Jackson, S. (2004), "Making health predictions: can we really be so accurate?", International Journal of Health Care Quality Assurance, Vol. 17 No. 4. https://doi.org/10.1108/ijhcqa.2004.06217daa.001
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Copyright © 2004, Emerald Group Publishing Limited
Making health predictions: can we really be so accurate?
Much has been written about the aging population and the impact that this will have on the health care system in 2030 and beyond. There is no doubt that improvements in living conditions, health care, employment environments and the availability of recreational pursuits have seen an increase in longevity over the last 50 years, so much so that predictions have been made that health care provision and environments will look very different in the future to the way they look now. For instance, the average age of patients will be higher, the conditions will be more chronic, and some have actually predicted that new conditions will emerge because of the as yet unknown effects of old age.
While all the aforementioned may be true, I am not convinced that the progress in longevity is set to continue and that health care provision will be for much older people than it is now. My viewpoint stems from the following observations. On the whole, over the last 50 years people have had access to better diets, better sanitation, cleaner working and living environments and have had more time to undertake recreational activities than ever before. In some cases, many people have embraced this and have enhanced their chances of living a longer, healthier life.
However, this has not been the case for everyone. In particular, it would appear that the younger population (around the age of 40 and below) are decreasing their chances of living longer because of the societal changes that have had an adverse impact on health. To explain, readily accessing healthy foods has been difficult in comparison to accessing unhealthy foods. Consequently, unhealthy, fattening foods have been consumed in plentiful amounts and resulted in an increase in the number of people suffering from obesity. Of even more concern is that a high proportion of obese people are children. Furthermore, obesity gives rise to other complications, including diabetes and heart disease. Another factor that needs to be considered in this equation is the lack of exercise amongst the population as a whole. With the increased use of computer games, Internet surfing, mechanical aids for manual jobs and domestic appliances for housework, the more sedentary lifestyle is proving too tempting for some. Hence it would appear that predicting health care services in the future can no longer be aligned to our past successes but needs to take a U-turn in order to reflect the changing dynamics currently inherent within society.
Given this to be the case, in the next 25 years and beyond we could be providing health services to a much younger client group and be faced not with new, unfounded conditions of old age, but with the predominant conditions we are mainly dealing with, namely diabetes and coronary heart disease. Moreover, we may see a reduction in the expected lifespan of our species rather than an increase in it.
A further factor that is worthy of consideration is that of compliance to treatment and/or advice. During most of the past 50 years of change, health care professionals have in the main been afforded the luxury of compliance with treatment regimes from patients. However, this is also becoming less frequent as the findings of Carter et al. (2003) stated that up to 80 per cent of people could be non-compliant when it comes to taking prescribed medication. Moreover, the prevalence of obesity, and the vastly understood knowledge that eating fatty foods and not exercising regularly is not good for you, also suggests that non-compliance is on the increase rather than the decrease. If this is the case, the challenges for health care professionals will no doubt escalate, as efforts towards empowering patients to be responsible for their own health will be delivered in a climate of adversity.
One element of adversity is the pursuit by international food outlets of ever increasing financial success. Their accommodating response to the knowledge that the customer is constantly looking for better value i.e. bigger portions of food for the same price further compounds the healthy messages being imparted from health care professionals. Just to digress, only the other day, I saw a group of school children, about the age of 12-13 years, feasting on chips and burgers at nine in the morning as they made their journey to school. Who knows whether they had breakfast or not, but it was concerning to see them start their day in such an unhealthy way.
I am not sure if this is the case in other countries around the world, but the increased prevalence of obesity has been picked up by the media as a way to provide television programmes that consumers want to watch. For instance, more television programmes are being dedicated to following obese people take on a regime of healthy eating and regular exercise. This can only be the case if more of the general population are interested in these types of programmes.
So my message is clear: can we really predict health care trends based on past knowledge, or do we need to constantly re-evaluate our current situation in order to base our predictions on a more complex set of variables? Furthermore, is our current grooming of health care professionals going to be sufficient for them to deal with the challenges that lie ahead?
If any of you are working in this field or know of someone who is working in this field and could enlighten us on what the future holds, we would be very interested to read your work. As the old English saying goes “forewarned is forearmed”, and to provide good quality health care in the future would require us all to be armed with the correct skills to be able to rise to our challenges.
Carter, S., Taylor, D. and Levenson, R. (2003), A Question of Choice – Compliance in Medicine Taking, Medicines Partnership, London