How good is the news?

In these troubled times, we all like to hear good news and health care is one area that seems to abound with uplifting language. Daily posts about “cures” and “new treatments” raise our spirits and are antidotes to the bleak predictions about shrinking health services and budgets. Even “groundbreaking”, which usually refers to some treatment only tried out in mice, can engender hope. We hear what we want to believe. For example, a “promising” treatment is readily translated in our minds into a “very effective” or “completely effective” treatment.

There is some really good news which is irrefutable across a range of health problems: dementia, childhood mortality and mental health.

The most obvious stretches of the truth occur where hope is lowest, for example in the treatment of cancer. Research shows us that the number of people suffering and/or dying from some cancers has decreased. Deaths from colorectal cancer (CRC) are one third less and prostate cancer deaths one half of what they were last century.

Early detection programs, such as those for prostate, breast, colorectal and cervical cancer result in earlier diagnosis – sometimes long before these cancers would be picked up otherwise. Once diagnosed, people with these early stage cancers are included in the overall cancer statistics and, because their disease is often slowly progressing, they extend the average life expectancy of all the cancer sufferers – even though there is no improvement in treatment for any sufferers. This artefact is called stage migration and can be quite confusing when we are looking for really good news.

Teasing out real changes requires looking at large datasets over long periods of time. Fortunately, we now have a lot of evidence coming from these sources and there is some really good news which is irrefutable across a range of health problems including dementia and mental health.  For example, the number of people over 65 years old suffering from dementia has decreased over the last decade from just over 11 percent to just under nine percent.

Improvements are not just restricted to particular diseases or those conditions that affect higher and middle income countries. Death rates for children have fallen all over the world. Effective vaccinations are a major contributor, especially in lower income countries where they are really needed, for example, the number of children ending up in emergency departments in Rwanda has halved after a rotavirus program.

Healthy good news health spreads out of health to other sectors too. In the last two years, the number of times police cells were used as a place of safety for people with mental health problems or addictive behaviours in the UK fell by half.

Health care is one of the domains that consistently offer us hope and proof of effective change. It’s a spread we don’t want to prevent.

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