Medical Expansion Leads People to Feel Less Healthy

A new study suggests that medical expansion may lower people’s subjective health perceptions, leading to an increase in health care utilization, and, in turn, fueling further medical expansion.

Hui Zheng, PhD, an assistant professor at Ohio State University (OSU; Columbus, USA) used several large multinational datasets, including Organization for Economic Cooperation and Development (OECD; Paris, France) health data, World Development Indicators, the World Values Survey, and the European Values Study to examine changes in how people rated their health between 1981 and 2007, and compared that to medical expansion in 28 countries that are members of the OECD.

Three kinds of medical expansion were identified; medical investment, which includes health care spending per capita and total health employment; medical professionalization and specialization, which includes the number of practicing physicians and specialists; and expanded pharmaceutical industry, which includes pharmaceutical sales per capita. A variety of factors other than medical expansion were also included, such as economic development, life expectancy at birth, whether people were married, levels of education and income. Health was rated by participants on a five-point scale, from 1 (very poor) to 5 (very good).

The results showed that even after all factors were taken into account, all three types of medical expansion were associated with poorer subjective health over time. For example, in the United States, the percentage of Americans reporting very good health decreased from 39% in 1982 to 28% in 2006. Among the reasons cited for why medical expansion leads people to feel less healthy are the risk of being diagnosed with "new" diseases, such as attention deficit hyperactivity disorder (ADHD), depression, and autism. In addition, more aggressive screening uncovers more diseases in people. The study was published early online on January 24, 2015, in Social Science Research.

“It seems counterintuitive, but that's what the evidence shows. More medicine doesn't lead to citizens feeling better about their health—it actually hurts,” said Dr. Zheng. “As more medical care becomes more widely available, people may expect better health, perhaps to an unrealistic degree. Consumers begin demanding more medical treatment because of the declines in subjective health and the increasing expectations of good health, and medical expansion continues. It is a cycle.”

Related Links:
Ohio State University
Organization for Economic Cooperation and Development