Are preventive health interventions really worth it?
July 25, 2012
One would think preventive health interventions would make a tremendous difference to the longevity and overall quality of one’s life. And after all, isn’t that the purpose of preventive health? Many health care providers and organizations have offered varying recommendations.
A recent study by The Partnership for Prevention looked at 25 preventive health care services and attempted to rank them according to the number of additional years of quality living that could be expected from these interventions on a group of same-aged persons in the United States over their lifetimes.
These preventive services include a variety of immunizations; counseling for smokers and excess alcohol drinkers; colon, cervical, and breast cancer screening; aspirin therapy; vision, hearing, diet, diabetes, depression, hypertension, cholesterol, osteoporosis, and obesity screening; and injury prevention counseling. The study showed that three interventions – aspirin, childhood immunizations, and tobacco-use screening with brief counseling – save the most quality-adjusted lives. The other interventions show progressively less effectiveness.
If current compliance rates are used, the average life gained per person from the above interventions equals .76 years or nine extra months of quality living. It doesn’t seem like very much over a 70-80 year lifespan, does it? Compare this to research estimates of one to two years of increased longevity in regular exercisers, and eight to 10 years of increased longevity in people who regularly go to church.
What are we to make of all of this? Certainly, nine months is not a lot of time. As a cartoon from The New Yorker noted: “… the problem with doing things to prolong your life is that all the extra years come at the end, when you’re old.” On the other hand, time seems to accelerate and become more precious as we age, and another nine months with loved ones could be worth a considerable amount.
The truth, however, is that the above estimates are averaged out over the entire population; any given individual might have a large portion of their life saved by some of the above interventions. The trick, then, becomes how to decide who would benefit from which intervention and how to select out these high-risk individuals. Although we can make some educated guesses, this does not always work; sometimes mystery prevails. One may wonder if the enormous outlay of time and money (estimates are over $200 billion annually) is worth the small increase, on average, in quality living.
My feeling is that preventive interventions need to be put into a larger perspective. As Socrates said when found guilty of heresy and sedition: “The unexamined life is not worth living.” Consider the following perspectives when examining your life and health: Look for your passion; live a life filled with meaning and purpose, love and belonging, connection and relationship. First and foremost, pay attention to what really matters; and then, if you are so inclined, see your friendly health care provider for a discussion about the risks and benefits of preventive health care interventions.
Dr. Larry George is a board certified family practitioner with High Country Healthcare in Silverthorne.