How is it that the US spends the most on healthcare but has one of the lowest life expectancies of all wealthy countries? (The exact numbers are $9,400 per person, 79 years old, and 31st.)
Maybe we in health care have been looking at it all wrong for too long.
A healthy way of life and living long
Researchers from the Harvard T.H. Chan School of Public Health used data from the well-known Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS) to look at how health habits affect how long people live. This means that they kept records on a very large number of people for a long time. From 1980 to 2014, the NHS kept track of more than 78,000 women. From 1986 to 2014, the HPFS kept track of more than 40,000 guys. This includes more than 120,000 people, 34 years of information about women, and 28 years of information about men.
The researchers looked at NHS and HPFS data from regularly given, validated questionnaires about diet, physical exercise, body weight, smoking, and alcohol use.
What exactly is a good way of life?
Previous research has shown that these five places have a big effect on the risk of dying too soon. Here’s how we identified and measured these healthy habits:
1. A healthy diet, which was calculated and rated based on the stated intake of healthy foods like vegetables, fruits, nuts, whole grains, healthy fats, and omega-3 fatty acids, and unhealthy foods like red and processed meats, sugar-sweetened drinks, trans fat, and sodium.
2. A healthy amount of physical activity, which was measured as at least 30 minutes of moderate to vigorous activity every day.
3. A healthy body weight is between 18.5 and 24.9 on the body mass index (BMI) scale.
4. When it comes to smoking, there is no safe amount. “Healthy” meant that the person had never smoked.
5. Moderate alcohol consumption, which was measured as between 5 and 15 grammes per day for women and 5 to 30 grams per day for men. Most drinks have about 14 grammes of pure alcohol in them. That’s enough for 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of drinks that have been distilled.
Researchers also looked at data about age, race, and medications, as well as comparison data from the National Health and Nutrition Examination Surveys and the Centres for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research.
Does living healthy make any difference?
It turns out that good habits matter a lot. This study found that people who had all five habits lived 14 years longer than those who didn’t (if they had all five habits at age 50). People who didn’t do any of these things were much more likely to die from cancer or heart disease than they should have.
The number of these five healthy habits was also used to figure out how long a person could live. Men and women both lived two years longer if they had just one good habit. It didn’t matter which one. It wasn’t a surprise that people lived longer if they did things that were good for them. I wish I could repeat their graphs for you because they are so cool. But if you are really interested, you can find the story online and the graphs on page 7. See Graph B, “Estimated life expectancy at age 50 according to the number of low-risk factors.”
It’s a big deal. And it backs up a lot of similar studies that have been done before. Using data from the Health and Retirement Study, a 2017 study found that people 50 and older who were a healthy weight, had never smoked, and drank booze in moderation lived an average of seven years longer. A 2012 mega-analysis of 15 international studies with more than 500,000 participants showed that unhealthy lifestyle factors like poor diet, lack of exercise, obesity, drinking too much alcohol, and smoking were responsible for more than half of early deaths. And the list of studies that back this up goes on.
So what is our big problem?
The writers of this study point out that in the US, we spend a lot more on making fancy drugs and other treatments for diseases than on trying to keep them from happening. This is a very big issue.
Experts have said that the best way to help people make healthy changes to their diet and lifestyle is through public health efforts and policy changes that affect the whole community. (Kind of like how laws require people to wear helmets and seat belts.) We have had some success with laws about tobacco and trans fats.
Big business has a lot of problems with that, of course. Big companies won’t sell as much fast food, chips, and soda if we have rules and laws that help us live better lives. And companies that are determined to make money at the cost of people’s lives are very angry about this.