Reinventing healthcare strategies to tackle detrimental behaviors: a novel perspective
In the quest to prolong and improve lives, many nations grapple with the challenge of enhancing the lifespans of their populace. A crucial aspect of this mission is developing a thriving health-conscious culture.
One vital component in achieving these objectives is modifying risk factors that directly impact mortality, disability, and anticipated lifespan. It's been estimated by the Ministry of Health and WHO that up to 87% of all deaths can be linked to chronic non-communicable diseases (NCDs), which are triggered by modifiable behavioral risk factors.
Neglecting risk modification and sticking to established behavioral patterns and lifestyles could condemn healthcare systems to an endless 'catch-up' phase – treating complications, hospitalizations, disabilities, and mounting expenses. In response, the need for a health-preserving ecosystem has arisen; an interdepartmental, cross-sectoral mechanism comprising governments, healthcare providers, employers, and citizens themselves.
This ecosystem is supported by the Association of Medical Specialists in Risk Modification (AMSRM) in Russia, which emphasizes development of practical tools geared towards empowering people to reinvent their lives and health. According to AMSRM Director, Alexander Rozhanov, their goal "is not just medicine, but also offering simple, understandable actions that lead to systemic results."
Rozhanov champions the "Ten Rules for a Healthy Life" developed by AMSRM experts as a clear system of daily prevention guidelines. These include managing blood pressure, sugar, and weight, quitting tobacco and alcohol, maintaining balance in nutrition, sound sleep, regular physical activity, proper hydration, and stress management. Simple yet effective formulas that, with support from healthcare providers, employers, and the state, can become sustainable habits.
Rozhanov believes that risk modification could be the missing piece in healthcare, enabling a shift from established diagnoses to a sustainable system of disease prevention. He highlights that access to trustworthy information, support, and inspiration, instead of moralizing, fines, or prohibitions, is crucial.
In Belarus, this tangible implementation of the approach is evident in their integrated strategy for addressing NCD risk factors within their health system. The country focuses primarily on prevention. According to Dmitry Ruzanov, Deputy Director for Scientific Work at the Republican Scientific and Practical Center for Pulmonology and Phthisiology, there have been significant decreases in smoking rates, especially among men, and a rise in the age of smoking initiation.
Special attention is given to smoking due to its role as a prominent risk factor for most NCDs. In Russia, a notable reduction in smoking rates has been achieved; according to official 2024 Rosstat data, only 18.6% of citizens smoke regularly, with another 7% smoking occasionally. This progress is credited to a cohesive and consistent state health policy, with the ongoing support of the WHO.
The smoking issue has evolved drastically in recent years, from a general fight against a harmful habit to understanding the causes behind smoking. Larisa Popovich, director of the Institute of Health Economics at the Higher School of Economics, explains that "if we look at the structure of smokers, we'll see that those most susceptible to nicotine addiction are those who sustain the functioning of the economy."
According to her analysis, the majority of smokers can be found within the working population. Among skilled workers in large and small industrial enterprises, including those in agriculture and transport, the smoking rate exceeds 50%. Meanwhile, among representatives of the managerial and financial sectors, it is notably lower, at no more than 30%.
Moreover, the distribution by nature of work is even more revealing. Among those who perform heavy physical labor, over half smoke. Conversely, among those reporting very heavy workloads, over two-thirds have been or currently are smokers at some point in their lives. "This group of people working in the real sector of the economy: construction, industry, logistics - their work is physically demanding, stress levels are high, and access to prevention and counseling is often limited," emphasizes Mrs. Popovich.
In this situation, Dr. Popovich advocates for a systemic approach involving employers, primary care physicians, and specialized programs to combat high smoking rates. Changing behavior requires accessible support, not moralizing, fines, or bans.
Overweight and obesity are becoming epidemic among younger individuals, contributing to severe metabolic consequences. Simple, systematic changes in daily behavior, such as taxing sugary drinks, hold the key to resolution. According to an expert, this tax should be seen as a signal supporting health, rather than a punishment.
In conclusion, reducing smoking and obesity risk factors to prevent chronic NCDs requires a coordinated, multifaceted, and cooperative approach incorporating lifestyle changes, medical care, education, and policy interventions. A successful strategy depends on ongoing collaboration between government entities, healthcare systems, workplaces, and the community to cultivate supportive environments for healthy living and effective risk factor modification.
