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Preventing chronic diseases starts with our lifestyle choices

20 April 2023 Ayesha Kriel, Head of Disease and Medicine Management at Medscheme
Ayesha Kriel, Head of Disease and Medicine Management at Medscheme

Ayesha Kriel, Head of Disease and Medicine Management at Medscheme

Ayesha Kriel, Head of Disease and Medicine Management at Medscheme, suggests how chronic diseases may be prevented.

The number of South Africans suffering from chronic diseases continues to rise annually. Although trauma related injuries often dominate the headlines, chronic diseases are the leading cause of deaths and disability both locally and globally, with global statistics confirming that 70% of all deaths are chronic disease related.

Almost one third of Medscheme administered members live with chronic illnesses. These include people living with heart conditions, hypertension, respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD), chronic back pain, diabetes, mental disorders, cancer, HIV and renal failure.
Together, these conditions account for the biggest spend across all our schemes – on average, 60-70% of total claims paid.

Data confirms five distinct behavioural risk factors that contribute directly to chronic diseases. These include poor nutrition, physical inactivity, smoking, excessive alcohol consumption, and environmental factors such as lack of sleep, high stress, mental health, socio-economic factors etc. These are referred to as modifiable behavioural risks and are responsible for most of the burden of death and disability across the world, regardless of a country’s economic status.

Modifiable disease risk factors are those that can be reduced or controlled with altered behaviour. However, the exposure that individuals and populations have to these risk factors is significantly higher in low- and middle-income countries than in high-income countries, where comprehensive interventions are in place to help protect people. Risk factors for chronic diseases are especially common amongst disadvantaged groups. The main biological risk factors are obesity, high blood pressure, elevated blood glucose, abnormal blood lipids and raised cholesterol. Non-modifiable disease risk factors are those that cannot be changed. These include a person's age, ethnicity, and family history (genetics cannot be changed), amongst other factors.

Most chronic conditions can be prevented and controlled. There are affordable solutions which exist to reduce the level of exposure of individuals and populations to the common modifiable risk factors, to improve access to care and to prevent complications and disability in those with established non-communicable diseases. It is time that we focus our attention on preventing chronic conditions, rather than just focusing on acute and in-hospital care. Staying physically active, maintaining a healthy diet, limiting smoking and alcohol consumption and being mindful of environmental factors where possible are important ways to prevent chronic diseases.

Early identification and proper management of risk factors associated with chronic diseases is essential for developing appropriate health policies to intervene at different levels, especially at the primary healthcare level. Appropriate healthcare system interventions can improve the use and quality of clinical preventive services. These services can help prevent disease or identify it early, reduce risk factors, and manage complications. It is important that we manage our chronic conditions so that we can improve our quality of life whilst reducing healthcare costs.

The old saying still rings true, prevention is better than cure. Whilst medicine has a definite role to play in helping to manage and maintain our health, there is most certainly a place for prevention. Since the onset of Covid-19, we have seen a concerning reduction in the number of members accessing their preventative screening benefits. These benefits are there for us to ensure early detection of chronic diseases such as cancer as well as for increased protection against infections such as through influenza and pneumococcal vaccinations, particularly for our high-risk beneficiaries. The uptake of these benefits is very low across most of our schemes and the focus remains to continue to empower our members with this information and the health benefits associated with it. These preventative screening tests are paid from risk, not from member savings and we really wish to encourage our members to make full use of the opportunity to be screened regularly, for example, go for mammograms if you are eligible, colorectal cancer screening, childhood immunisations, HIV test to know your status, pap smears, prostate screening, health risk assessments (done at network pharmacies or biokineticists to check your blood pressure, blood glucose, BMI, cholesterol, waist-to-hip ratio). Consult your medical aid benefit guide to confirm your eligibility for these tests and services. Our Medscheme philosophy is going back to basics – by adapting your lifestyle, trying to live and eat better every day, making small incremental changes such as getting more sleep, making healthier choices at school or work, knowing and understanding your family history, utilising our preventative care screening packages offered by our schemes and being more intentional, we can make a difference. Prevention through healthy lifestyle choices is more cost-effective and sustainable and will positively impact overall health and well-being, resulting in a more productive quality of life. Why not start now?

At AfroCentric we continue to actively encourage chronic disease prevention. Through a holistic approach that leverages innovation, we support our scheme members on their journey to adopting healthier lifestyles. Through educational material and push notifications via our mobile platform, our members have better control of their health in the palm of their hands.

We have developed innovative solutions to help prevent chronic disease, for example, members can complete a health questionnaire in their member App and track their personalised Health Score. Once a member is diagnosed with a chronic condition, we are also able to provide holistic support that helps members manage their condition and follow a healthy lifestyle as far as possible. We are particularly encouraged by more than 44 000 members who have completed an online Health Risk Assessment. We have noted that 65% of them have started to exercise at least 5 days a week for 30 minutes or more, 84% are incorporating fruit and vegetables in their diets, 16% are still smokers, 3% are consuming more than 10 alcoholic drinks per week and 30% have indicated that they are suffering from depression or anxiety. These are leading indicators of developing, or worsening, a chronic condition, and the data is used to inform our personalised interventions to help our members, particularly those who have indicated that they are in trouble and need our support. Again, it can start one day at a time by developing one good habit at a time. We can start now.

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