How to live longer – make active not passive decisions
Health – and longevity – is unevenly distributed across socioeconomic status. Persons of lower income, education, or occupational status experience worse health, and die earlier than do their better-off counterparts. These disparities can be lessened by being active not passive in terms of decisions about your health, and the medical care you seek.
Why is this there this disparity?
Some of it is chance, e.g. the genes you are born with, the parents you have. But a lot of it is that more educated people are active in health decision making. They do not ‘trust the system’. They chase things that don’t happen. This may be because in their work (and social) life, they are leaders that take responsibility for the teams performance; so have to be aware of pitfalls in the system, to navigate the team around. They also often have a good network including senior health professionals.
Preventing disease
Broadly speaking there are two ways of preventing disease, and living longer: screening and non-screening. Though it is true that many diseases are affected by genetic/racial factors (and luck), beyond your control.
Nonetheless, you (with the help of the NHS) can help with both screening and non-screening methods. Both are partially under your control. And you can chase the system, if things are not happening. Health, and preventative medicine, need to be actively sought. This includes lifestyle choices you can make as well.
We will now explain how to live longer – by making active not passive decisions. And we will go through ten top tips that are examples of how you can do that.
Screening
These are free tests offered by the NHS automatically once you reach a certain age. The tests check for signs of a disease. You should receive a letter directly from the screening programme or via your GP.
If you do not receive an invitation, contact your GP (or the relevant place, e.g. the nearest breast unit for mammograms). To get these services you need to be registered with a GP and have an NHS number.
Screening for women
1. Cervical cancer. This test checks the health of your cervix (the base of the uterus, or womb) and helps to prevent cancer. Cervical screening starts from the age of 25 years through to the age of 64. The test is very quick and usually painless. Find out more about cervical smear tests on myHSN here. If you are not called up, contact your GP surgery.
2. Breast cancer. Mammograms are x-rays used to look for early breast cancer that you cannot feel. Any female registered with a GP, will be invited for a mammogram every 3 years between the ages of 50 and 71 years. Again, the test is very quick, and testing centres are usually in easily accessible places like your local supermarket carpark. Chase them by contacting your local hospital’s breast unit, if you are not called up for one. They are not organised through your GP.
Screening for men
3. AAA (abdominal aortic aneurysm). An AAA is a widening of the main blood vessel in the abdomen, the aorta. You should be invited for a screening from the age of 64, or soon after your 65th birthday. Again, chase it, if nothing happens.
Screening for men and women
4. Bowel cancer. Do a home screening test. This test is for everyone aged 60 or over (and 56 year olds). You will be sent a home test kit, called a faecal immunochemical test (FIT). You then need to collect a small sample of poo and send it to a lab.
The sample is checked for tiny amounts of blood (which can be a sign of growths in the bowel called polyps, or bowel cancer). If the test finds anything unusual, you might be asked to have further tests to confirm or rule out cancer, e.g. a colonoscopy or CT.
It is easy not to do this test as its a ‘bit yucky’. Again, be active and do it – and engage with the available system.
5. NHS Health Check. You should automatically be invited for an NHS Health Check if you’re aged 40-74 years and you have not had a stroke, or do not already have a pre-existing health condition. If not, contact your GP surgery. Some pharmacies do these checks as well.
6. Lung cancer. Targeted Lung Health Check (TLHC) programme – this is a trial at present in some parts of England. People aged 55-75 who have ever smoked will be invited to a free lung check. Following the lung health check those assessed as high risk will be offered a scan. If you think you might be at risk, why not discuss it with your GP and see if you can have one?
[Hint: Never assume that no news is good news. Always chase up results if you don’t receive them within two weeks.]
Non-screening
These are things its a good idea to keep on top of, but there are not currently NHS screening programmes for.
7. Other ways of preventing cancer. Examples include:
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- Breast cancer – from the age of 16 years, women should feel for lumps by examining their own breasts and armpits at least once a month in the shower or bath. Men get breast cancer too, so should do the same.
- Skin cancer – avoid excessive sun exposure, and use high factor sunscreens – especially when abroad in hot countries. Wear a hat and long sleeves shirts. If any mole changes significantly, ask your GP to look at it. And if they are not sure, see a skin specialist (dermatologist).
8. Diabetes and high blood pressure
To prevent these two ‘silent killers’, eat healthily, exercise and keep your weight down – try to keep your BMI under 30. MyHSN’s advice on weight loss here.
Form the age of 30 years, check your own blood pressure every six months. From the age if 40, take it every three months. All homes should have a blood pressure machine. A&D is a good make. They are quite cheap.
Type 2 diabetes is an inherited disease. It is especially important to start looking for ‘early diabetes’ if either of your parents has diabetes; by having a blood glucose (sugar) test every six months, from the age of 30 years. This is especially true if you are Black or Asian.
9. Don’t smoke – to prevent smoke-related disease
- Heart attack, stroke and dementia. Also keep your blood pressure down
- Chronic obstructive pulmonary disease (COPD, a long term lung disease)
- Peripheral vascular disease (PVD, tightening of the blood vessels in the legs that can lead to gangrene and amputation)
- Lung cancer
- Cancer of the head and neck.
10. Don’t drink alcohol excessively – to prevent alcohol-related disease
- Liver problems (e.g. cirrhosis)
- Alcohol-related heart disease (cardiomyopathy)
- Alcohol-related nerve damage and dementia.
Other hints
- Use NHS services well – e.g. attend follow-up appointments, x-rays (e.g. CT scans) and procedures (e.g. cystoscopy for bladder cancer). If you are offered an appointment, there is a reason! Often it’s because the doctor feels they can help you with preventing or controlling diseases. So be active, and attend your appointments, and rebook if you miss one.
- Take tablets and medicines as prescribed. Your pharmacist can support you in ensuring you take the right tablets at the right time.
- Dentist or optometrist. Have regular trips to both. They can identify diseases that can become a problem in the future, such as mouth ulcers that become cancer, or glaucoma that can cause blindness. These appointments are free for the elderly, children and those on low pay.
- Healthy lifestyle. As well as the above, it is also good to sleep well. MyHSN has more advice on lifestyle changes to prevent cancer.
- Depression and other mental health issues: Maintain a good social network of friends and family, take care of your physical health (as above), talk about issues.
- Vaccinations – have them. Full stop! The benefits outweigh the risks.
- Human papillomavirus vaccine (HPV). The 1st dose of HPV vaccine is given, in England, to girls and boys aged 12 to 13 years – i.e. when they’re in School Year 8. The 2nd dose is offered 6 to 24 months after the 1st dose. It can prevent most cases of cervical cancer, if the vaccine is given before girls or women are exposed to the virus. This vaccine can also prevent cancer of the vagina and vulva. In addition, the vaccine can prevent genital warts, anal cancers, and mouth, throat, head and neck cancers in women and men.
- Inherited disease. Even though many are rare, some are not. These include polycystic kidney disease, sickle cell disease and cystic fibrosis. So if you know that a disease runs in your family, ask for a test to make sure you don’t have it too.
I know we sound a bit preachy here – doctors can be like that. But this is because we want our patients to live long and healthy lives. To do that you need to be active in decision making, not passively waiting until the system chases you. And is important to make time for fun too: parties, holidays, good food, and alcohol … in moderation.
Summary
We have explained how to live longer – by making active not passive decisions. We hope you have found it helpful.
Other resources
MyHSN has related articles.
10 lifestyle changes to prevent cancer
Are you healthy? (NHS quiz)
This is WHO data: 10 most common causes of death
This is a good US video, with 7 top tips to prevent cancer.
