The new preventive program “My health – adult health assessment” has replaced the previous pilot program “Prevention 40+” implemented in primary care clinics since May this year. Is this a positive change in the context of preventive health care?
Dr. Zbigniew J. Król from the Department of Public Health, Faculty of Health Sciences, Wroclaw Medical University does not expect the program to bring the desired effect, just as – in his opinion – the idea of a 40-year – old assessment did not work .
The program “My health – an adult’s health assessment” assumes more laboratory tests related to diagnostics of cardiovascular or oncological diseases, among others . It will also be available to a wider group of people , because it will be available to people aged 20 and older. And here the first doubt appears:
– Healthy adults aged 20-45 rarely visit doctors, and even less often undergo tests if nothing ails them – points out Dr. Zbigniew J. Król . – We have ample evidence of this in the form of summaries of the results of preventive programs addressed to young people around the world and implemented in health facilities . Such programs simply do not bring results . In the case of this group, it makes much more sense to organize screening tests in places where these people frequent. A young person will not come to a clinic, but they can be persuaded to undergo a test at a university or at a concert. In many countries, this is how it works and it is effective.
The expert from the Wroclaw Medical University considers the “involvement” of children in the program as part of the diagnosis of familial hypercholesterolemia to be absolutely wrong. In his opinion, it is completely unnecessary, because children have their own balances and there is no need to duplicate tests and create additional barriers, including the stress caused by another visit to the doctor. In general, the target group in preventive programs is extremely important. According to the expert, better results are brought by screening programs directed to specific risk groups, within which specific tests are performed. Such an example could be the colon cancer prevention program, in which patients benefit from a reimbursed colonoscopy, or screening mammography for older women, thanks to which cancerous changes can be detected at an early stage. However , even such programs – although valuable from the point of view of the individual and potentially positive impact on the health of the entire population, still do not achieve the assumed participation rates .
– The failure of preventive actions in Poland to date is evidenced by hard data – emphasizes Dr. Zbigniew J. Król . – What should their effect be? In principle , it is a higher average life, lived in good health. This is important because the goal is not only a longer life in terms of metrics, but also its good quality. Meanwhile, this indicator has not been growing in our country for years. There is a lack of comprehensive actions that would involve not only the Ministry of Health, but also other state bodies. Family doctors have a huge role to play in prevention, but this burden cannot rest solely on their shoulders. Especially in a situation where doctors in primary health care clinics are overloaded and in some periods of the year (infectious seasons) simply do not have time for prevention.
Dr. Zbigniew J. Król adds that it has long been known why Poles do not live longer and their condition is not improving. Nicotine, a poor diet combined with a lack of exercise and alcohol – these are the main “culprits” for the lack of extending life in good quality in Poland.
– To eliminate these risk factors from the population, it is not enough to create more preventive programs based on diagnostic tests. Health education alone, implemented in isolation from the entire system, is also not enough. They should be interconnected vessels, which requires the involvement of many institutions – sums up Dr. Król .
