Common Anxiety Shown To Reduce Life Expectancy By 8 Years

 Excising our internal anxieties is an essential aspect of wellness. Relief from internal strife and stress is a key component for health. In The Lancet’s published study on all-cause-loss-of-years-of-life attributable to mental illness, men were found to have lost fifteen years and women, thirteen. To arrive at these conclusions, the researchers analyzed 35,865 studies and found 109 which were similar for inclusion in their meta-analysis of 12,171,909 patients with mental disorders. (Joe Kwun Nam Chan, 2023) This is a type of statistical analysis called meta-analysis, where high quality studies which are similar in hypothesis and population, are analyzed to find a pattern and to draw conclusions on the study findings from a much larger population sample. Conclusions from meta-analysis studies are very valuable for health policy planning and funding for interventions in public health. Statistically when the studies are of high quality, with confidence intervals in the 90^th percentile and represent a larger population, the findings are more reliable than smaller studies for informing systemic changes in healthcare. A confidence interval is a statistical measure to determine the likelihood of the same result being generated using similar data. It is a validator for the quality of the study methods and analysis. What makes the conclusions so urgent is even a benign diagnosis of anxiety or neurosis showed a reduction in life expectancy of eight years. It was no surprise the study found those suffering from substance abuse disorders had a reduction in life expectancy of twenty years. People with eating disorders were found to have a loss of sixteen years in life expectancy. Intriguingly those suffering from schizophrenia showed fewer years of lost life than the eating disorder group. Please note this study was only for patients seeking treatment, when untreated mental illness is a global problem and some would say crisis.

 Youth Suicide

The United States has one of the highest youth suicide rates in the industrialized world with 11.5 deaths per 100,00 persons between the ages of 19 and 24, second only to Australia and tailed by Canada. (Cristopher Doran, 2020) The National Institutes of Health study on global youth suicides found that for youths between nineteen and fifteen years, the mean suicide rate was 7.4 deaths per 100,000. In other words, the rate of youth suicide in the U.S. is 35% higher than the rate elsewhere in the world. Males showed much higher suicide rates at 10.5 to females of 4.1 per 100,000 of their peers. This study reviewed data from ninety countries and alarmingly found the suicide rate for females was increasing and the overall suicide rate for men and women was also increasing, except in Europe. Information was drawn from the World Health Organization Mortality database. (DANUTA WASSERMAN, 2005) Young people killing themselves is a public health crisis of immense proportions and is indicative of poor primary care, the limited availability of qualified mental health clinicians, and the lack of funding for adequate treatment.

 The point is what you spend your time thinking about and how that impacts your nervous, circulatory, and immune systems are indelibly linked. Thankfully, there are many more tools today to help people redirect their thoughts and make changes in negative practices. Virtual therapy allows those in rural areas to access high quality therapy, as well as busy working parents to be able to do it from their home or office. The advent of smart phones means many more people in the world have access to the internet and this is empowerment. Health and Human Services has invested thirty-five million dollars in expanding community mental health services and suicide prevention. (Substance Abuse and Mental Health Services Administration, 2022) The total mandatory spending for healthcare in the United States Budget for 2024, which was approved on March 23^rd, designated 4.2 trillion in mandatory allocations and 1.9 trillion for discretionary programs like this. As you can see, the amount mental health services are receiving in the federal budget allocation is tiny compared to the overall investment.

US Government Investment in Targeted Mental Health Services-2024 Budget

 Currently, there are three federal government initiatives to increase access to care for mental health services: shared Savings Programs through the Accountable Care Organizations (Health & Human Services, Centers for Medicare and Medicaid, 2012), targeted funds for health care in rural America, and the expansion of state Medicaid programs which decrease the likelihood of rural hospitals closing by half. (United States Department of Health and Human Services, 20232) The Accountable Care Act was created in 2010, along with the Accountable Care Organization Shared Savings Program and has been instrumental in creating financial rewards for health care organizations to target key health outcome criteria, based on evidence-based planning and medical research. Though the expansion of Medicaid under the Affordable Care Act was good for increasing the number of people whom can obtain affordable medical insurance, it did little to increase access to the availability of mental health services, as most mental health practitioners do not accept the Medicaid reimbursement level. Under the Accountable Care Act, which is administered by the Centers for Medicare and Medicaid, as of January 2024 there is additional funding allocated for rural hospitals to help them obtain advance payments to fund mental health workers. The Biden-Harris Administration allocated twenty-eight million in direct funding for health care for rural entities and another sixteen million for technical support in the 2024 budget. (United States Department of Health and Human Services, 20232) The goal is to expand the rural health care workforce and increase access to care for the sixty million people who live in rural areas. However, the implementation of these programs will be determined after the 2024 presidential election.  We can only hope this is supported by both parties.

 And this is the healthpolicymaven signing off encouraging you not to sign blanket releases when you agree to medical procedures, do stipulate that to which you agree and decline.

 This column does not purport to give medical advice and all opinions are those of Roberta Winter, an independent healthcare analyst and journalist who accepted no reimbursement for its contents.

 

References

Cristopher Doran, I. K. (2020, May 19). Economic and epidemiological impact of youth suicide in countries with the highest human development index. PLOS One. PLOS One.org. doi:https://doi.org/10.1371/journal.pone.0232940

DANUTA WASSERMAN, 1. Q.-X. (2005, June 4). Global suicide rates among young people aged 15-19. World Psychiatry(June 4 (2) 114-120). World Health Organization. doi:PMID: 16633527

Health & Human Services, Centers for Medicare and Medicaid. (2012, April 10). First Accountable Care Organizations Under the Medicare Shared Savings Program. CMS.gov. Retrieved June 1, 2024, from https://www.cms.gov/newsroom/fact-sheets/first-accountable-care-organizations-under-medicare-shared-savings-program

Joe Kwun Nam Chan, a. C. (2023, October 31). Life expectancy and years of potential life lost in people with mental disorders: a systematic review and meta-analysis. The Lancet.com, Volume 65. London, England/United Kingdom. doi:https://doi.org/10.1016/j.eclinm.2023.102294

Substance Abuse and Mental Health Services Administration. (2022, May 9). HHS Announces Nearly $35 Million To Strengthen Mental Health Support for Children and Young Adults. SAMSA.gov Press Release. United States. Retrieved May 27, 2024, from https://www.samhsa.gov/newsroom/press-announcements/20220309/hhs-announces-35-million-strengthen-mental-health

United States Department of Health and Human Services. (20232, November 3). The Biden-Harris Administration is taking actions to improve the health of rural communities and help rural health care providers stay open. Health & Human Services News. Washington, District of Columia, United States. Retrieved May 30, 2024, from https://www.hhs.gov/about/news/2023/11/03/department-health-human-services-actions-support-rural-america-rural-health-care-providers.html