on average after the age of 65.

The bitter pill: in only 20% of cases, these diseases are a result of a genetic disposition. In reverse, 80% of them could have been prevented if it wouldn’t have been for wrong and harmful habits. Being healthy, in younger years as well as in retirement, is therefore more of an active decision than a circumstance we have no control over.

In this blog, we want to discuss the topic of health prevention, what role it can play to relieve our future healthcare system and what you can (or should) do now to improve your health in later years. It’s inspired by the conference “Healthier for longer”, which was held on 28 June 2022 at PwC Luxembourg.

Healthcare and prevention: a personal and political matter 

Looking at these numbers, it would be fairly obvious to assume that you are the only one responsible for your personal health and wellbeing. This is, however, far from being true for mostly two reasons.

First, living a healthy life is based on multiple factors and is a result of socialisation, education, level of wealth, access to medical facilities and also the political will to advocate and inform about certain health risks and issues. Second, a society is only as healthy as its citizens.

Being healthy, therefore, is a very personal and individual matter but has also consequences for society as a whole, and demographics have an important role to play. Let’s take France as an example. It’s estimated that by 2050 around 50% of the total workforce in France would need to work in the healthcare sector to keep up with the workload of looking after and curing the by then elderly baby boomer generation.

In Luxembourg, the situation is less intense as a big group of professionals and expats are joining the country in their younger years  and plan to go back to their home country for their retirement life. That said, the dynamics and trends are however the same throughout Europe: the population is ageing, and the already battered healthcare systems are overburdened and on the edge of collapsing.

An ageing society, however, isn’t the problem per se as “being old is not a question of age, but rather of your health status,” as says Éric Boulanger, Professor for Geriatrics & Ageing Biology at the University of Lille. Of course there are diseases that are directly linked to ageing, such as Alzheimer’s or Parkinson’s disease, where challenges remain when it comes to prevention. But to fight a lot of illnesses which frequency increases with age —such as cancers as a result of smoking—  adopting a prevention-focused healthcare policy could be a turning point.

As put by Guy Brandenburger, Partner and Health Industries Leader at PwC, our healthcare systems are truly “sick care systems”, as their main goal is to heal and treat diseases instead of preventing them before they even occur. A stable and sustainable health policy would thus focus much more on avoiding diseases through preventive measures and encourage all members of society to stay fit and in good health. 

In Luxembourg, the topic of prevention should become the top priority for the next elected Government and Minister of Health in 2023. A significant objective for the government could be to try to push the average age in good health from 63 to 68, also as this could mean to spare EUR75mn yearly (EUR15mn for each year that we gain in good health). 

The price we pay for an unhealthy lifestyle is therefore not only what we personally would have to sacrifice by giving up a certain quality of life one day; we as a society quite literally have to pay for our care even more.

What you can do
I decide to age well

1. Don’t waste any(more) time

The WHO acknowledges three types of prevention. Primary prevention refers to actions aimed at avoiding the manifestation of a disease. Secondary prevention deals with early detection when this improves the chances for positive health outcomes. Tertiary prevention involves the prevention of complications in people who have already developed disease, and in whom disease prevention is no longer an option.

You want to start as early as possible to invest in your health to especially avoid entering the phase of tertiary prevention; that is rather a stage of damage control than trying to reinstall the healthy status quo. This is especially true when it comes to diseases that influence your autonomy, such as mobility, hearing and visual capacities. Also, there is no age to train your brain, so don’t neglect your cerebral activity. 

In fact, there are three potential scenarios that await you in older age: robust, frail, and dependant.

Stage of functional global ageing
Source: Presentation Prof. Eric Boulanger, “Healthier for longer” conference, 28 June 2022. 

The sooner you start, the better. But don’t be discouraged: it’s better to start late than never. 

2. Don’t procrastinate on your regular medical check-ups

Starting your journey to health is firstly done by booking an appointment with your primary care physician. Together and in consideration of your age, gender, family history and genetic predispositions, you should regularly undergo preventive check-ups and get your vaccination refreshed if needed. Check out the table for a non-extensive list of the most common preventive medical check-ups.

3. Keep track of your health

Now that you brought attention to your overall health status, a very good method of keeping yourself motivated is to track your progress and health journey. Measuring the quality and length of your sleep, the number of steps per day or having regular knowledge about your cardio-related data, such as blood pressure and pulse, can help you visualise where you come from and where you are heading. It can also help you flag and quicker react if some methods don’t work out for you.

Common preventive medical check-ups
Click to enlarge | Source: Kassenärztliche Bundesvereinigung

Apps and measurement devices have developed to become a reliable tool for medical professionals when it comes to prevention, as can be seen through the app Tempoforme, which aims at inviting the inhabitants of a specific territory (so far applicable in the North of France) to assess their state of health. Afterwards, an algorithm establishes a score and a first evaluation of the user’s functional state of health that can be downloaded and shown to the primary caregiver. 

4. Learn from the blue zones

The blue zones are a concept that includes five geographic regions, namely Loma Linda in California, Nicoya in Costa Rica, Sardinia in Italy, Icaria in Greece and Okinawa in Japan, where an exceptionally high number of centenarians live in good health.

Studies on these regions and their outstandingly healthy elderly population show that, albeit the big distance separating the regions, some similarities remain. These include their diet and nutritional intake, the amount of physical activity, but also their social roles and strong bonds in their communities.

Based on these studies, we can make up ten secrets for a healthy long life:

The centenarians of the blue zones…

  1. …are moderately physically active
  2. …have a purpose in life
  3. …pursue a family-centred activity
  4. …are socially engaged in their community
  5. …avoid stress
  6. …have a lot of spiritual reflection
  7. …are often semi-vegetarian and eat natural unprocessed products coming from the earth (fruits, vegetables, meat) and the sea (fish, seafood)
  8. …avoid an excess in caloric intake or even follow a restrictive die
  9. …have moderate alcohol consumption
  10. …live in sunny and unpolluted regions.


5. Be a positive influence to others 

As mentioned before, living a healthy life is a result of multiple factors, among which socialisation and education are important elements. In this regard, we want to draw your attention to the so-called “First 1,000 days”, referring to the time of conception until the second birthday of a child.

These first 1,000 days of the life of a human being are so very vital to his or her future health and represent a unique period of opportunity when the foundations for optimum health and development across the lifespan are established. On the other hand, this timespan holds major risks, as the effects of neglect and malnutrition can be irreversible and last a lifetime, leading to impaired brain development, lower IQ, weakened immune systems and greater risk of diseases later in life. 

This dependance on the good sense of responsibility of others in the first days of a person’s life make it clear that we —as a society, as parents, as teachers, as organisations and employers— hold a responsibility to educate, sensitise and lead by example to protect our children’s health as is it us who have the power of passing to the next generation.


Conclusion

The COVID-19 crisis has given us a foretaste of what it means when primary medical care is pushed to the limit and what a society goes through if a significant part of their members become vulnerable or is potentially threatened. The key lessons learned from the pandemic and the imperativeness of a stable healthcare system make it clear that we need to, preventively, reform our healthcare system as long as we still have the chance to. 

Furthermore, every member of society has a role to play and a responsibility to carry; as an employer, organisation, or colleague, you should use your platform and reach out to the broader community to advocate for health topics and also invest in fostering a healthy internal work environment. Because, as usually, the solution is sometimes pure and simple: the only youth elixir there is to live forever is prevention today.

What we think

Guy Brandenbourger, Advisory Partner, Industry & Public Sector, Healthcare Leader at PwC Luxembourg
Guy Brandenbourger, Advisory Partner, Industry & Public Sector, Healthcare Leader at PwC Luxembourg

The benefits and necessity of shifting healthcare policies to centralise prevention are vital and need to become a priority for policy makers in Luxembourg. This is not about economic and structural efficiency: it is a question of how we want to live as a society in the future.


If you want to learn more about the conference “Healthier for longer”, you can watch Guy Brandenbourger and Éric Boulanger on RTL Today ThinkLab, read the following article in Paperjam and listen to Jacques-Félix Wirtz intervention at RTL Radio.

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