Prevention better than costly cure

Chronic illness is the leading cause of disease, disability and death in Australia. Over half the population have at least one chronic illness — that is, a condition that generally lasts longer than three to 12 months.

More than 60 per cent of people aged 65 or older have more than one chronic illness. Many of the illnesses are preventable. About 38 per cent of the chronic disease burden in Australia is preventable, in fact. The rate of chronic illness is far higher for people living in lower socio-economic areas, and the burden greater in rural or remote locations, with reduced access to health care, options, and fewer resources.

It costs us an estimated $38 billion a year as a country to manage the burden of chronic disease. The most common long-lasting illnesses include mental and behavioural conditions, which accounts for more than 20 per cent of all chronic health issues.

In 2019-20, a total of $11b, averaging $431 a person, was spent on mental health services in Australia — and the cost is rising at just over one per cent, year-on-year. Other common chronic health issues, by prevalence, include back pain, arthritis, asthma and diabetes — followed by heart, stroke and vascular disease. About 8 per cent of the population live with what are classed as rare diseases.

Then there are a good number of people experiencing undiagnosed enigmatic chronic illnesses. They often exist in an intertwined web of physical and somatic symptomatology, but lack a biomedical diagnosis. Some of the common symptoms without conclusive medical diagnoses include fatigue, dizziness, pain, gut issues, headache and visual and auditory sensitivity and disturbance.

Trying to find answers can feel like being on a merry-go-round. Because of this, frustration and high levels of distress, due to a lack of clarity, validation and suitable care and treatment options can be a common feature of the patient experience.

I’ve heard stories of some people waiting more than 20 years to receive an accurate diagnosis, and then receive the suitable treatment. If a diagnosis had been more forthcoming earlier, their quality of life, and social and economic contribution would have improved far sooner.

It’s important to remember that medicine, as with science, is not static. It’s an evolving practice. As science increasingly gains ground, and testing capabilities improve, we’ll hopefully see better health and quality of life outcomes for previously unknown and undiagnosed conditions.

In the meantime, improving health literacy, with greater government and private investment in preventive strategies would provide exponential social and economic dividends. Yet only a small portion of State and Federal funding, ranging between 2 to 5 per cent, is allocated to prevention.

Outside of systemic reform, there are many things we, as individuals, can do though to take ownership of our own health and wellbeing. First, understanding risk factors and your particular health profile is important to help reduce the chances of developing a chronic illness.

Create a lifestyle that is conducive to maintaining good health now and into the future — exercise, eat well, reduce stress. Maintain a positive relationship with your healthcare providers.

Find practitioners who are willing to take the time and listen, with a sense of validation and curiosity to your personal health story. Ask questions. If you’re not satisfied, seek another opinion, do your own research through trusted sources and be your own advocate.

Living with a chronic illness isn’t an easy ride. Yet, it’s something most of us will, if not already, face. Be ahead of the game. Caretake your health and guard it as though your life depends on it — for it does.

This article was first published in The West Australian in Renée Gardiner’s weekly column in Agenda, 13 August 2022.