Where Should Our Health Focus Be? | Triage Thoughts Ep. 200

Updated on February 23, 2023

Where should our health focus be? There are so many things that you could be focusing on, so how do you narrow down your focus to the high-value things so you can protect your health long term? In this podcast episode, we discuss this and more.

Show Notes

Firstly, healthcare is not the same as medical care.

America has great medical care, but their societal healthcare is very lacking.

The Three Legs of the Healthcare Stool

Prevention
Treatment (what we traditionally think of as medical care)
Care

Prevention is better than cure and that is what we focus on when we personally discuss health here, because we are not doctors, and doctors are only one part of the healthcare landscape. However, it must still be integrated into the wider framework of healthcare/medical care.

Prevention is both what the individual does and what governmental and NGO bodies do to prevent disease and encourage flourishing.

Prevention is basically just risk reduction, as you can’t account for simple bad luck.

You listening to this, as an individual, have the ability to shift the focus of healthcare from reactionary to prevention. There are barriers to this, both in how society is currently structured, but mainly in how your tax money is being allocated. However, we would consider it your civic and moral duty to reduce the burden on the healthcare system.

How much disease is preventable?

roughly 25-40% of deaths are preventable (depending on the source and country)

The return on investment from focusing on prevention is likely far greater than the return on investment focusing on treatment. However, that is a hard sell to the current medical system, as I don’t think many people would be happy to see hospitals less well funded because that money has been portioned to preventive services which don’t have as immediately obvious benefits.

Using Eurostat data:

On average in the EU, public and private expenditure on preventive care accounted for 2.8% of total health expenditure in 2018, with the highest shares recorded in Italy (4.4%) and Finland (4.0%).
In contrast, the lowest share of preventive care expenditure was recorded in Slovakia (0.8% of total health expenditure), followed by Greece, Cyprus and Malta (all 1.3%) as well as Romania (1.4%).
In the UK the number is 5.1%, and should be noted that they are the best in all of Europe, and Ireland ranks relatively low with 2.6% (below the average of 2.8% and basically half the UK allocation).

What that looks like on a per-person basis is slightly different though, and is arguably more important to us as individuals.

The average EU investment was €82 per person.
Sweden (€165 per inhabitant), Finland (€152), Germany (€148) and the Netherlands (€146) in 2018, while it was lowest in Romania and Slovakia (both €8 per inhabitant).
The UK figure is 185€, and it is 120€ in Ireland. Switzerland is at the top with 219€ (this number can be deceiving due to actual healthcare and living costs)

What can we do for prevention then? Where should our focus be?

Baseline Health practices (discussed in the previous episode)

Risk stratification for you (discussed in previous episode):

What do people in your family die/get sick from?
What do people in your area die/get sick from?
What do people in your career die/get sick from?
Which is more likely for you?
Are any of these preventable?
Are there things you can be doing now to prevent future disease/illness?
Are you wasting time focusing on stuff that is less likely to happen (i.e. worrying about terrorist attacks rather than heart disease?)

What are the major killers of humans worldwide?

The global totals for 2019 (according to WHO):

The world’s biggest killer is ischaemic heart disease, responsible for 16% of the world’s total deaths.
Stroke is the 2nd leading causes of death, responsible for approximately 11%
Chronic obstructive pulmonary disease is the 3rd, responsible for 6%
Lower respiratory infections remained the world’s most deadly communicable disease, ranked as the 4th leading cause of death.
Neonatal conditions are ranked 5th
Trachea, bronchus and lung cancers are 6th
Alzheimer’s disease and other forms of dementia ranked as the 7th leading cause of death.
Diarrhoeal diseases are 8th
Diabetes is 9th
Kidney diseases have risen from the world’s 13th leading cause of death to the 10th

(Of note for higher-income countries, hypertensive heart disease, colorectal cancer and lower respiratory infections features in the top 10)

Total for 2020 in America (according to CDC):