As boomers age, focus should be on keeping folks healthy

Tennessean.com



With Americans living longer than ever, many medical policy experts say it's critical that the health-care system undergo a shift from a focus on treatment of diseases to preventing them.

Life expectancy at birth in 2006 rose to a record 78.1 years nationwide as mortality rates fell in almost all leading causes of death, according to preliminary data from the Centers for Disease Control and Prevention's National Center for Health Statistics.

But some in the medical community worry that the U.S. health-care system isn't designed properly to handle a flood of aging residents as the first members of the baby-boomer generation begin to reach retirement age.

"The question is how's that longevity going to look like: people living 30 more years with poor health and sedentary lifestyles not being able to enjoy life, work, see family and enjoy their time on earth?" asked Maddy Dychtwald, co-founder of AgeWave Inc., a San Francisco-based think tank.

"The other scenario is: We can create a new way of looking at aging, so we can hold off or prevent many of the diseases that happen to us as we get older," said Dychtwald, whose group studies aging of the population and what it means for business.

Live well, live sensibly

Dychtwald's observation was echoed in a commentary in this month's Academic Medicine, a journal of the Association of American Medical Colleges.

Instead of the current system's disease-oriented, reactive and sporadic approach to care, Drs. Ralph Snyderman and Ziggy Yoediono of Duke University suggest a movement toward an approach that emphasizes personalized medicine and strategic health planning to prevent disease and maximize health.

A separate study last month from the Trust for America's Health found that Tennessee could see annual savings of $351 million, or a 6-to-1 return, within five years of investing $10 per person a year on disease prevention. Targets might include programs related to boosting physical activity, improving nutrition and quitting smoking.

The 2006 increase in life expectancy the CDC found in its study a jump of four months versus the previous two-to-three months annual average reflected a drop in mortality rates for causes of death such as heart disease, cancer, accidents and diabetes.

But Dychtwald said that although strides are being made in extending life, much remains to be done to ensure that it's a life worth living.

For instance, more changes are needed in the way that health care is reimbursed to emphasize and reward prevention over sick care, Dychtwald said. More emphasis also needs to be placed on encouraging behavior in people, including eating a healthy diet, exercising and managing stress, to help build resistance to various diseases.

That implies individuals taking more personal responsibility for their health care.

"The doctor can't stand next to you and say eat less fatty foods, eat more whole grains and veggies," Dychtwald said. "It's something you have to do for yourself."