The thinking goes that if we are going to reduce the rates of cardiovascular disease (CVD) we need to look at the things that cause CVD, at the people who are suffering from CVD and at ways of helping to reverse CVD. The same applies for other maladies and forms the basis of medical research and public health advice as we know it. It's a difficult thing to explain but I firmly believe that we are approaching things from the wrong direction.
I was a police officer in a former career and I got increasingly frustrated at how my performance was measured. Being a state-run service, the Government wanted to see key performance indicators to check we were working adequately. The fact that the selection process was a rigorous and exacting procedure, designed to ensure only trustworthy public servants, who were committed to upholding the letter of the law, were selected was clearly not sufficient to preclude an officer from having to submit a detailed list of jobs done to prove that he or she had played an active role in improving society. So it was then that forms were submitted to senior management documenting the number of arrests, number of fixed penalty notices issued and suchlike. I tried in vain to point out that this was a backwards way of looking at things; explaining that if I was doing my job properly there should be a reduction in crime and disorder and therefore less arrests and parking tickets, etc.
And so it should be with disease and illness. If healthcare professionals - across all disciplines - are doing their jobs properly, there should be less illness and disease.
The current model seems to currently be looking solely at people who have presented with issues of ill health and working backwards from there to form associations with various habits, dietary preferences or, as the BSLM would call it, ‘lifestyles’.
Yes, we need to look at disease to understand its symptoms, its pathology and any methods by which we can treat and manage the disease. Once a disease or illness has taken hold every practical measure must be put in place to either rid the sufferer of the cause or, at the very least, attenuate the severity of the symptoms. This is why the pharmacological industry exists. And so it should.
However, when it comes to prevention of disease and illness, I believe that we need to turn around 180 degrees. We need to look in the opposite direction.
As a runner of ultra-marathons, I am of slight frame and very good general fitness. If I had a pound for every time someone looked at my body shape and said, “You run a lot so you can eat what you want”, I’d be considerably wealthier than I am now. I’ve given up trying to get people to flip this way of thinking to the more accurate, “I can run a lot because I eat a healthy diet”, as people just don’t seem to be able to work that one out.
But it’s the same thing when looking at good health and the prevention of illness. Rather than looking at what the ill people have been doing, recording all manner of metrics and then saying, “don’t do this or that, because that’s what will get you ill”, we should be looking at healthy people, recording their metrics and saying, “do this or that, because that is what will keep you healthy”. Why aren’t researchers at the end of local running races, asking people over the age of 60 about their lifestyles? Surely the finishers over the age of 70 at the local Park Run must be doing something right? Something that might even be worth looking into. Why aren’t medical professionals who give pill-free pensioners their regular check-ups asking for tips on how to stay pill-free? Health insurance companies must have reams of data on people who never make a claim.
It seems absurd to me that, with the Nation’s health at stake, such a resource (i.e. healthy people) is neglected. The best preserved, shining examples of physical fitness and quality ageing are an untapped mine of living, breathing data. The truth is out there, as they say, we just need to make sure that we are looking in the right places for it.