Is anyone perfectly healthy? Study finds everyone has room for improvement

New research shows that just 3% of adults show no major health risk factors linked to death

TORONTO — You’ve probably heard the lifestyle and health recommendations from various government agencies and health services time and time again. Exercise regularly. Eat a clean, green diet. Don’t spend too much time scrolling on screens. Be sure to get at least seven to nine hours of sleep daily. Keeping up with all of the recommended lifestyle choices for cultivating a long, healthy, and happy life can feel overwhelming at times. After all, adult life isn’t just about fitness and well-being. So, perhaps it shouldn’t come as all that much of surprise that a new, long-term research project by a team from York University reports that, when it comes to overall health, pretty much everyone has at least one area or two they can improve upon.

Notably, the relationship between risk factors and death also appears to change over time, sometimes in quite surprising ways.

“You can take this as a good news story or a bad news story, depending on how you want to look at these numbers,” says Faculty of Health Associate Professor with the School of Kinesiology and Health Science Jennifer Kuk, lead author of the study, in a university release. “What we discovered is that the relationship with risk factors and mortality changes over time, which could be explained by factors such as evolution in treatments and changes in social stigma. Overall, most of us have something wrong with us, and we’re more likely to have a lifestyle health-risk factor now than in the ’80s and that’s actually associated with even greater mortality risk now than before.”

For this project, researchers used U.S. survey data collected between 1988-1994 and 1999-2014 in order to assess five-year mortality odds among adults 20 or older. Study authors were sure to analyze 19 different risk factors, and then adjust that data for differences in age, sex, obesity category, and ethnicity.

This approach led to the discovery that less than three percent of people displayed none of the risk factors. While earlier studies documented the risk factors very well, Prof. Kuk explains what was far less understood at that time was the relationship between various risks and the likelihood for mortality over time. Researchers note that relationship may sometimes be paradoxical.

For instance, Prof. Kuk explains that smoking rates, which have long been linked to numerous potentially fatal health conditions like cancer, heart disease, and diabetes, have generally decreased in large part thanks to strong public health campaigns. Still, overall risk of being a smoker did increase over time, which Prof. Kuk says may be explainable by increased stigma as the addiction became less common and awareness of risks grew. This may also be reflected in research funding.

“If you look at cancer research, there’s a lot of funding overall, but specifically for lung cancer, it seems to be associated with moral fault and as a consequence lower funding,” Prof. Kuk explains. “When you look at the mortality risk associated with having lung cancer relative to all the other common cancers, it’s extremely high. So I think that this lack of push is detrimental.”

Normally, Prof. Kuk’s main area of research is obesity. She explains that while obesity prevalence has increased, the risks have declined.

“Even though there’s more and more people with obesity, it’s actually not resulting in more deaths over time. And so I think that that’s another clear thing we need to recognize, that we’re very good at treating the outcomes associated with obesity. And regardless of what our body weight is, most of us have something that we can probably work on.”

Additional health trends identified by researchers in the data include:

• Diabetes and hypertension rates have increased over time, but the risks have declined.
• More people are failing to exercise, and this is now related to worse outcomes than it once was.
• Being on mental health medications was not a significant risk factor in the 1980s, but in the later dataset it was associated with increased mortality.
• Not finishing high school is associated with health risks, besides during the 1980s.

All in all, while Prof. Kuk says this study suggests nearly everyone has at least some room for improvement when it comes lifestyle choices like diet, exercise, smoking, alcohol and drug intake, she adds there are other factors totally out of many people’s individual control.

“When we look at things like food insecurity, low education — as a society, we’re making it so that health might not be an easy choice for a lot of people. We need to be sensitive to that when we take a look at these risk factors.”

The study is published in PLoS ONE.