Preventive health checks linked to lower mortality risk: Study

Attendance at a preventive health check in the UK has been linked to a smaller long-term risk of disease and mortality, according to the findings of a study published in BMC Medicine this week.
 
The study used data from the UK biomedical database Biobank to track the progress of 48,602 people who had taken an NHS Health Check between January 2008 and June 2016.
 
The health is a free check-up of overall health in the UK available to those aged 40–74, and is designed as a preventive intervention to identify people at risk of heart disease, stroke, diabetes and kidney disease among other conditions.
 
Those identified as having a health check were compared to a control group that had not,
but had similar, potentially confounding, characteristics.
 
Researchers checked the health records for disease diagnosis over an average follow-up period of nine years.
 
In follow-ups carried out two years after the health check, there were higher rates of diagnosis for hypertension, high cholesterol, and chronic kidney disease compared to the control group.
 
However, in later follow-ups researchers found recipients of the health check had a significantly lower risk for multiorgan disease, as well as for cardiovascular and all-cause mortality.
 
This included a 19% lower rate of dementia diagnosis, as well as 23% lower level of acute kidney injury diagnosis, and a 44% lower rate of liver cirrhosis diagnosis.
 
Overall, NHS Health Check recipients recorded a 23% lower risk of death from any cause.
 
The authors suggested the difference could be down to modifying risks through earlier detection, as well as addressing risk factors such as hypertension and high cholesterol.
 
‘This work adds important evidence to the growing body of research supporting the effectiveness of preventive interventions in reducing longer-term multimorbidity,’ the authors wrote.
 
They noted that while countries had preventive health programs, evidence for longer-term outcomes ‘is proving to be particularly challenging to find’.
 
They also acknowledged self-selection bias as ‘a very important factor to consider’ when considering voluntary intervention like the NHS Health Check.
 
‘People who engage with health screening programs are systematically different in important ways from those who do not,’ they wrote.
 
‘They tend to have a more favourable social, lifestyle, and health profile compared to non-attenders.’
 
Researchers said they adjusted for confounders but acknowledged the possibility of ‘residual uncaptured confounding’ associated with UK Biobank membership and attendance NHS Health Checks.
 
A future study involving a larger matched cohort could look at participants receiving their first health check at the same time to remove another area of potential confounding, they also suggested.
 
According to statistics published in the RACGP’s Red Book, which focuses on the role of general practice in preventive health, around 32% of Australia’s total burden of disease is caused by modifiable risk factors.
 
‘Preventive care is also critical in addressing the health disparities faced by disadvantaged and vulnerable population groups,’ it states.
 
‘Prevention of illness is the key to Australia’s future health – both individually and collectively.’
 
However, recent studies have suggested that Australia lags behind other OECD countries in the proportion of funding that goes to preventive health.
 
In an article published in The Lancet Public Health journal last year looking at the burden of disease and their risk factors, authors found that while Australia spends more than average on health overall, its funding is less focused on prevention.
 
They concluded that Australia spends around 0.13% of its GDP on preventive health, which they wrote presented ‘a strong case for increasing investment’.
 
The RACGP’s Red Book Guidelines for preventive activities in general practice are available on the RACGP website.
 
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