Re:Is Preventive Medicine Its Own Health Risk?
by mariodiana on Tuesday December 09, 2014 @09:22PM
(#8727335)
> whatever is being done in public health and medicine in the developed world appears to be working
"Whatever" is a pretty broad statement. What if we found out that the biggest factor is nutrition and health care while young: in other words, maybe poor health and nutrition while young leaves "scars" of a sort that come back to bite us as we age?
I'm not saying that that's the case. I'm just saying that "whatever" is too broad a statement. The piece is about the comparatively superfluous effect of so-called preventative medicine in late middle-age. If we just grant that point, for the sake of argument, then that's a whole bit of "whatever" that we could save our money on and do without.
First of all, it is plain that screening test programs that are not based on "hard endpoints" (actual reductions in all-cause disease or death) often end up being discovered to be wastes of time and money and the cause of needless patient worries. There is a group blog, Science-Based Medicine, with participation by multiple medical doctors, pharmacists, lawyers, and even reformed chiropractors, which examines the issue of the usefulness of screening tests from time to time.[1] An informed patient might well decline many currently offered screening tests, and might also well decline some preventive treatments, for example statin drugs.
But the second bit of context to look at is that whatever is being done in public health and medicine in the developed world appears to be working in part, as life expectancy at age 40, at age 60, and at even higher ages is still rising throughout the developed countries of the world.[2] Chances of surviving to healthy old age from middle age have been increasing steadily in the United States and in the whole developed world throughout my lifetime, so I may have to get ready to live as long as some of my aunts and uncles, who are now well into their nineties and still living independently.
[1] "Recent Developments and Recurring Dilemmas in Cancer Screening: Colon, Lung, Thyroid" 18 November 2014 http://www.sciencebasedmedicine.org/recent-developments-and-...
"A Skeptical Look at Screening Tests" 23 July 2013 repost http://www.sciencebasedmedicine.org/a-skeptical-look-at-scre...
"Screening Tests - Cumulative Incidence of False Positives" 30 June 2009 http://www.sciencebasedmedicine.org/screening-tests-cumulati...
[2] http://www.nature.com/scientificamerican/journal/v307/n3/box...