ANN ARBOR—Lifestyle may be a stronger link to disease than aging, according to a study by the University of Michigan Health Management Research Center. And unlike aging, lifestyle can be controlled. The study looked at such conditions as heart disease, cancer, diabetes and past strokes and found that those with a high-risk lifestyle were significantly more likely to suffer from disease than those who were considered low risk. HMRC senior research associate Shirley Musich analyzed the self-reported health data of 135,251 people among age group and risk levels. Risk level was determined by factors such as smoking, lack of exercise, overweight, high blood pressure or cholesterol, high stress and life dissatisfaction. People with two or fewer health risks are categorized as low risk, while persons with five or more are high risk. The correlation between risk levels and presence of disease is dramatic:

• In the 65-and-older group, disease affects 26 percent of the low risk individuals and 80 percent of those at high risk.
• For 45-to-64-year-olds, about 10 percent of those at low risk report a disease, compared to 56 percent of those at high risk.
• Only 3 percent of the low risk adults under 45 report a disease. Among high risk people in that age group, it’s 25 percent.

“Living a healthy life does not guarantee you will not get a disease,” Musich said. “But it certainly raises the odds against it.” Her findings, reported in Disease Management & Health Outcomes, are based on the health survey data of current and retired employees of General Motors Corp. who were also continuously enrolled in traditional or preferred provider organization (PPO) medical plans during the period 1996-99.

“Our objective was to measure the magnitude of excess health care utilization associated with excess health risks for persons with a diagnosed chronic disease,” she said. “In particular, we were looking at the implications for corporations and managed care organizations that help patients monitor and manage chronic diseases.” The findings have particular relevance to health management programs, Musich said. To improve quality of life for the people they service, programs should consider “the whole person,” not just the disease and its symptoms. While managed care organizations and PPOs are the most common providers of disease management programs, some corporations are also coming on board, Musich said. General Motors includes disease management as part of its company-wide health management program.

The HMRC has been associated with GM’s efforts in health management since 1996. The center provides and processes health risk appraisals (HRAs), which are distributed to over 1 million current and retired GM employees annually. HMRC researchers like Musich draw upon the vast databank to analyze issues related to health risks and provide data for effective program management. The HRAs measure three kinds of health risks. Lifestyle risk factors include smoking, lack of exercise, excessive alcohol use and not wearing a safety belt. Health/biological risk areas include high blood pressure and cholesterol, excess body weight, absence days due to illness and presence of disease.

The third category is psychological risk measures, including perception of physical health, job satisfaction, personal life satisfaction and stress. Looking at the health risk profiles of their employees as a group helps companies like GM design interventions for those who need them. Disease management programs are one such intervention. This raised awareness can alert people to reduce their health risks at any age. It may stave off disease, or make disease management programs more effective. “The message is that even with a disease, you can be ‘the best you can be’ by living practicing a healthy lifestyle,” Musich said.

Related Links:

• Health Management Research Center
• Disease Management & Health Outcomes
• General Motors Corp