Health prevention: the big winner of the epidemic?
At the end of May 2020, just after two months of confinement, saturation of our intensive care units and a proven excess mortality, the Covid-19 pandemic had officially claimed 29,000 victims in France and around 350,000 deaths worldwide. These are dramatic figures, destined to increase, and which undoubtedly justify radical health measures, but which have brought the world economy to a standstill. This is an unprecedented situation, particularly for the health sector, with the exemplary mobilization of all players, both public and private.
These figures should also ask us about the impact of our behaviours, habits and lifestyles on our health. In the context of a global health crisis, prevention is more than ever an appropriate response, both collective and individual. As a key element in the necessary evolution of our health system, prevention is one of the major challenges of a health policy that is undoubtedly too focused on curative care. However, these two months of confinement will have made it possible to profoundly change the health habits of the French people, particularly in two areas: remote urban care (teleconsultation, digitalisation, etc.) and prevention through the implementation of barrier gestures. Wearing a mask is more broadly an awareness, in the space of a few weeks, that each one of us can act on our health, which is a capital; and also protect others. This accelerated awareness of the French on the importance of prevention is crucial: indeed, the French health system, and the management of the epidemic has proved it, is excellent in terms of corrective action, but for decades has always been insufficient in terms of prevention, not to mention predictive action.
However, 80% of health costs are still caused by non-communicable diseases(1), whose risk factors are well known and always the same: smoking, alcohol consumption, poor diet and lack of physical activity. Today, almost one teenager in five is overweight from the third grade onwards and one adult in two is overweight or obese(2). A large number of hospitalizations in intensive care units and deaths related to Covid19 are, in addition to the virus itself, the result of co-morbidity factors in the patients concerned: overweight - diabetes, etc.
Finally, and I will end with the data, a third of all deaths in France can be attributed to behavioral risk factors(3).
Once again, these are figures that should alert us collectively and on which we can act.
Some people will analyse the reluctance of the French people to prevention as a typical flaw in our character: individualistic and protestant, and therefore not very sensitive to prevention messages. No doubt. But the premature excess mortality, the prevalence of chronic diseases, the ageing of the population, the better knowledge of health determinants and risk factors, and today's outbreak of an epidemic without a vaccine mean that prevention must be stepped up. Not an injunction and a guilt-ridden doctrine. No. A prevention that initiates and spreads a collective culture and that accompanies its appropriation by each individual, as, globally, the French have shown during this epidemic.
Informing and acting to make the general public aware of the importance of preventive health care and to enable them to play an active role in their own health: this is the ambition of our Ramsay Santé Foundation, which calls for cooperation and solidarity between all public, associative and private players, to ensure that every French person, above and beyond all social factors, adopts good behaviour. Because they will have understood that their health depends on their own life choices and daily behaviour.
Neurosciences, genetics, health... new approaches and new tools already allow us to approach prevention in a plural and complementary way. But this is probably not enough and the health system itself will have to produce its own expertise.
For this, we will need a prevention policy based on the training of professionals in the specific modalities of this health prevention. They will become the levers and guarantors of the implementation of concrete action policies. With this in mind, the Foundation, in partnership with the University of Western Brittany, will open the first DU Health Prevention Officer in January 2021. The aim is to create a structured professional career path and referenced professions.
From now on, it is therefore advisable to capitalize on this awareness and the actions implemented by the French in the field of prevention. It is therefore crucial, at a time when the Ségur de la santé is opening up with its four pillars, that prevention be an integral part of the reform of the health system desired by the government. As Ramsay Santé, we are ready to contribute to this by drawing on the experience and care structures put in place within the group in the Nordic countries, which have long proven their effectiveness in building prevention that is sustainable, motivating, effective and non-punitive.
(2) : https://drees.solidarites-sante.gouv.fr/IMG/pdf/er1122.pdf
(3) : https://ec.europa.eu/health/sites/health/files/state/docs/2019_chp_fr_english.pdf
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5yPrevention is crucial indeed and all citizens became aware of their roles on this topic! Thanks Pascal Roché for this article!