What price good health? One in five people of working age in the UK has a long-term disability, according to official figures, and Cash has compared the costs of being ill with the costs of healthy living. Is it feasible to reduce your susceptibility to back pain, heart disease, stress and the other main debilitating conditions of our time? The results are very encouraging.
Of all the investments you could make, investing in your health must be the best one. For virtually nothing, you can take several simple steps to improve your resilience and overall health. And, if you can afford it, you can do a lot more with £500. Of course, you cannot defeat the worst genetic inheritances or simple bad luck, but most people can probably live happier, longer and better lives by this route.
First, the bad news. Poor health is expensive. For instance, only 52 per cent of disabled people are 'economically active' (in work or looking for work) - compared with 79 per cent of the working population overall. One in eight unemployed people in a 1998 Department of Health study cited back pain as a cause of their unemployment.
'Diabetic complications' such as foot ulcers and blindness, which hit one in five sufferers of type 2 diabetes, cost individuals on average an extra £500 a year for medications and are 'linked to a significant increase in loss of earnings', according to charity Diabetes UK.
If these are the consequences, why do so few of us practise self-help?
It may be - to posit an unfashionable argument - that while sickness is subsidised through the NHS and benefits systems, there is little government encouragement to stay well. And few of us probably appreciate the costs we bear, because they are mostly indirect.
The average expenditure on each person in the UK is £1,275 - through the NHS, nursing homes, charities, prisons and other organisations, according to the government's health expenditure accounts. This comes out of our taxes - with each of us paying an average of £77,000 through our lives, in current prices, to fund the NHS. But few of us spend more than £200 a year from our own wallets on health-related purchases, according to the 2001/02 Family Spending Report, so perhaps we are not used to the idea that we can buy into health. (We spend vastly more on alcohol and tobacco.)
Actuary Mercer estimates that £34 billion - £1,300 per worker - is lost each year to employers and shareholders as a result of the direct and indirect costs of sickness absence. So for your own sake, as well as the community's, there are some basic steps you could take to get healthier.
Drink more water: We are a dehydrated nation which, through the burgeoning of sugary, caffeine-containing and alcoholic drinks, is losing its thirst mechanism. Water flushes out the toxins which will otherwise linger internally. Asthma, allergies, eczema and many other conditions have been linked to poor hydration. More information from the College of Natural Nutrition. Cost: virtually nothing.
Get your diet right: Junk food (high in salt, cholesterol and calories and low in nutritional merit) increases your susceptibility to heart disease, while fruit and vegetables build up your immune systems to fight a range of conditions from the simple cold to certain types of cancer. Cost: none. You can save money (One premium-brand ready-made individual cottage pie costs nearly £2.20 - but the ingredient cost is less than 70p.)
Take exercise: You will reduce stress, cut your exposure to heart disease, lower your blood pressure, strengthen your bones, improve your flexibility and produce many other positive effects. 'Walk for 20 minutes a day so that you are slightly out of your comfort zone, just slightly short of breath,' says fitness trainer Gill Phelps. 'Then gradually build it up so you get fitter.' A third of women over 50 are on course to develop osteoporosis, largely preventable by taking weight-bearing exercise. Cost: nothing, or very little (annual membership of run ning clubs is typically £10 to £30, and a decent pair of trainers cost £80 plus) or £800+ pa for membership of a city-centre gym.
Improve your balance: Half of nursing home admissions follow a fall, so improving balance, easily achievable in exercise classes, is particularly beneficial for the elderly. Cost: about £2 a week for a class.
Take food supplements: Intensive farming has depleted our soil of trace elements, so even fresh vegetables are not as nourishing as they used to be. A lack of selenium is now being linked to the growth in numbers of asthma sufferers. Selenium and other trace elements, including copper and zinc, can be taken through food supplements, available in many high street health food shops. Cost: typically £1 a day.
Have preventative check-ups: Your GP may offer free checks. Bupa does health assessments for between £120 and £495, tests which will detect tendencies to heart disease, the onset of prostate cancer (treatable with far better results when caught early) and many other conditions. Holistic checks from alternative practitioners (acupuncturists, oriental medicine special ists, chiropractors and others) can cost as little as £30 and complement the traditional approach. Cost: £30 to £550.
Consider private medical insurance: You can get quicker treatment - crucial in eye or other conditions which deteriorate - and the treatment may be better. Although the consultants are often the same people offering NHS treatment, they may be more inclined to give you choices over your own treatment when you go private. Cost: typically £50-£60 pm for a 20-year old, £80-90 pm for a 40-year-old and £140-160 for a 60-year old, according to actuary Mercer.
Improve your posture: Most people walk and sit in a way that will lead to problems later. See an osteopath (a particularly good idea for pregnant women whose sudden weight gain and distribution can lead to continuing back problems). Cost: £30- £60.
Have a positive mental approach: Take control of your health. The very word 'patient' and the phrase 'being under the doctor' show how we tend to regard ourselves as victims when it comes to health. Cost: nothing.
Back pain
Four out of five people can expect to suffer back pain at some stage - and you increase the likelihood if you regularly sit, without moving, for periods of more than 20 minutes (perhaps at work or in front of the TV). Back pain is the nation's leading cause of days off work, leading to nearly 120 million days off a year (suggesting employer costs of more than 10 billion pa). Prevention - by developing a strong and flexible back and learning how to lift properly - can provide the answer for most people.
Stress
UK National Work-Stress Network
One in five people suffers from stress, according to the Health and Safety Executive. More than 13 million working days are lost each year as a result - costing employers over £1 billion a year and an estimated £4 billion to society as a whole, says the HSE. Prevention is all in this field. You are in the danger zone if you regularly work more than 50 hours a week, for instance. Taking exercise and having outside interests can greatly defuse stress. Sensible job design - so that people are not blamed for issues over which they have no control - for instance, is a big issue for managers.
Alzheimer's
Alzheimer's Society helpline 0845 300 03336
There are more than 700,000 Alzheimer's sufferers in the UK. Costs of long-term care for older people with 'cognitive impairment' were estimated at £4.6 billion by the London School of Economics this year. The cost is felt not just by the sufferers but by their families, particularly partners who often provide informal and unpaid care 24 hours a day. But there is increasing evidence that lifestyle can play a significant role in prevention. In its 'Mind your head' awareness week in early July, the Alzheimer's Society outlined several preventative measures including: eating oily fish once a week, taking regular exercise, not smoking, avoiding head accidents, keeping an active mind (by, perhaps, doing a crossword once a day) and having an active social life.
· Unattributed figures quoted in this article are generally taken from Social Trends 2003, a government annual.
