A recent trip to San Francisco gave me time to ponder what could help people trying to live better: an app monitoring and hitting healthful targets for food choices and portion size, blood pressure, blood sugar, your sleep, stress and inflammation levels, and avoidance of toxins (such as tobacco, mercury and heavy metals, BPA and phthalate products). Tracking these should be as easy as the 10,000 steps a day you should be taking (and there’s an app for), as well as easy to understand and see on your phone or wrist.
Such an app might help change the direction of statistical projections suggesting the nation’s health – actually, the increasing lack of it – is becoming a major threat to the U.S. economy.
Such an app is needed particularly as a reality check. For example, more than 3,000 recently surveyed American adults think they are eating healthier than they are: only 10 percent got the recommended amount of essential nutrients , but 57 percent believed they do. We need something easy to help them hit their target.
In 1974, when I finished my residency in internal medicine, there were about 3.2 million type 2 diabetics, with fewer than 1 million treated. Last year, there were 29 million, with 16.9 million treated at a cost of about 1.5 percent of total USA GDP, equaling about 8 percent of total medical costs just due to diabetes. In 2050, projections say there will be 120 million to 180 million diabetics.
Our genes haven’t changed that much; our lifestyle has, affecting the genes for diabetes and many other chronic diseases. If we care for the up to 180 million diabetics expected in 2050 as we do now, without new drugs or treatments but in consideration of the aging of these diabetics, their treatment will soak up 15 of total GDP. Related escalations cite the 242,000 hip replacements done in 2007; 572,000, I’ve been told, will be done in 2030, and in 2050, more than 1.85 million. Knee replacements will be even more common.
Costs for these and for cancer and post-cancer care, heart and stroke care, post-heart attack and post-stroke care, and dementia care will use up more than 60 percent of the entire USA GDP in 2050. There will be no need for a hospital to have sports medicine or pediatrics departments, or for society to budget education or food stamps or research into new jobs, let alone manufacturing. Medical care expenses will suck the life out of such efforts.
A prominent economist told me increasing medical costs and the insurance to meet those needs and cover those costs have consumed every dollar of the North American worker’s productivity gains since 1996; the relative misdistribution of the fruits of productivity gains is disrupting society now.
And rationing will come and disrupt society – we already have rationing of expensive medications – unless we change our behavior and our culture.
That’s why we need an easy-to-read app to help get you and all you know there. Never go to bed without taking 10,000 steps a day; that’s a start. I do it and I want you to get there – for your brain, your heart, your immune system, and the social robustness of your country. We can do this, but you have to get there yourself. Buy two pedometers (so you’ll always have one), great walking shoes, and find a walking buddy. Just start. You can do it.
Dr. Michael Roizen is chief wellness officer and chair of the Wellness Institute at Cleveland Clinic. Follow him on Twitter @YoungDrMike.