State of Health: Answers to seek
Last week, I met a terrific Orthopedist, in his mid-50s, for a niggling back pain issue that was affecting my Mom. This experienced, gentlemanly Doctor patiently answered all our questions, acknowledged things that he clinically thought were outside his purview and made us feel that we were secure under his guidance. The more we probed, the more convinced we got that he was one of the best we had seen so far.
However, even as I was getting impressed with the way he went about the consultation, I couldn’t for the life of me get past how obese this Doctor was. If obesity has been proven to be a risk factor for so many conditions in later years, why was this expert Clinician not taking care of his own health?
It befuddled me more than I’d like to admit. I know this can be a touchy subject and to each his own but this little experience once again brought to my mind the complexity of the subject that health is.
As someone building for Cognitive Health, I am always curious about these inexplicable behavioral quirks of human motivation towards health. These ebbs and flows and the whys and hows are so fascinating to me. As a thought experiment e.g. who do you think is more motivated to do something about their health in 2025?
- A 19-year old boy who wants to be popular in college?
- A 57 -year old retired banker looking forward to his retirement years?
Can these people be influenced by their peer group to lean or veer away from a healthy lifestyle? What effect will other external stimuli, like health brands and influencers, have on their motivations? What about their own personal experiences in the years leading upto today? All these permutations will go into what would spur their attitudes, behaviors and actions towards health.
Now, imagine the micro-motivations at play for each of us and then healthcare startups like ours trying to build for far more complex problems than weight loss.
It’s a Herculean task.
However, while these micro-motivations will continue to be highly divergent, it’s worthwhile to take a stab at important questions about the state of health in India and around the world that at a macro-level can help us refine some truths around consumer motivations.
So without much ado, here are some of those questions/hypotheses.
Will the level of sickness and illness in the world going forward become worse or better or will it stay the same?
The thing about us humans is that we believe in optimism. We believe the human condition, metaphorically and medically speaking, will get better. But science and experts say that it’ll get worse.
It’ll get worse because urbanization is on a rampant spree, people are living in more and more congested areas. There is more and more human and animal contact and more and more people are also traveling than ever before. So the level of transmission and risk is only going to go higher.
Professors at Harvard believe that we’ve already had our best years as far as sickness and the human race is concerned. Everything emfrom here on, according to science, is going to get worse, unfortunately. The general thinking in the scientific circle with regard to the next pandemic e.g. is not about if, but when.
If things are going to get worse, how do we stay ahead of the curve?
The answer, obviously, is spending more time and resources on Preventive health. While Curative Healthcare attract significantly more dollars both from a research and consumer spends perspective it’s common knowledge that Preventive Health as a segment is growing really fast.
More importantly, that gap between curative and preventive spends (anywhere between 3x to 20x) depending on geography) is significantly reduced today, than let’s say a decade ago. Now the bet that thousands of preventive healthcare companies like ours are taking is that the pace at which the gap will reduce will accelerate because the more we keep diseases at bay, the less we’ll spend on curative.
But why will hospitals and big pharma encourage for more preventive spends, if the bigger dollars are in curative healthcare?
There are three good reasons for that.
Let’s begin with an underlying systemic shift, that of the tailwinds of behavioral change brought about by people who lived through the pandemic and are far far more knowledgeable about all things health and prevention than they were five years ago. I know it seems like Covid never happened but those who had a close run-in or worse, lost a loved one deal with all things health very differently today.
Second, look at the state of healthcare in UK or US — the two most advanced countries in the world. Spending all that money on curative healthcare has only led to hospitals overflowing with patients, queued up claims and months to get a single appointment on a doctor’s calendar.
Conversely, the fact that Austria, Denmark, Finland, Canada and Singapore are some of the countries that spend the highest (5%+) on preventive healthcare speaks something to the effect of how moving in this direction uplifts the overall quality of life.
On a related note, I was super impressed to see the thoughtfulness and precision with which a question on how spending on preventive healthcare helped Singapore, was answered on their Ministry of Health website.
Now, the third reason.
As a society, how are we pacing on qualified professionals to take care of us in the future?
So we’ve already established the level of sickness in the world is going to get worse.
But do we have enough qualified medical professionals?
According to WHO, a country like India needs about 45 healthcare workers, (mix of doctors, nurses, midwives) to take care of every 10,000 people. In India today, we are at 20.6. So we are grossly understaffed.
This is a problem that’s going to be faced largely by low and middle income countries. Advanced countries like, USA, Germany, China are way ahead of us. But having said that, globally we are not pacing well as well. That is yet another opportunity for some of us to enable.
Let’s take Dementia in India, specifically.
Dementia India Alliance, which is a nonprofit organization, has set out to train caregivers to take care of dementia patients, as one of their core objectives. In a labor rich country like India, an initiative like this can go a long way in reducing the healthcare burden on hospitals. We need more institutions like Dementia India Alliance to do this especially for conditions that do not have any pharmacological breakthroughs.
But we all know before things break, we do get signals from our body, don’t we?
This brings me to the next question.
How many of you reading this are tracking at least some aspect of your health?
The thing about data in health is India is we’re in our days of infancy.
When you look at the landscape, you’ll realize that the opportunity here, too, is immense. People who have spent time in the UK and have gone to the UK health care system would know that there is a Biobank in the UK, which is a collection of publicly available, aggregated, anonymized data through which young startups like ours can take use of the data pool and build data models on top of it.
India, unfortunately, today does not have any such model.
But institutes like the Indian Institute of Science, NIMHANS and AIIMS are making some concerted efforts towards this end. But before we get to big data, how about you reading this take care of one aspect of your health in a quantified way?
Calories, Steps Tracking, RHR, Quality of Sleep, Cognitive Skill Scores (there had to be an Ivory sprinkle here), the luxury we individually have to track these, is immense in today’s world.
The more you take better care of yourself, the more you again reduce the health care burden on a hospital or a clinic.
And finally, is Medicine 3.0 the future?
Medicine 3.0 is a term that got popularized by Dr. Peter Attia, who recently wrote a book called Outlive that came out last year and has been widely acknowledged as one of the best evidence-based books on the subject of maintaining a better healthspan.
Medicine 3.0 is about using your own health data to take action towards a better healthspan. Now as big as it can sound, to me the impact of looking out for yourself can be something as small yet significant as what yours truly gathered.
E.g. I have found out after a lot of trial and errors across drinks that if I have two or more drinks, I will end up waking up at least once during the night.
Knowing this about my body has helped me manage my sleep better.
Imagine the impact of small practical steps like these, compounding over a period of a year and then two, and then it becoming second nature. Yes, there will be inconsistencies with those peaks and troughs along the way but that’s where tracking your data on your own can help you stay the course.
Which brings me to the final existential-ish question about what will health tech startups’ contribution in the coming decade look like?
I believe a lot of the action, given the factors listed above, will move towards early detection and patient-managed self-care. That is to say, that the user / patient will want to get data on their fingertips that until something is not well and truly broken, he or she will avoid going to Doctors.
And that’s where, rigorous AI-assisted solutions will help Doctors take the right course of action in curative space. The pot at the end of the rainbow to chase, is the hope that the combination of proactive prevention and advances in cure, will bring mortality rates significantly down.
Utopia beckons! But a ton of hard work lies ahead.
