2020 has provided us with plenty to think about; what lessons do we carry forward from living through a pandemic? Many have focused on their health, leveraging a more profound awareness that health is wealth. Health is often conflated with healthcare, something we all need to prevent and treat disease, but healthcare alone is necessary but not sufficient.
Health happens in how we live, where we live, how we spend our days, and who we spend our time with, day after day. Genetics also plays a role, but the behaviors we engage in daily and the environment we live in play a more prominent role in our overall health status.
A new commentary in NEJM Catalyst by Kevin Volpp from the University of Pennsylvania reflects the need for a broader lens for health outcomes. Currently, the USA is 36th globally for life expectancy even though health care expenditures outpace every other country. Healthcare costs now account for 18% of GDP, up from 5% in 1960. Chronic conditions also rose in this timeframe, and today 42% of Americans have obesity. Commute times mean people spend as much time in their cars as they do outdoors, 6% versus 7%.
Technology has had a profound impact on our lives, and the authors argue that our current methods of impacting health outcomes are insufficient, outdated, and outmoded. They say that harnessing technology to support the day to day changes in our health behaviors is warranted.
January 1 is just around the corner, and in regular times, gyms get full with new hopeful members looking to improve their health and wellbeing; come March, those gyms are back to baseline use. This is an annual predictable event, one the fitness industry relies on for healthy revenue streams. As humans, our preferences and needs change over time; what if we signed a “pre-commitment contract” in which we agree to pre-commit to a set of future choices. These contracts can be specific and simple and may be easier to stick to than a lofty complex goal of losing weight, which requires a comprehensive set of behaviors and actions.
The authors conceive technology as an ally. AI algorithms could improve healthy meal planning by sourcing ingredients, and recipes tailored to a family of any size. This can work for those who can afford it.
Data from scooters and e-bikes, when analyzed, can provide invaluable insights for urban planners and create new ways for people to move around their neighborhood and decrease reliance on cars. We also have smart homes now, with temperature and lighting controls, which can, in theory, lead to more prudent energy consumption. The authors also reflect on augmented reality, made famous by the game Pokemon Go, which can get people outside and walking around their neighborhoods. How are we leveraging all these new tech-enabled tools to support health?
Technology can give us more data to understand our routines and use our data to make different decisions that impact our health. Policymakers may also need to broaden the lens of data used to map our lives so investment in policies that move the needle can be crafted.
Data tend to sit in siloes, and it takes effort, planning, and time to bring non-traditional data sets together. Health systems are actively looking at the Social Determinants of Health (SDOH). The next frontier in this is to better leverage data from smartphones, apps, sensors, and wearables if we are to have an opportunity to go upstream and truly impact health. The pandemic has shown how fragile our social systems are in the USA and how frayed the social fabric has become. We have a chance to rebuild as we move to life with a vaccine and a return to some new sense of normalcy by mid-2021.
Wishing you all a happy, healthy 2021!
Thanks for reading – Trina
(Opinions are my own)