In an ideal world a person with a health issue would go to a doctor, be diagnosed early, treatments would be available, and then they would get better. Unfortunately we are far from in an ideal world. Any part of this chain of events could be the cause of pain or death, but seemingly the simplest part to fix would be the first. Unfortunately it seems that making otherwise-inclined people visit their doctor falls in the same bucket as lifestyle change, in that it would be fantastic, but is incredibly hard to do.
Measures introduced to track the quality of healthcare on offer contain the Potential Years of Life Lost (PYLL). This is based on a list of conditions that are thought to be treatable and the standardised life expectancies. Returning to our ideal world, this number would be zero. It isn’t, partly due to complications, partly due to chance, and partly due to uptake of treatments.
Below is a chart of years of life lost per 100,000 registered patients by condition.
To me the first thing that jumps out is the disparity between male and female. These are supposedly the same conditions, each with comparable prognoses for each sex, yet with vastly different outcomes.This is further emphasized when plotted by location as below.
The difference is clearly visible to see. Because the PYLL measure has already been normalised based on the differing life expectancies of men and women, it would suggest that there is something separate from the actual disease progression that is the cause. Males are more likely to smoke, drink to excess, but they are also much less likely to visit their GP. The following chart uses data from 2009, but the principles should still be applicable.
Now not all of these fewer visits may have been for something life threatening, but it at least shows a large difference between the ages of 15 and 60.
Up till now I’ve focused on the role of sex in this equation, this is largely due to it being very easy to quantify and the data being readily accessible. Perhaps more insidious are the roles of society and taboo.
In terms of preventable causes of death, none seem more obvious than suicide, and yet thousands of people every year decide to kill themselves. Many studies over the years have shown that early treatment of suicidal ideation and mental illness lead to improved outcomes across the board. The same can be said of most diseases, however the stigma and embarrassment behind seeking help for sensitive conditions continues to throw up road blocks.
The summary of this post is simple - if we have the resources, technology and inclination to help then we absolutely should.