Do we truly value our health?

In the second of a six-part series on longevity, Dr Chris Edmond looks at the future of the Island’s health.

Over the past year or so, I’ve been honoured to be part of the Island of Longevity project. This entirely voluntary and community-based initiative was brought together with Islanders from all walks of life, to reimagine our society and to look at how Jersey can be the happiest and healthiest place in the world to live and to grow old.

We have been asking ourselves, and the range of participants at our launch conference and workshops, questions on how to shape a future where the norm of living beyond 100 years is supported by wellbeing, vitality, and participation at all life stages.

As you would expect, as a doctor I approached this first from the perspective of healthcare, and looked at the changes we need to improve healthspan as well as lifespan – that is how do we keep people healthy longer into older age, rather than just extending life. And how do we challenge the assumption that people will inevitably live in ill health and need increasing care as they age? We know that approximately 80% of long-term health conditions are preventable with lifestyle and environmental changes, so how do we best support this?

The medical pieces of the jigsaw aren’t controversial. It’s recognised worldwide that that we need healthcare that is more preventative, community-based and connected. So I was very pleased to see recent announcements on investment in these areas in Jersey – with a bit of luck, we really could see the evolution of our healthcare system over the coming years.

I also talked at our conference in May about the longer term ‘revolution’ that is required – building trust, active citizenship, understanding the causes of disease on an individual level (using big data and AI to guide us), and most importantly giving children the best possible start in life.

And the incredible thing about the Island of Longevity project is that we’ve not been working in silos. It’s the interwoven themes – of economics, education, social and physical infrastructure, personal finance, health and community building – that have brought the project to life. It’s in those connections where the magic is emerging.

For example, we’ve been considering economic measures beyond Gross Domestic Product (GDP), and the impact of initiatives including the OECD Better Life Index and the Wellbeing Economy Framework. These models include wider societal measures, such as housing quality, work-life balance, social connection and citizen engagement in government targets. And in Jersey we have made good progress in this area with the Jersey Performance Framework and the Island Outcome Indicators.

But these conversations started us thinking even more deeply, particularly about how we value health and healthcare. We say “health equals wealth”, but do we really act like it?

When governments make political decisions, they tend to base these on a short-term cost-benefit analysis – how much will a policy cost to implement vs the financial return in GDP terms.

But so much of importance isn’t included in such calculations, for example:

A stay-at-home parent officially has zero economic value, and is a drag on ‘productivity’. Despite a falling birth rate and an aging population, and the proven lifelong health benefits of stable parental attachments, our economic system places little value on creating and caring for the next generation. We can change that.
We measure value by ‘price’ and its effect on GDP, rather than long-term impact. What value do you place on a playground? Or a volunteer-led coffee morning? Or the care worker that supports you in your final days? These are the things that bring meaning to life, yet are greatly undervalued by current measures.
We struggle to account for longer-term and indirect costs and benefits – consider a construction worker who has an injury, meaning they can’t work. They might wait six months for a scan. Another six months to see a specialist. And another six months for surgery. Their care might cost £10,000 in total. But when they lose their job, their house, and perhaps their family as a result of delays, the lifelong impact – to them, their family, and their business – is almost incalculable.

To achieve our aim of being the happiest and healthiest place in the world to live and to grow old, Jersey needs to think hard about these deeper issues, and make some big changes.

The financial case is sound. McKinsey Health Institute published a report in September, concluding that investment in the health of society could add $11 trillion to the global economy in 2050. Without such an investment, they estimate ill-health causing a $36 trillion drag on global GDP over the same period.

As the Island of Longevity, Jersey has the opportunity to show the way forward. Will we?

A series of podcasts about longevity on the JEP’s sister website, Bailiwick Express, will be released on Mondays and Thursday. The first episode was released on Monday with the second released today. To listen, visit Bailiwick podcasts.