I recently had the opportunity to visit my dad just before his 94th birthday. By far the member of his biological family to survive to the oldest age, I remain both grateful for and amazed by his longevity. As the eldest in a family of 5, most of whom like his father passed in their mid-70s, my dad remains fully independent. After my mom’s recent passing at age 90, he manages the household, runs all his own errands, keeps up on his outdoor chores and generally functions as he has since middle age.
As a primary care physician for nearly three decades, one of the biggest challenges that I have faced is how best to encourage healthy behaviors that promote not only longevity but also a higher quality of life. I have found it profoundly difficult to get people to embrace changes that are proven to mitigate health risks and promote a healthier life.
Medical science has described an observation known as the healthy adherer effect. It is sometimes used to describe a positive health outcome that exceeds that which would be expected from a studied intervention alone, such as taking a medication. To be clear, this observation is a form of bias, meaning that it distorts the findings of a clinical study. It is also difficult to monitor.
That said, the healthy adherer effect is based on the observation that people who properly follow a recommended treatment (such as taking a medication) are more likely than others to engage in other healthy behaviors.
It stands to reason that you are more likely to benefit from a recommended medication if you actually take it regularly, as prescribed. Yet, medication adherence rates generally hover around 50%, meaning most people only take any given prescribed medication half the time. Of course, there are valid reasons why someone may choose not to take their medication, such as side effects, which should be discussed with the prescribing health care provider.
The benefits of adherence to healthy lifestyle choices are likely cumulative. The same person who collaborates with their health care provider in their treatment plan and takes their medications as prescribed also likely exercises routinely, avoids smoking and excessive alcohol intake, gets their recommended vaccines and follows a healthy diet. The net effect is a higher likelihood of both longevity and better general health. While healthy lifestyle choices alone do not guarantee these things, they certainly improve the chances.
My dad has long been fully invested in his health. Though he has several medical conditions, he regularly attends his medical appointments, takes his medications as prescribed, exercises daily, avoids unhealthy habits such as smoking, gets his vaccines when recommended, and remains socially engaged. As his son and a primary care doctor, he continues to teach me important life lessons.
Dr. Matthew A. Clark, a board-certified physician in internal medicine and pediatrics, works for the Indian Health Service.
