The good, the bad and the digital
The good - Death rates are falling
Australian death rates from cardiovascular disease continue to fall according to the latest report from the Australian Institute of Health and Welfare (AIHW) released this week. This may seem like cause to celebrate, and whilst the improvements in clinical research, treatment and medical care that have largely contributed to this decline are very commendable, this win masks Australia's unhealthy little secret - a decline in prevention.
The bad - Preventable risk factors on the rise
The incidence of risk factors associated with cardiovascular disease is on the increase. These include poor nutrition, high blood pressure and cholesterol, physical inactivity, obesity and smoking. Whilst there have been some improvements (a continued decline in smoking), 95% of Australians still have at least one of these risk factors, and two thirds have three or more of these risk factors.
According to the AIHW:
- 34% of Australians have high blood pressure, up from 32%
- 63% were overweight or obese, up from 56%
- 15% still smoke daily
- 45% don't get enough exercise
- And 5% have diabetes
Prevention better than cure
Whilst it's intuitive that prevention is better than the cure, this doesn't seem to be playing out in practice. The prescription of a magic pill (or indeed a cocktail of drugs) to tackle high blood pressure or reduce cholesterol levels is all too alluring when compared with the education and investment required to address the underlying lifestyle issues that are contributing to Australia's health burden.
The role of the General Practitioner
Medical appointments would seem to provide a perfect avenue to talk about diet and lifestyle changes, yet this doesn't seem to happen in practice, why is that? According to Professor Caryl Nowson of Deakin University’s Centre for Physical Activity "Medical graduates in Australia are ill equipped to identify and appropriately manage nutritional issues of patients". Dr Rebecca Jarvis, a GP who works in a practice with a focus on lifestyle medicine explains "Medical students would benefit from more education on nutrition". Even if the issue of GP education was solved, a 10 to 20 minute consult simply isn't long enough to address both the patient's immediate need, as well as coach them in preventive health strategies.
The Digital - The trends that could make Australians healthier
A number of key trends are emerging that may shift Australians’ attitudes to preventive health:
- The Quantified Self – this decade has seen the rise of the wearable and life logging. Millions of Australians now track each step with devices from FitBit, Garmin, Striiv and even the smartphone, with the ability to seamlessly share this data on social media. There is no doubt that wearables have significantly raised awareness to address inactivity, but few yet address the important risk factor of nutrition.
- Corporate Wellness Platforms – many Australian organisations now have corporate wellness and health screening programs in place in an effort to protect and reward their most important asset. Healthtech start-ups such as Wellteq now offer a plug and play corporate wellness platform that leverages gamification and behaviour change principles to improve lifestyle and enhance productivity.
- The 12 Week Body Transformation – thanks to The Biggest Loser, traditional Weight Watchers style plans have now evolved into lifestyle changing body transformation programs. Technology also has a key role to play here, for example healthtech start-up Feel Great Challenge delivers tailored nutrition and exercise programs fully integrated with wearables designed to permanently change lifestyles.
- The Digital Lifestyle Coach – US digital wellness platform Noom has yet to gain traction in Australia, but in other markets claims to have changed the lives of 45 million people by helping them to form new lifestyle habits in 16 weeks.
- Inner Health Tracking – surprisingly with all this tech, there are limited ways to measure the real impact of lifestyle changes on your health. Has increasing your number of steps actually lowered your cholesterol? Has cutting back on alcohol improved your liver function? Is a vitamin D deficiency leaving you fatigued? The only real way to answer this is with pathology. Enter Australian healthtech start-up i-screen which provides digital tracking of your more sensitive health data - your blood.
The future for preventive health
It’s clear there’s still vast room for improvement to address chronic disease prevention in Australia, which is still responsible for 83% of all premature deaths in Australia and 66% of the burden of disease. It’s also clear that advances in digital technologies have a key role to play in Australia’s preventive health agenda - “Health conscious customers are becoming more interested in the meaning behind their activity stats,” said Dan Bartel, Garmin VP, “as in I like seeing the data, but how does it correlate to my overall wellbeing?”. i-screen addresses this issue by democratising pathology services and enabling the digital tracking of improvements or declines in important health biomarkers. These insights inform the development of very targeted lifestyle changes designed to optimise health from the inside out.
The question still remains in the integration of all this health data - Apple already offers the Health app, which consolidates health data from the iPhone, Apple Watch and third-party apps, although the loop back to the general practitioner has not yet been closed. It seems that private insurers will likely beat the public system in becoming the first consumers of this aggregated data, and when the insights translate into individualised insurance premiums, we will likely see a further shift in Australians' attitude to preventive health.