Prevention can be a key to a more productive economy and to financing the healthcare system

• Survey of 1,000 Germans reveals unhealthy lifestyles – Prevention is vital!
• More than 50% of Germans are overweight, over 40% get hardly any exercise, 25% smoke – roughly 30% of adults describe their lifestyles as "rather unhealthy"
• Prevention can improve quality of life and strengthen the workforce, thereby lessening state spending on healthcare
• The secondary healthcare market, which is based primarily on prevention, has barely been affected by the economic crisis: 86% of Germans want to continue to pay for private healthcare services
• An effective prevention strategy must take a targeted approach to people who live unhealthily, reaching them through their doctor, employer and insurance company – however, this also requires political support

The Germans clearly have some catching up to do when it comes to prevention and living healthy. That's the result of a study by Roland Berger Strategy Consultants which surveyed 1,000 Germans. According to the survey, roughly 30% of adults lead unhealthy lifestyles. All study participants could benefit from an effective prevention policy: mostly the people themselves, but also society in general (with a more affordable healthcare system) as well as companies, which will become more and more dependent on maintaining the fitness of an increasingly older workforce. Insurance companies would be able to avoid the costs of expensive treatments. Yet doctors, hospitals and private service providers are only slowly discovering prevention as a profitable field of business.

"25% of adults smoke at least half a pack of cigarettes a day, 24% never exercise, and 23% exercise only sporadically," says Karsten Neumann, Principal in the Pharma & Healthcare Competence Center at Roland Berger Strategy Consultants. "The result is that 15% of the population is obese according to the medical definition, with a body mass index (BMI) over 30. A further 35% are overweight with a BMI between 25 and 30." However, Germans are generally not adverse to the idea of prevention. They are even very open about this when talking to their doctors, employers or insurance companies. 94% indicate that they are seriously interested in and willing to take preventative action. All that needs to be done is to leverage this openness.

A positive development is that the willingness to spend one's own money on healthcare has been hardly influenced by the financial and economic crisis. "86% of those surveyed stated that their spending on private healthcare services has not been affected by the crisis," says Neumann.

Gender and education as risk factors

"The study shows two clear trends," says Dr. Joachim Kartte, Head of the Pharma & Healthcare Competence Center at Roland Berger. "Men's lifestyles are considerably less healthy. Of those who lead very unhealthy lifestyles, approximately two-thirds are men. In addition, a lower level of education significantly increases the risk of obesity and unhealthy behavior." Obesity occurs in people with a technical school degree more than twice as often as in those with a more academic bent. The same holds true for smoking and an unhealthy diet. "We saw no correlation with income," says Kartte. "This indicates that education is one of the keys to cushioning the negative effects of a lower social status on health."

Strategy for "prevention dodgers"

In Germany, there are numerous successful prevention programs that bring about the desired effects for the participants and also have a positive impact on insurer costs. However, thus far there has been no real target group analysis, and prevention programs reach the less motivated people only rarely. "That's why for us it was important to develop a prevention strategy that focuses on people and can therefore have the optimal effect on the entire healthcare system," says Kartte. Neumann explains further: "Only when target customers are reachable – both physically and emotionally – can prevention work. These target groups must be approached through various channels: not just the doctor in the doctor's office, but also the employer, the insurance company and of course their own families." The study zeroes in on those groups who especially need to be addressed and defines the areas where they can best be reached.
Implementing and financing these actions requires active cooperation between all areas of politics involved in healthcare and prevention.