200 years ago there were fewer than one billion humans living on the planet. Now there are over seven billion of us. Populations are burgeoning, we’re seeing an unprecedented increase in life expectancy and with this, more of us are living for longer but in poorer health. It is no secret that health systems around the world cannot sustain these pressures and our focus must be to serve the unmet needs of our citizens and support our economies to do so. But whose responsibility is it to do this?
On one hand, some will argue it is the preserve of government to maintain health systems, whereas others will recognise the value that the private sector and companies, like pharmaceuticals, bring to sustainable healthcare. When both come together, real progress can be made – as evidenced in the UK which is leading the way in genomics with the 100,000 Genomes Project.
However, the role of the individual is also critical in helping to build more sustainable healthcare systems. Within this context, sometimes the most significant impact can come from the smallest changes we make. Perhaps the most effective and fundamental thing we can do to help support our health systems as individuals is, simply put, to seek help when we need it.
Most recently in the UK we wanted to explore this further as we identified that despite the ubiquity of mobile phones and the vast amounts of readily available health advice they bring, people are still not engaging with their health. In fact in England, there are already 15 million people living with a long-term health condition and 83% of middle aged adults aged between 40 and 60 years old either drink too much, weigh too much or don’t exercise enough.
We wanted to highlight this issue and go beyond medicine as a company, to find out more about the barriers preventing people from engaging with their health. By partnering with leading think tank, 2020health, we carried out a unique piece of research which revealed that the cause for this seeming inertia when it comes to our health is surprising in its simplicity. People are afraid.
Our research showed that the ‘Fear of Finding Out’ (or ‘FOFO’) is a major psychological barrier making up nearly a third of all conscious reasons why individuals may be delaying or avoiding visiting a doctor or seeking medical advice when they may be concerned, or not taking the relevant steps to improve their health. The fear was found to be far-ranging, from those who fear being pressured into making lifestyle changes, to those who fear the impact of a diagnosis on their career, to those who fear stigmatisation and more.
This fear, which is preventing people from getting worrying health symptoms checked out, is not only crippling for the individual but for the economy too, with late diagnosis leading to more costly and complicated treatment. As Michael Bloomberg (appointed the World Health Organisation’s first Global Ambassador for Noncommunicable Diseases) has highlighted, for the first time in human history more people are dying of preventable noncommunicable diseases such as obesity and heart disease than communicable diseases. So what if we gave people the opportunity to overcome fear and take control of
Along with a team of experts from the worlds of data, gaming, tech and healthcare – including Alan Milburn, former UK health secretary – we did exactly that. We created an online, interactive quiz – very different from an ordinary health questionnaire – in which the public was asked a series of fun questions interspersed with gameplay. At the end of the quiz, written by a psychologist from the University College London, an algorithm assigned a personal ‘gremlin’ to the players depending on the size of their fear, which they were then able to ‘crush’. The quiz (aptly named, ‘Crush Your FOFO’) was also designed to yield a valuable bank of anonymous open-data. The data is compelling and readily available to anyone interested in exploring and furthering understanding of what lies behind the Fear of Finding Out.
Whilst the analysis of the open-data is a crucial part of the project, what is relevant here is the ability this tool had to empower people to face their fears and take control of their health. We saw conversations on social media reflecting a change in the way people were engaging with their health. Men and women alike were communicating openly about how they had been emboldened to take up health checks, or face up to worrying health symptoms – the quiz was affecting real behaviour.
Whilst this was on a relatively small-scale, with just over 4,000 people taking the quiz, if we take a moment to imagine the possible positive effect that helping people to overcome health-related fear could have, the results could be significant.
Feeling a sense of empowerment when it comes to our health is vital, particularly when we look at our own individual economic potential and the benefit this can bring to economies as a whole. Evidence, including from the World Health Organisation, shows that healthier, active and engaged employees are more productive and have lower levels of sickness absence. Importantly, employment is recognised as a determinant of health and unemployment is associated with an increased risk of mortality and morbidity.
Work that AbbVie has undertaken over the past few years, relating to the impact of musculoskeletal conditions on work productivity, bears this out. Under the Fit for Work initiative, AbbVie worked with patient and physician associations to demonstrate the link between early diagnosis, proper early intervention and treatment, and people’s ability to recover more quickly from these conditions – thereby reducing unnecessary disability, improving workforce productivity and eliminating secondary complications. This work, across many countries, established links between health and workforce policies – driving awareness of the impact that chronic conditions can have on work-related performance and leading to the development of models for earlier treatment. To achieve this ‘triple win’ for patients, health systems and the economy, we must continue to improve our diagnoses as well as early, effective treatment of potentially chronic conditions in areas such as musculoskeletal conditions. If patients are to be brave enough to fight their FOFO, they also need to have the confidence that the health system will respond with rapid, effective treatments.
It won’t happen overnight, but we need to make sure we are working together to help people take better care of themselves and as part of this, we need to be stepping away from familiar territory. As a global biopharmaceutical company, we are perhaps the least likely player in the preventative health space, but we are committed to focusing on prevention for sustainable healthcare. We have seen the benefits of encouraging small change – in this instance, getting worrying symptoms checked early – which could have a significant impact. And this could be just one of many transformative ideas. This needs to be a collective effort; not just businesses, not just governments and not just individuals themselves – a truly collaborative approach to healthcare is needed to empower people to take control of their health.
To find out more about Crush Your FOFO, visit www.live-lab.co.uk