We made huge progress in many areas of medicine over the last century. We can now expect to live 81 years in the UK for example, that’s 24 years longer than in 1920 (life expectancy of 57).
But, with any massive global change and ‘progression’, there are pros and cons. We live life at a faster pace than ever before, we consume a completely different diet due to mass production, convenience and taste, we sit for longer periods, we’re less active, and the heart of many local communities is fizzling out. As a result, environment and lifestyle created conditions are increasing at a rate we haven’t seen before — type 2 diabetes, heart diseases, high blood pressure, cancers, and psychological conditions like depression and anxiety, all on the rise.
An unsustainable approach to medicine
The way we’ve done medicine for the last century isn’t compatible with managing health in the modern world. Doctors are mainly taught to address diseases which have already occurred. But in reality, most modern illnesses are the result of an accumulation of small, automatic behaviours over a series of months, years, and decades.
Treating chronic (long term) disease after the fact is unsustainable. For example, the annual cost of treating someone with type 2 diabetes is around £5000 per year, that’s nearly 2.5 times as much as treating someone without the condition. And it’s anticipated that if we continue on the same track as we are, 1 in 3 Americans will have type 2 diabetes by 2050. Even the richest countries in the world will be crippled by the cost of these treatments at that scale.
We also have to consider the secondary effects of chronic ill health. Chronic conditions have a huge impact on quality of life, productivity and mental wellbeing, often for decades of someone’s life. In the UK, we can expect to live with disease from 61 years old, on average, however more and more people are developing long term conditions, like type 2 diabetes, in their 30s and 40s.
What's the solution?
Through addressing lifestyle behaviours, we can significantly change our health outcomes. By improving just a handful of our health behaviours while under 50 (like physical activity, vegetable consumption, alcohol intake) we can increase our disease free lifespan by up to 20 years.
But it’s a challenge to get a 20, 30 or even 40 year old to recognise the importance of making changes early, before the onset of disease. Plus the process itself is really hard while we live in a high paced, stress inducing environment. Of course, our ability to change is affected by so many factors, including social norms, access to support, education etc.
Let's say that some of the basics for health behaviour change are in place, like health awareness and education, access to healthy food, and social support. Even with this strong grounding, making changes to our long term lifestyle habits is really challenging without a strong psychological focus.
Psychological aspects, in this context, include:
- The initial process of deciding you want to make some lifestyle changes (motivation for change).
- Followed by the reflective process to identify where your strengths and weaknesses lie, so therefore which changes will be most helpful.
- The process of implementing changes. This means being careful not to overdo it too soon, in an unsustainable way. But also to keep motivated to take small consistent actions for a long time until they become automatic & natural.
- The iterative process of constant reflection and adjustments in order to keep making progress into the future.
The truth is, there are very few people in the world who can manage this entire psychological process on their own. Our brains are wired for automaticity rather than effort. This wiring helped us to survive millions of years ago, by preserving thinking energy, but it's less helpful now that we're in such a different world.
Achilles heel of healthcare
Our biggest achilles heel in healthcare is a lack of joined up thinking and management between physical and psychological aspect of health. As long as we keep treating chronic conditions with physiological solutions, like drugs and surgeries, we will remain on a dangerous trajectory, with rising cases and worsening outcomes. Any chronic condition which has developed over years or decades of life needs some level of psychological or behavioural support to address the causes. It simply will not happen by magic! And it definitely wont happen by barking at people to lose weight......that is not a supportive behaviour change approach.
We created Holly Health after observing ourselves and our communities really struggling with the small and consistent types of behaviour change needed for disease prevention. It's too big a problem to watch grow when we think we can have a positive impact.
The modern world is gradually coming to terms with the fact we need a different approach to medicine. But unfortunately the tools and resources haven't been provided for successful population level behaviour change.
What we'll see more of in the coming months is obesity prevention campaigns and weight loss drives. Unfortunately, many of these will miss the point. They will be too heavily focused on weight loss alone, and not on permanent behaviour change. This will lead to the same yoyo effects which we've already seen as the result of decades of diet culture.
Thankfully, we do see some pockets of more positive approaches. Some of these are human lead, through coaching sessions. Some are more digitally led, with support for changing particular behaviours. It will be a long time before these types of support are available to everyone as standard. So, releasing the Holly Health app is our way of leapfrogging the existing options, and making psychological behaviour change support available sooner. Although we're releasing first of all to consumers, we will shortly be starting rollouts with local/national authorities and healthcare providers. I hope we will soon be able to support you or your friends or family, wherever you are.
Read more about the Holly Health launch here.
By Grace Gimson
Holly Cofounder and CEO
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