Health is so much more than just the absence of disease. A wide range of lifestyle factors, such as physical health, happiness, fitness, thoughts, and relationships, all contribute to a symbiotic relationship where your health is significantly influenced by your “quality of life” (QOL) – and vice versa. So, why don’t we prioritize improving and uplifting our QOL when it comes to maintaining and creating health?
The main issue may be that mainstream medicine focuses more on the illness model rather than the wellness model. QOL can be difficult to measure objectively, which may further contribute to the problem. In our fast-paced, modern lives, there’s often little time to discuss lifestyle choices and changes that could positively influence QOL. Additionally, quick fixes from Big Pharma tend to be the norm.
However, QOL should be a significant concern. So much so, that it may change the way medicine is practiced. In September last year, a scientific statement from the American Heart Association (AHA) emphasized the importance of a healthy lifestyle in the prevention and treatment of cardiovascular disease and other noncommunicable diseases. The statement highlighted that investing in primary prevention, such as modifying health risk behaviors, could result in a four times improvement in health outcomes compared to pharmacological treatment-based secondary prevention. This statement is essential as it encourages a natural, behavior-based model for prevention and treatment that typically isn’t the norm for science-based medical organizations.
Dr. Eldrin Lewis, a cardiologist at Brigham & Women’s and Harvard Medical School, acknowledges that patients with heart failure experience significant impairments in their quality of life. Still, this factor often isn’t measured clinically because many clinicians don’t understand the concept of QOL. The path to change will require a significant shift, including altering medical school curriculums and implementing billable codes and protocols with insurance companies. Unfortunately, most physicians don’t believe in the concept, can’t bill for it, or don’t have enough time to counsel patients effectively within our current medical system. The AHA aims to convince more physicians to adopt this approach, proposing “medical training to achieve competency in lifestyle counseling” – essential for prevention and treatment of cardiovascular diseases and other chronic medical conditions.
Another obstacle is that many patients feel that they aren’t capable of helping themselves. Patients often expect their healthcare practitioner to “make” them well, rather than advising them on how to influence their health independently. Moreover, even with the full compliance of patients and healthcare providers, the AHA’s list of lifestyle characteristics could be more comprehensive – currently, it includes nutrition, physical activity, smoking, and obesity. However, many other factors can affect QOL.
QOL is a personal measure of how “good” your life is to you. It impacts your health, while your state of health also affects your QOL. Engaging in activities you enjoy, like gardening, reading, meditating, and exercising, can improve QOL. Additionally, making healthier choices like eating organic food, avoiding processed foods, getting plenty of sleep, and exercising regularly can improve QOL and directly affect your health. On the other hand, lifestyle choices like smoking, heavy drinking, inactivity, and eating a poor-quality diet can negatively affect health by causing obesity, high blood pressure, heart disease, diabetes, and chronic pain.
Lifestyle factors influencing QOL can be traced back to behaviors and include elements like sleep patterns, eating habits, food choices, stress reduction, posture, interpersonal interactions, frequency of intimacy, exercise, hydration, creative outlets, worry, and anxiety. While lifestyle medicine has long been advocated by some, especially a demographic known as LOHAS (Lifestyles of Health and Sustainability), the medical establishment is beginning to catch up. As we begin to understand the connection between health and QOL, it’s essential to implement these principles, making them the foundation of our healthcare.
