Democrats and Republicans finally have agreed on something: Rising health costs eventually will overwhelm the federal budget and make health care unaffordable for many Americans.
Health care expenditures in the United States increased by $1 trillion in the past 10 years. The average annual premium for employer-based health insurance has gone from about $6,000 in the year 2000 to nearly $16,000 per year. We can’t continue doing health care the way we have been doing it.
It is time to incorporate a low-tech solution into our high-tech health care system. An article published in the Journal of the American Medical Association identified lifestyle as the cause of about 1 million deaths in the United States each year, half of the nation’s total deaths. Smoking, poor diet and physical inactivity caused the majority of these deaths.
“Poor diet and physical inactivity may soon overtake tobacco as the leading cause of death,” the authors concluded.
In health care today we focus a lot on numbers, such as blood pressure or cholesterol levels, that can reveal an underlying problem. Diabetes, high blood pressure, heart disease and even cancer are often the symptoms or the results of unhealthy lifestyle. Rather than simply lowering the cholesterol level or blood pressure numbers, we need to focus on what is causing them to go up. Disregarding the underlying causes and treating only risk factors is somewhat like mopping up the floor around an overflowing sink instead of turning off the faucet.
Study after study show us how lifestyle change is the solution. The National Cancer Institute tells us that physical activity can reduce the incidence of colon cancer by 30 percent to 40 percent and breast cancer by 20 percent to 80 percent. In a recent study in Germany, more than 23,000 people were followed for nearly eight years to see if healthy lifestyle factors could help reduce chronic disease. The four healthy lifestyle factors were: never smoking, body mass index (BMI) less than 30 (that is, not obese), at least 3.5 hours of physical activity per week, and simple healthy dietary principles, including high intake of fruits, vegetables and whole grains, and low meat consumption.
The study found a reduction in diabetes of 93 percent, heart attacks were reduced by 81 percent, strokes reduced by 50 percent, and cancer reduced by 36 percent. We don’t have any medications or high-tech treatments that give us these kinds of results. Simply maintaining one of these healthy lifestyles, not being obese, resulted in a 67 percent cumulative reduction in these chronic diseases. Early prevention does save lives.
The effects of lifestyle change have been seen locally at the Richmond Area Health Center. For the past three years, we have been working with patients to make a difference through lifestyle changes. Using simple strategies, motivation and affirmation, we help our patients to make lifestyle changes. Over the past three years, about 900 patients have lost a collective weight of 11, 614 pounds — equal to the weight of an average-size elephant.
More importantly, these people have overcome personal challenges and are living healthier and feeling better. The number of medications I have prescribed to patients has dropped by 45 percent, while the number of diagnostic tests I have ordered has dropped by 64 percent during this time period.
I have been able to stop more medications than I start for patients with chronic diseases such as diabetes and high blood pressure because patients have chosen healthy living over medications. When asked if they’d like to try to stop some of the medications they take and make lifestyle changes instead, many choose lifestyle changes. Medications for blood pressure, diabetes or cholesterol, for example, often can be stopped when healthy lifestyle changes are made.
Patients need and deserve a perspective; they deserve to be part of their health care decision-making. They need strategies and someone who listens, someone who gives them what I like to call a “relationship of hope.” This is not health care reform; this is health care transformation, transformation through healthy living.
What is going on at the Richmond Area Health Center is not happening in a vacuum. In Allagash, Paula Charette, a nurse practitioner, has started a similar healthy living program in her community. Through the encouragement and support of Charette and her staff, patients have lost a combined total weight of 295.5 pounds since February. At Swift River Family Medicine in Rumford, Emily McCue, also a nurse practitioner, initiated a similar program, with 478 pounds of weight lost by patients since June.
The Maine Nurse Practitioner Association recently has joined in with its support to promote healthy lifestyle at practices throughout the state.
Healthy lifestyle is contagious. With a greater emphasis on healthy lifestyles, on simple strategies to improve health, on building relationships of hope with patients, health care can be transformed. We health care givers need to do more “dancing” and less “wrestling” with our patients. It may be faster to give medications, to treat the numbers or the symptoms but then the health care system will need to keep mopping up around an overflowing sink. It’s time for patients and health care givers to work together to focus not just on the symptoms but on the causes of health problems.
Health living is the best revenge for our ailing health care system.
Tom Bartol is a nurse practitioner at the Richmond Area Health Center and on the board of directors of the Maine Nurse Practitioner Association. He can be reached at: [email protected]