Category: SOCIAL PROTECTION

Digital transformation: Health systems’ investment priorities

Health systems around the world are facing a host of challenges, including rising costs, clinical-workforce shortages, aging populations requiring more care (for example, to treat chronic conditions), and increasing competition from nontraditional players.1 At the same time, consumers are expecting new capabilities (such as digital scheduling and telemedicine) and better experiences from health systems across their end-to-end care journeys.2 In response, health systems are increasing their focus on digital and AI transformation to meet consumer demands, address workforce challenges, reduce costs, and enhance the overall quality of care.3 However, despite acknowledging the importance of these efforts to future sustainability, many health system executives say their organizations are still not investing enough.

AI, traditional machine learning, and deep learning are projected to result in net savings of up to $360 billion in healthcare spending.

AI, traditional machine learning, and deep learning are projected to result in net savings of $200 billion to $360 billion in healthcare spending.4 But are health systems investing to capture these opportunities? We recently surveyed 200 global health system executives about their digital investment priorities and progress.5 Seventy-five percent of respondents reported their organizations place a high priority on digital and analytics transformation but lack sufficient resources or planning in this area.

Increasing prioritization

In line with other industries, the majority (nearly 90 percent) of health system executives surveyed, in both technical roles (such as chief information officer or chief technology officer) and nontechnical roles (for example, CEO or CFO), reported that a digital and AI transformation is a high or top priority for their organization. At the same time, 75 percent of respondents reported their organizations are not yet able to deliver on that priority because they have not sufficiently planned or allocated the necessary resources.


Health system digital investment priority areas and anticipated impact

For health system executives, current investment priorities do not always align with areas they believe could have the most impact. There is alignment in some areas, including virtual health and digital front doors, where about 70 percent of respondents expect the highest impact.1 In other areas, such as AI, 88 percent of respondents reported a high potential impact,2 yet about 20 percent of respondents do not plan to invest in the next two years. The absence of investment in a robust, modern data and analytics platform could delay value creation in areas that depend on these capabilities—such as efforts to close gaps in care, improve timely access for referrals, and optimize operating room throughput.

Major headwinds and slow progress

Given the current macroeconomic climate and increasing cost pressures on health systems, most respondents identified budget constraints as a key obstacle to investing at scale across all digital and AI categories of interest (51 percent of respondents ranked this obstacle among the top three). For example, a health system that is building a digital front door may lack the resources to simultaneously invest in the latest generative AI (gen AI) capabilities.

Respondents called out challenges with legacy systems as the second-greatest concern (after budget constraints). Core tech modernization is key to delivering on the digital promise,1 but health systems have typically relied on a smaller set of monolithic systems that have become a challenge to untangle.

Additional highly ranked challenges include data quality (33 percent), tech talent and recruiting (30 percent), and readiness to adopt and scale new technology (34 percent).

Satisfaction with digital investment

Most executives of health systems that have invested in digital priorities (72 percent) reported satisfaction across all investment areas. Among the comparatively fewer respondents who reported investing in robotics and advanced analytics, satisfaction was even higher, at 82 percent and 81 percent, respectively. Given that investments result in a high level of satisfaction and that 75 percent of executives reported they are not yet able to deliver on their digital transformation ambitions (as noted above), health systems may be facing a failure to scale their digital programs.

What health systems can do and how they can learn from other industries

The goal of digital and AI transformation is to fundamentally rewire how an organization operates, building capabilities to drive tangible business value (such as patient acquisition and experience, clinical outcomes, operational efficiency, and workforce experience and retention) through continuous innovation. Delivering digital value for health systems requires investment and new ways of working.

Building partnerships. Scale is crucial to value creation. But the definition of at-scale systems has changed in the past few years; today, it takes more than $13 billion to be a top 20 system by revenue, and many have reached their current position through inorganic growth.6 Partnerships (joint ventures and alliances) may offer a promising avenue to access new capabilities, increase speed to market, and achieve capital, scale, and operational efficiencies.7

Moving beyond off-the-shelf solutions. History shows that deploying technology—such as electronic health records (EHRs)—on top of broken processes and clinical workflows does not lead to value. Realizing value from healthcare technology will require a reimagination (and standardization) of clinical workflows and care models across organizations. For example, optimizing workflows to enable more appropriate delegation, with technical enablement, could yield a potential 15 to 30 percent net time savings over a 12-hour shift. This could help close the nursing workforce gap by up to 300,000 inpatient nurses.8

Using the cloud for modernization. Health systems are increasingly building cloud-based data environments with defined data products to increase data availability and quality. Health systems can also use cloud-hosted, end-user-focused platforms (such as patient or clinician apps) that integrate multiple other applications and experiences to simplify stakeholders’ interactions with the system.

Operating differently. Operating differently entails fundamental changes in structure (flatter, empowered, cross-functional teams), talent (new skill sets and fully dedicated teams), ways of working (outcome orientation, agile funding, and managing products, not projects), and technology (modular architecture, cloud-based data systems, and reduced reliance on the monolithic EHR). With these changes, some health systems have begun to see real value within six months. Building a digital culture helps the transformation succeed over time.9

Cautiously embracing gen AI. Gen AI has the potential to affect everything from continuity of care and clinical operations to contracting and corporate functions. Health system executives and patients have concerns about the risks of AI, particularly in relation to patient care and privacy. Managing these risks entails placing business-minded legal and risk-management teams alongside AI and data science teams.10 Organizations could also implement a well-informed risk-prioritization strategy.

Digital and AI investments provide health systems with opportunities to address the many challenges they face. Successful health systems will invest in areas with the greatest potential impact while removing barriers—for example, by upgrading legacy infrastructure. Health systems that make successful investments in digital and analytics capabilities could see substantial benefits and position themselves to benefit from the $200 billion to $360 billion opportunity.11

ABOUT THE AUTHOR(S)
Jack Eastburn is a partner in McKinsey’s Southern California office; Jen Fowkes is a partner in the Washington, DC, office; and Karl Kellner is a senior partner in the New York office. Brad Swanson is a consultant in the Denver office.

The authors wish to thank David Bueno, Camilo Gutierrez, Dae-Hee Lee, Audrey Manicor, Lois Schonberger, and Tim Zoph for their contributions to this article.

Πηγή: mckinsey.com
find more :https://eefam.gr/digital-transformation-health-systems-investment-priorities/

New evidence that brain and body health influence mental wellbeing

The study, published in Nature Mental Health, analysed UK Biobank data from more than 18,000 individuals. Of these, 7,749 people had no major clinically-diagnosed medical or mental health conditions, while 10,334 had reported a diagnosis of either schizophrenia, bipolar disorder, depression or anxiety.

Using advanced statistical models, the researchers found a significant association between poorer organ health and higher depressive symptoms, and that the brain plays an important role in linking body health and depression.

The organ systems studied included the lungs, muscles and bones, kidneys, liver, heart, and the metabolic and immune systems.

Dr Ye Ella Tian, lead author of the study from the Department of Psychiatry at the University of Melbourne, said. “Overall, we found multiple significant pathways through which poor organ health may lead to poor brain health, which may in turn lead to poor mental health.

“By integrating clinical data, brain imaging and a wide array of organ-specific biomarkers in a large population-based cohort, for the first time we were able to establish multiple pathways involving the brain as a mediating factor and through which poor physical health of body organ systems may lead to poor mental health.

“We identified modifiable lifestyle factors that can potentially lead to improved mental health through their impact on these specific organ systems and neurobiology.

“Our work provides a holistic characterisation of brain, body, lifestyle and mental health.”

Physical health was also taken into account, as well as lifestyle factors such as sleep quality, diet, exercise, smoking, and alcohol consumption.

Professor James Cole, an author of the study from UCL Computer Science, said: “While it’s well-known in healthcare that all the body’s organs and systems influence each other, it’s rarely reflected in research studies. So, it’s exciting to see these results, as it really emphases the value in combining measures from different parts of the body together.”

Professor Andrew Zalesky, an author of the study from the Departments of Psychiatry and Biomedical Engineering at the University of Melbourne, said. “This is a significant body of work because we have shown the link between physical health and depression and anxiety, and how that is partially influenced by individual changes in brain structure.

“Our results suggest that poor physical health across multiple organ systems, such as liver and heart, the immune system and muscles and bones, may lead to subsequent alterations in brain structure.

“These structural changes of the brain may lead to or exacerbate symptoms of depression and anxiety, as well as neuroticism.”

 

Find more : https://www.ucl.ac.uk/news/2024/aug/new-evidence-brain-and-body-health-influence-mental-wellbeing?utm_source=linkedin&utm_medium=social&utm_campaign=vpee_linkedin_newsletter&utm_content=bodyhealth_aug24

What to Know About the HPV Vaccine and Cancer Prevention

New research shows many eligible people are not getting the shots.

Nearly 20 years after the first vaccine against human papillomavirus became available, many eligible Americans still are not getting the shot — even though it provides powerful protection against the leading cause of cervical cancer and a strong risk factor for anal cancer.
HPV is the most common sexually transmitted infection in the United States, and while most infections are asymptomatic and clear up on their own within two years, a small number persist and can cause cancer. HPV causes nearly all cases of cervical cancer, and can also lead to penile, anal, oral, vulvar and vaginal cancers.

The HPV vaccine, delivered as two or three doses, can significantly cut the risk of infection. It “is really one of the most effective vaccines we have,” said Dr. Lauri Markowitz, the HPV team lead in the Centers for Disease Control and Prevention’s division of viral diseases. But uptake remains stubbornly low: A report released by the C.D.C. this month showed that in 2022, only 38.6 percent of children ages 9 to 17 had received at least one dose of the HPV vaccine. Other new research suggests that HPV vaccination rates stalled in the wake of the coronavirus pandemic.

A study published this week laid out some of the primary reasons cited by parents in the United States who don’t plan to vaccinate their children against HPV, including safety concerns, a lack of knowledge about the vaccine and a belief that it isn’t necessary.
“We are still facing an uphill battle from what I would call inappropriate messaging or incomplete messaging when the vaccine rolled out about why this is so important,” said Karen Knudsen, chief executive of the American Cancer Society.

The HPV vaccine fools the body into thinking it has come into contact with the virus, marshaling antibodies in defense. Those antibodies can help clear the virus and prevent infection if someone is later exposed, which can happen through oral, anal and vaginal sex.

The vaccine offers protection from the types most likely to cause cervical and anal cancers and genital warts. Since the vaccine was introduced in 2006, infections with the types of HPV that cause most HPV-related cancers and genital warts have fallen by 88 percent among teen girls and by 81 percent among young adult women, according to the C.D.C.
One reason doctors are so enthusiastic about the vaccine is that it is one of very few tools to combat HPV: Condoms do not entirely prevent transmission, and there is no treatment for the virus itself. Researchers believe HPV is responsible for more than 90 percent of cervical and anal cancers and a majority of vaginal, vulvar, and penile cancers.

Children can be vaccinated starting at age nine. The C.D.C. recommends the vaccine for all preteens from the age of 11 or 12 and anyone up to age 26. It’s most effective before people are exposed to the virus, and “the assumption is that most people have started having sexual intercourse by age 26,” said Dr. Ban Mishu Allos, an associate professor of medicine at Vanderbilt University Medical Center.

The vaccine may still provide some benefit for people over age 26, and is approved up until age 45. The C.D.C. says that people between the ages of 27 and 45 might get the vaccine after talking to their doctors about their risk for new HPV infections.

You can ask your primary care doctor or local health centers for the vaccine. Most insurance plans fully cover it through age 26. Children and adolescents who are uninsured or underinsured can get the shots for free through the Vaccines for Children program. After age 26, insurance may not fully cover the shot, which can cost hundreds of dollars per dose. Merck, which makes the HPV vaccine Gardasil 9, has a patient assistance program for eligible people.

Researchers believe much of the hesitation stems from a key misunderstanding: “More people perceive it as a sexually transmitted infection prevention vaccine, as opposed to a cancer prevention vaccine,” said Kalyani Sonawane, an associate professor of public health sciences at the M.U.S.C. Hollings Cancer Center and an author of the new paper on parental attitudes toward HPV vaccination.

Dr. Sonawane’s research has also found that many parents are concerned about side effects. But doctors say many people do not experience side effects, and for those that do, the issues are generally mild and can include arm soreness, nausea, dizziness or, in some cases, fainting.

Doctors urge parents to vaccinate their children before they’re likely to become sexually active, which gives some parents pause, said Dr. Monica Woll Rosen, an obstetrician-gynecologist at the University of Michigan Medical School.

“You’re doing something to prevent them from getting cancer in 30 years,” she said, “and the disconnect might be too large for some people to really wrap their heads around.”

 

Find more : https://www.nytimes.com/2024/02/22/well/live/hpv-vaccine-cancer.html

Telehealth Palliative Care Provides the Same Benefits as In-person Care

A recent study found that video-based telehealth palliative care produced results similar to in-person palliative care for patients with advanced non-small cell lung cancer and their caregivers. The study, presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting in June, found that quality-of-life scores were virtually the same for telehealth and in-person palliative care.

Barriers Impacting Access to Palliative Care

According to Lindsey Ulin, a palliative care fellow at Massachusetts General Hospital and Dana-Farber Cancer Institute in Boston, who was not involved in the study, palliative care is focused on providing supportive care to people living with cancer and other serious illnesses. Palliative care physicians help manage symptoms and side effects like pain, fatigue and nausea.

According to a 2019 analysis in Quality of Life Research, patients with advanced non-small cell lung cancer and family members or friends who care for them often face physical, emotional and financial challenges that may impact their mental health and overall quality of life. And a 2024 article in American Society of Clinical Oncology Educational Book argued that early integration of palliative care alongside cancer treatment can improve patients’ quality of life.

However, both Greer and Ulin say many barriers limit access to this care for advanced-stage patients and their caregivers. Common roadblocks include hospitals and clinics not offering palliative care, the misconception that palliative care is only for people at the end of life, transportation issues and the cost of care.

“The hope is that telehealth palliative care reduces these burdens for the patient and the caregiver,” Greer says.

Telehealth Palliative Care Study Shows Promising Results

Greer’s study involved 1,250 patients with advanced non-small cell lung cancer and their caregivers. His research team randomly assigned participants to telehealth or in-person early palliative care across 22 cancer centers in the United States.

Participants attended palliative care appointments every four weeks throughout their cancer treatment. At the week 24 assessments, quality-of-life scores were similar for telehealth (99.67) and in-person palliative care (97.67) based on the Functional Assessment of Cancer Therapy-Lung (FACT-L).

Researchers found there wasn’t a significant difference in patient-reported symptoms, such as anxiety and depression, between the groups. “These are fairly standard measures when looking at the effects of palliative care,” Greer says. “We look at these because we’ve found that palliative care clinicians can help patients improve their quality of life, as well as their symptoms of anxiety.”

One difference that study data revealed was less caregiver involvement (36.6%) in virtual palliative care than in-person care (49.7%). “We had hypothesized that, given how convenient telehealth is, it would be easier for caregivers to participate,” Greer says. “We realized that telehealth gives patients more autonomy to decide when to have a caregiver present. But with in-person care, the patient often needs a loved one to help them get to the clinic.”

“In palliative care, we think about the person living with cancer and their caregiver together as a unit,” Ulin says. “Palliative care is an extra layer of support, helping caregivers cope, communicate with other providers, understand a cancer diagnosis and treatment options, and provide resources.”

See more
https://www.cancertodaymag.org/cancer-talk/telehealth-palliative-care-provides-the-same-benefits-as-in-person-care/

Transforming Healthcare: The Power of Timely Information and Exercise in Underserved Communities

In today’s rapidly evolving world, having the right information at the right moment can determine success or failure, health or illness. As professionals, we recognize the critical impact of timely information, especially in health and wellness. It’s imperative to leverage this knowledge and take decisive action, particularly to support underserved communities.

Access to Healthcare: An Ongoing Challenge

Despite technological advancements, timely access to healthcare information remains a significant challenge in America. Disparities in healthcare access lead to varying health outcomes across different populations. Underserved communities often face systemic barriers that hinder their ability to receive prompt and adequate healthcare.

The consequences are evident: delays in health screenings, diagnostics, and treatments exacerbate conditions that could be manageable or preventable. This results in higher rates of chronic diseases like diabetes and hypertension among marginalized groups. The American Heart Association reports that African Americans are nearly twice as likely to have diabetes compared to non-Hispanic whites. These delays perpetuate cycles of poor health and reduced quality of life.

Exercise is Medicine: A Call to Action

The CDC’s extensive research underscores the benefits of regular physical activity. Our task is to ensure that underserved communities can access and utilize this powerful tool. The focus is on making fitness accessible to everyone, regardless of their circumstances.

Healthcare providers, fitness professionals, and community leaders must disseminate accurate and actionable information about exercise, empowering individuals to make healthier choices. It’s about promoting physical activity and breaking down barriers to make fitness accessible to all.

A Successful Example: HEALTHEFIT DWF in Covington, GA

HEALTHEFIT DWF in Covington, GA, exemplifies how integrating Exercise is Medicine (EIM) and Remote Therapeutic Monitoring (RTM) can revolutionize healthcare delivery in underserved communities. As a trusted advisor from its inception, I have seen firsthand how their innovative Medical Fitness Therapy program significantly enhances patient care.

Patients at HEALTHEFIT DWF benefit from real-time updates and personalized recommendations delivered via advanced digital platforms. This seamless integration of technology into healthcare management allows for easier chronic condition management and better adherence to treatment plans.

The success of HEALTHEFIT DWF is built on several key elements, including:

  • Integration of Cutting-Edge Technologies – HEALTHEFIT DWF uses advanced digital health solutions for continuous patient monitoring. These platforms collect and analyze data on vital signs, physical activity, and other health indicators, enabling prompt responses to emerging health issues.
  • Personalized Health Plans – Patients receive tailored health plans with specific exercise regimens, dietary recommendations, and lifestyle modifications, continuously updated based on real-time data and progress to meet their unique health needs and goals.
  • Enhanced Patient Engagement – Digital platforms have improved patient engagement by providing access to health data and facilitating easy communication with healthcare providers. This transparency fosters ownership and active participation in treatment plans.
  • Community Outreach and Education – HEALTHEFIT DWF emphasizes community outreach and education through regular workshops and seminars on exercise and healthy living, empowering individuals to take proactive steps towards better health.
  • Collaboration with Healthcare Professionals – The success of HEALTHEFIT DWF stems from collaboration between fitness professionals and healthcare providers, ensuring comprehensive care that addresses both medical and fitness needs, enhancing overall treatment effectiveness.
  • Measurable Health Outcomes – HEALTHEFIT DWF’s approach has led to measurable improvements in managing chronic conditions such as diabetes, hypertension, and obesity. Timely health information and personalized care plans have resulted in better health outcomes and quality of life.

Conclusion: Information and Exercise as Catalysts for Change

The challenges in healthcare access underscore the transformative power of timely information and the promotion of exercise as medicine. Whether delivering health advice or emphasizing the benefits of physical activity, receiving the right information at the right time is crucial for individual and collective well-being.

The example of HEALTHEFIT DWF in Covington, GA, illustrates how integrating EIM and RTM can revolutionize healthcare delivery, particularly in underserved communities. Their proactive approach, leveraging cutting-edge technology and personalized care, has led to significant health improvements for their patients. This model provides valuable insights and a blueprint for future healthcare initiatives aiming to bridge the gap in healthcare access and outcomes.

As we reflect on our progress and future goals, let us commit to ensuring that everyone has access to the information they need for a healthy and fulfilling life. By prioritizing timely and equitable access to healthcare information—especially regarding exercise as medicine and RTM—we can advance toward a healthier and more just society.

This is our call to duty. Let’s remain vigilant in our pursuit of timely information and accessible exercise opportunities, understanding that these are not just conveniences but fundamental rights that can unlock freedom, health, and opportunity for all.

References:

  • American Heart Association. “African Americans & Cardiovascular Diseases.” Retrieved from heart.org.
  • Centers for Disease Control and Prevention. “Physical Activity and Health.” Retrieved from cdc.gov.

David Rachal III, MBA, EIM-C, MFP-C, is a Medical Fitness Practitioner with decades of experience in chronic disease management and preventive solutions. David is dedicated to integrating digital health solutions into traditional healthcare practices to enhance patient outcomes and promote a healthier lifestyle. He has been instrumental in the start-up phases of DWF Wellness in Covington, GA, and continues to serve as a trusted advisor.

read more :

Transforming Healthcare: The Power of Timely Information and Exercise in Underserved Communities

Ending financial discrimination for cancer survivors: embedding the Right to be Forgotten in legislation across Europe

A new study published today in The Lancet Oncology highlights that many of the current 20 million cancer survivors across Europe are being discriminated against in accessing financial services, including loans, mortgages, health and travel insurance.

The work indicated that on average, up to 25% of those living beyond their cancer may be having more difficulty accessing appropriate financial services.

A European-wide effort is currently attempting to fight this discrimination, by supporting the introduction of legislation that will permit successfully treated cancer patients to not declare a previously diagnosed cancer, so that their diagnosis is essentially “forgotten”.
In January 2016, France became the first country in the world to introduce the “Right To Be Forgotten”, specifying that long-term cancer survivors do not have to share medical information with a financial institution about their cancer diagnosis after a delay of five years without recurrence. Seven other European countries have since taken similar legal measures to counter financial discrimination against cancer survivors. Other European Member States have chosen to implement self-regulatory codes of conduct (Denmark, Finland, Greece, Ireland, Luxembourg), but these are not legally binding.

With over eight years of experience, evidence from France indicates no significant negative impact on insurance companies operating in the French jurisdiction.

Those who are living beyond their disease should not be penalised for a previous cancer diagnosis. Cancer patients across Europe who have been successfully treated should, by law, be able to avoid disclosing a previous diagnosis of cancer, so that they can access the financial services that they need.

Professor Lawler added: “This is not about compassion; this is about evidence and acting on that evidence. When a cancer professional says that you are cured and international benchmarking agrees, then why do the financial institutions say that you are not? Don’t make cancer patients pay twice. Ensure the Right To Be Forgotten is enshrined in law throughout Europe.”

Read the full study here: https://lnkd.in/e_PZHn_j

It’s never been more important to focus on cancer prevention

With an ageing population, cancer cases predicted to increase from 17 million to 30 million by 2040 and rising levels of overweight and obesity, it’s never been more important to focus on cancer prevention. Over 40% of cancers could be prevented if we all lived healthy lifestyles, including maintaining a healthy weight, being physically active and eating a healthy diet.

But what does this mean in practice? Every day we’re bombarded with information about what’s healthy and what isn’t. It can be confusing and seem contradictory: what’s missing is the context – how do all the disparate pieces fit together to make a coherent picture?

That’s where our Global Cancer Update Programme, formerly known as the Continuous Update Project, comes in. This huge undertaking pulls the puzzle pieces together to show how what we eat, what we weigh and how active we are all affect our risk of cancer. The Expert Paneloverseeing the process then use that information to develop Recommendations for Cancer Prevention.

A while back I wrote about how this work was moving into a new and exciting phase of development. This new phase has now started and the programme has changed in a number of ways. It’s more:

  • targeted – looking at specific research questions such as early life exposures and their impact on cancer risk later in life.
  • collaborative – to increase the reach and scope of the work a number of collaborations with leading international research groups will take place that focus on specific areas such as dietary patterns and the life course.
  • efficient – we are shifting from reviewing all risk factors for every cancer to systematically scanning the evidence to identify which topics are likely to be the most fruitful areas of detailed study. Integrating more automation into the review process will be central to this.
  • inclusive – in addition to looking at cancer prevention, the work will expand to encompass cancer survivors. With improved diagnosis and treatment the good news is that there is a growing population of people living with and beyond cancer. The Global Cancer Update Programme will help us to understand how diet, nutrition and physical activity can improve long-term health and prolong survival after a cancer diagnosis.

There are four major themes to the work:

1. Cancer incidence

Looking at how a wide range of factors relating to diet, nutrition and physical activity as well as patterns of diet and lifestyle can affect cancer risk – either through decreasing risk or increasing it.

2. Cancer survivors

Focusing on the impact of diet, nutrition and physical activity on long-term health (cancer and non-cancer related morbidity, mortality and quality of life) after a cancer diagnosis. As part of this, we will look to determine for the first time the impact of diet, nutrition and physical activity on childhood cancer survivors.

3. Cancer mechanisms

Understanding the biological processes that underpin the links between diet, nutrition and physical activity and cancer.

4. Obesity

Ensuring previous work in relation to overweight and obesity remains up to date, given its critical role in increasing the risk of many cancer types. In addition, we will explore whether more specific guidance can be made for preventing obesity in adulthood and early life.

This comprehensive programme of work will allow us to look more deeply at how diet, nutrition and physical activity affect cancer risk and survival. In the next few years, the Global Cancer Update Programme will enable a more sophisticated understanding, with a more personalised approach to cancer prevention and survival than ever before.

Find out more about our Global Cancer Update Programme

Commercial determinants of health: how they are driving up rates of cancer and other NCDs

A new report from the WHO Regional Office for Europe looks at the impacts of the commercial determinants of health

Tobacco, alcohol, highly processed foods and fossil fuel industries cause 19 million deaths per year globally. These shocking statistics, reported in Commercial Determinants of noncommunicable diseases in the WHO European Region, show how commercial activities are harming our health and increasing the global burden of non-communicable diseases (NCDs), including cancer (WCRF International contributed to two case studies to this report, one on civil society engagement and one on alcohol warning labels).

The commercial determinants of health (CDOH) assess how commercial industries and their products can influence and impact the overall health and health equity of people, and whole societies.

Impacts of CDOH are felt across society, from the individual consumer, their health behaviours and choices, extending to global levels of consumption, and the politics and economics of increasing globalisation.

Health-harming industries

Commercial determinants that negatively impact health involve products from unhealthy commodity industries, which produce and sell health-harming products such as:

  • tobacco
  • alcohol
  • highly processed foods
  • and fossil fuels

The recent WHO/Europe report shows how exposure to these health-harming products is driving up already exceptionally high rates of cancer and other NCDs globally.

In the European Region alone, almost two thirds (61.3%) of deaths caused by NCDs can be attributed directly to risk factors linked to unhealthy diets, physical inactivity, alcohol and tobacco consumption.

This equates to an estimated 2.7m deaths annually, or more than 7,400 deaths every day. Many of these deaths could be prevented with reduced exposure to these commercial products.

Corporate channels of influence

You will certainly have experienced commercial forces at play in the world in both visible and invisible ways. Industries influence and impact health, and undermine policymaking through the following corporate channels:

  • marketing and advertising
  • engaging in corporate social responsibility strategies and activities
  • lobbying governments and policymakers; and
  • deflecting attention away from their role and responsibilities in causing health harms

Marketing and advertising enhance the acceptability and desirability of health-harming products. Often selling a certain lifestyle, aesthetic or experience, it normalises these products as part of everyday life, as well as more aspirational ways of living.

Marketing and promotions have been found to disproportionately target low socioeconomic status or minority populations, with industry tactics ranging from timing marketing campaigns to coincide with the distribution of benefits from food assistance programmes, to aiming advertisements directly at children.

Corporate social responsibility activities serve to improve corporate brands and reputations. Coca-Cola or PepsiCo’s frequent sponsorship of sports teams, events, and funding children’s physical activity programmes seeks to shift focus away from how their own products contribute to the obesity epidemic, and instead reflect favourably on their support for physical activity promotion.

DrinkAware, an alcohol-industry funded health information organisation, promotes “responsible drinking” campaigns (despite alcohol being classified as a Group 1 carcinogen that is causally linked to 7 types of cancer), and engages in partnerships with government and public health agencies.

Lobbying governments and policymakers works to avoid or circumvent regulation. Examples include the food and beverage industry’s opposition to sugar-sweetened beverage taxes, or the alcohol industry’s use of legal threats to stop the implementation of health warning labels.

Public health experts are also targeted through less obvious channels, such as Coca-Cola’s emails to the US Centre for Disease Control (obtained through Freedom of Information Act requests) to advance corporate objectives over health, including trying to influence the WHO.

Other tactics include funding research and political parties to sway the evidence base and policymakers in their favour—influencing all levels of policy, from scientific evidence through to policy development and implementation.

Where does the buck stop?

Perhaps the most significant and insidious tactic used by health-harming industries is their deflection of responsibility. Industry uses the rhetoric of ‘personal responsibility’, ‘individual’ or ‘freedom of choice’ around the consumption of their products.

These messages shift the blame away from health-harming industries, and onto their customers. This argument is used not only to shape societal views around consuming tobacco, alcohol and unhealthy foods, but also in legal arguments to deny or downplay their responsibility and liability for the costs they impose on society.

Do not be mistaken: these efforts are intentionally well-crafted and funded. Health-harming industries seek to protect their own interests and offload their responsibility at the expense of public health. These narratives serve to manufacture doubt and increase uncertainty in the public, while simultaneously undermining trust in government agencies and scientific evidence to normalise the prevalence and use of their products.

Is addressing commercial determinants of health anti-business?

It’s also important to recognise what addressing CDOH is not. Addressing CDOH is not anti-business; but rather, it challenges the existing status quo and power imbalances. It also does not assume a solely negative impact: it accounts for industry actors to drive health and equity in either direction.

Profitable business and health promotion do not need to be mutually exclusive. For example, a coalition of Nestlé shareholders (co-ordinated by Share Action) has filed a resolution to challenge the company to increase their proportion of sales from healthier products.

Work to address CDOH is also not an attack on the free market, or personal liberties. It is about a consumer’s right to know about the risks involved with consuming a harmful product.

Say for instance you had a higher risk of developing breast cancer. Would knowing that drinking alcohol increases your risk of developing it, or 6 other types of cancer, impact whether you decide to consume alcohol? When buying products, would you want to be thoroughly informed about the risks you take?

Interestingly, critics of responses aimed to address CDOH often (knowingly or unknowingly) follow the same script taken straight from health-harming industries’ playbook.

This upholds the narrative that responsibility solely rests with the individual and does not hold corporations accountable for the health impacts of their products, or their influence through the four corporate channels.

Getting rid of the industry playbook; reframing the issues

But this criticism is misplaced: rather than effecting a ‘nanny-state’ or ‘prohibition’, addressing CDOH is an act to abolish and break free from the false-narratives and manipulation that industries employ for their own profit and gains.

Given the scale and size of transnational corporations, some with incomes higher than GDPs of whole countries, putting a focus on the CDOH and their impacts will have a global effect.

This is a movement to shift the focus and alignment of political will in a direction that better serves public health and health outcomes, including the reduction of health inequities, and incidence of cancer and other NCDs.

For more information on CDOH
> WHO Europe Report Commercial Determinants of noncommunicable diseases in the WHO European Region – the report also contains a number of case studies, which WCRF International has contributed to.

Nearly half of adult cancer deaths in the US could be prevented by making lifestyle changes, study finds

About 40% of new cancer cases among adults ages 30 and older in the United States — and nearly half of deaths — could be attributed to preventable risk factors, according to a new study from the American Cancer Society.

“These are things that people can practically change how they live every single day to reduce their risk of cancer,” said Dr. Arif Kamal, chief patient officer with the American Cancer Society.

Smoking was the leading risk factor by far, the study found, contributing to nearly 1 in 5 cancer cases and nearly a third of cancer deaths. Other key risk factors included excess body weight, alcohol consumption, physical inactivity, diet and infections such as HPV.

Overall, researchers analyzed 18 modifiable risk factors across 30 types of cancer. In 2019, these lifestyle factors were linked to more than 700,000 new cancer cases and more than 262,000 deaths, the study found.

Cancer grows because of DNA damage or because it has a fuel source, Kamal said. Other things — such as genetics or environmental factors — can also create these biological conditions, but modifiable risks explain a significantly larger share of cancer cases and deaths than any other known factors. Exposure to sunlight can damage DNA and lead to skin cancer, for example, while fat cells produce hormones that can feed certain cancers.

“With cancer, it oftentimes feels like you have no control,” Kamal said. “People think about bad luck or bad genetics, but people need to feel a sense of control and agency.”

Certain cancers are more preventable than others, the new study suggests. But modifiable risk factors contributed to more than half of new cases for 19 of the 30 types of cancer evaluated.

There were 10 types of cancer where modifiable risk factors could be attributed to at least 80% of new cases, including more than 90% of melanoma cases linked to ultraviolet radiation and nearly all cases of cervical cancer linked to HPV infection, which can be prevented with a vaccine.

Lung cancer had the largest number of cases attributable to modifiable risk factors — more than 104,000 cases among men and 97,000 among women — and the vast majority were linked to smoking.

After smoking, excess body weight was the second largest contributor to cancer cases, linked to about 5% of new cases in men and nearly 11% of cases in women. It was associated with more than a third of deaths from cancer of the endometrium, gallbladder, esophagus, liver and kidney, the new study found.

Another recent study found that the risk for certain cancers was significantly reduced for people taking popular weight-loss and diabetes medications such as Ozempic and Wegovy.

“Obesity is emerging, in some ways, as just as potent of a risk for people as smoking is,” said Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials. He was not involved in the new study, but has prior experience working on cancer prevention initiatives.

Intervening on a set of “core behavioral risk factors” — quitting smoking, eating well and exercising, for example — can make a “dramatic difference in the rates and outcomes of chronic diseases,” Plescia said. And cancer is one of those chronic diseases, just like heart disease or diabetes.

Policymakers and health officials should work to “create environments where it’s easier for people, where the healthy choice is the easy choice,” he said. And it’s particularly important for people who are living in historically disadvantaged neighborhoods, where it might not be safe to exercise or easy to get to a store with healthy food.

As rates of early-onset cancer rise in the US, it’s especially important to create healthy habits early, experts say. It’s harder to quit smoking once you’ve started or lose weight that you’ve gained.

But “it’s never too late to make these changes,” Plescia said. “Turning (health behaviors) around later in life can make a profound difference.”

And making lifestyle changes to minimize exposure to certain factors can reduce cancer risk relatively quickly, experts say.

“Cancer is something your body fights every single day as your cells divide,” Kamal said. “It’s a risk that you face every day, and that also means that the reduction of the risks can benefit you every day as well.”

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The evolution of customer care: AI and the Gen Z effect

With the coming of age of Gen Z—both as customers and new workforce entrants—customer demands are evolving. At the same time, generative AI (gen AI) is transforming how contact centers respond to these demands. Forward-thinking leaders must explore the latest trends, emphasize cohesive support strategies, and take actionable steps to enhance their customer care functions, addressing challenges such as service improvement, cost reduction, and sales function integration.

In this episode of McKinsey Talks Operations, host Daphne Luchtenberg sits down with McKinsey partners Brian Blackader and Eric Buesing. Listen in as they discuss the latest trends, the importance of a cohesive support strategy, and actionable steps contact center leaders can take to improve their customer care functions.

The following conversation has been edited for length and clarity. Dates and statistics correct at time of recording in May 2024.

Daphne Luchtenberg: Every time you buy a product or service, you start or build upon a relationship with the company that stands behind it. And when something goes wrong or you just need help, the ease with which you’re able to get the support you need can have a big impact on how you feel and whether you choose to continue the relationship. With the arrival of more communication channels than ever before and the onward march of gen AI, how should organizations be thinking about where to improve their customer care functions? Throw Gen Z into the mix—with perhaps surprising preferences about how they want to engage with companies today—and you’ve got a complex landscape to navigate.

I’m delighted to be joined today by two of the people behind our recent research, “Where is customer care in 2024?,” Eric Buesing is a partner in our Charlotte office, and Brian Blackader is a partner based in Düsseldorf.

Eric, what do contact centers look like at the moment, and what are the challenges that they are facing?

Eric Buesing: The customer care function of the contact center is currently in the spotlight more than ever before, discussed even at the board level. Contact center leaders face unprecedented pressure in various forms: operational pressure to be efficient and reduce costs, enhance the customer experience, manage employees in increasingly complex environments, and expand the contact center’s role to include more advisory or consultative selling to build loyalty.

Customer expectations aren’t getting easier. With more platforms available for sharing information, disgruntled customers can amplify their dissatisfaction more loudly and broadly.

Daphne Luchtenberg: Eric, what does good customer service look like in today’s contact centers? What should companies strive for?

Eric Buesing: I don’t know if there’s any one organization that gets it all right all the time. At its core, good service involves excelling in the moments that truly matter—those critical times when customers are most in need. In these moments, the goal is to delight them in a way that impresses, garners loyalty, and resolves their issues, while generally maintaining good service overall.

Good service is characterized by several key aspects: the ease of resolving issues, the accessibility of information, and the integration of communication channels so that every interaction contributes to a cohesive resolution process.

Brian Blackader: Adding to that, what good looked like a few years ago, especially during the pandemic, has changed. Back then, simply being available was often enough. Now, we’ve returned to fundamental principles like solving problems effectively and knowing the customer across different touchpoints. Expectations have risen; customers now expect not just solutions, but also personalized understanding and engagement.

Eric Buesing: Absolutely, Brian. The principles of, “Know me, know my issue, and understand me,” are easily said and very difficult to achieve. The organizations that manage to do well in this area invest considerable effort in understanding how to meet these expectations. It’s not a game you win. It’s a game you play. You’re always trying to get better.

Daphne Luchtenberg: It’s interesting to see leaders turning to gen AI tools across various business operations, particularly in business services and customer care. Could you elaborate on the potential for adopting these tools in these areas and how they might enhance the services you described?

Eric Buesing: We’re about 16–17 months into the era of gen AI being available to the wider public. From my perspective, gen AI promises significant disruption, particularly in service functions. I believe that it could reduce current phone volumes by 50 percent within five years. However, the initial progress has been slower than expected. Many believed that gen AI would quickly reduce call volumes and transform customer interactions, but that hasn’t been the case yet. Few organizations have implemented gen AI at a scale where its impact can be effectively measured, and it’s crucial to understand why.

Despite the technological advances, the need for human interaction remains critical, especially for empathy and connection. I do see gen AI playing a significant role in efficiently resolving complex customer issues. We’re likely to see an increase in interactions with chatbots and virtual voice assistants, which will provide quicker, more accurate responses. However, the moments that truly matter will still require a human touch.

Additionally, foundational elements such as data connectivity, data quality, and the technical systems needed to deploy these AI capabilities are also vital. It’s important to recognize that it’s never just tech; early strategic planning and implementation are key to leveraging these tools effectively.

Daphne Luchtenberg: Eric, considering we’re recording this session, could you discuss the role of recording live conversations and how this might enhance intelligence and optimize the call center experience in the future?

Eric Buesing: First, the concept of speech-to-text isn’t new; organizations have been recording conversations for years. However, there’s been a shift in expectations regarding the quality of insights derived from these recordings, moving toward what’s now often referred to as conversational or voice intelligence. This advancement is crucial as it helps organizations explore the root causes of customer calls. Generative AI plays a significant role here, particularly with the concept of multi-intent. This means recognizing that customer calls are complex and cannot be simply categorized as, for example, a “billing call” or a “policy inquiry.” Conversational intelligence enables organizations to understand the multiple reasons behind a customer’s call, which in turn helps in resolving issues more effectively and proactively sharing information across the organization to prevent future frustrations.

There’s potential to use customer care data beyond traditional confines, such as for improving product design or service delivery to reduce customer friction. This approach involves leveraging voice data more strategically than just for compliance and quality assurance.

Brian Blackader: Adding to Eric’s point, while many discuss using these insights for training models, the reality is that many organizations still have a basic understanding of why customers call. Often, the primary reason logged is simply the first option an agent selects from a dropdown menu. It’s vital to understand not just the primary reason for a call but also the second-, third-, fourth-, or fifth-level intent. This understanding is crucial for two reasons: it helps address root causes throughout the organization and enables more targeted training for agents on specific recurring issues, rather than a general overview of a category like billing. We can really be specific on the issue that they’re struggling with.

Daphne Luchtenberg: With the technological advancements in customer care, there’s also a growing need for new skills. Brian, could you expand on the talent challenges that customer care leaders are currently facing?

Brian Blackader: There are two main challenges that care leaders face regarding talent. First, in countries like Germany where I am, or even in the US, there’s a general labor shortage. This makes it difficult to recruit people who can handle increasingly complex issues, especially as simpler tasks become automated. The challenge is not only to find frontline talent but also to enable them to address these complex queries effectively, all while striving to provide excellent customer service amid rising expectations.

Second, the traditional customer care path, where an agent progresses to a team leader, and then to a business unit manager, has been effective for developing people managers for the past 25–30 years. However, this pathway doesn’t necessarily produce the specialized skills needed today, such as data scientists, engineers, or developers. Leaders need to consider how to attract individuals with these skills to the agent level, perhaps targeting students with backgrounds in these areas. Additionally, they must make roles in customer care appealing compared with opportunities in big tech and other industries, where demand for these skills is also high.

Daphne Luchtenberg: That’s interesting. Let’s talk more about the talent pipeline. As Gen Z matures into consumers and the workforce of the future, their perspectives and behaviors might differ from previous generations. I found your insights in the blog post “Why your kids aren’t calling you, but they are calling their bank” particularly interesting, where you noted that some expected trends aren’t necessarily holding true. Could you expand on that?

Brian Blackader: Our research revealed some surprising findings about Gen Z’s communication preferences with companies. Contrary to what might be expected, their behavior isn’t drastically different from millennials, Gen X, or even boomers. When facing an unsolvable problem, about 70 percent of Gen Z individuals prefer to make a phone call, a share similar to older generations. This preference changes when it comes to personal communications, such as contacting friends or family, where they favor texting or messaging apps. However, for serious issues with services like banking or telecommunications, they still turn to phone calls. This indicates that companies that can effectively resolve issues through voice bots and provide excellent experiences will likely outperform their competitors.

Eric Buesing: Adding to that, our research also touched on email preferences across different customer segments. Surprisingly, about 70 percent of customers still prefer using email to resolve issues, despite its decreasing popularity among organizational leaders. Leaders often consider email a challenging channel to manage because it’s hard to track and measure compared with phone or chat interactions. This creates a disconnect, as customers appreciate the asynchronous nature of email—it allows them to send a message at their convenience, while someone else works on the issue later. This discrepancy poses challenges for organizations as they plan future communication strategies.

Brian Blackader: Exactly, and there’s an additional layer to this when considering people’s preferences during work or school hours, where email is particularly favored for its convenience. Additionally, our work in financial services highlighted another unique aspect of Gen Z, especially in the premium segments. Unlike millennials, Gen Z individuals in these segments expect high levels of service, akin to what baby boomers expect. They view phone service as a justified expectation for the fees they pay, demanding quality assistance and a positive experience as part of their service package. This insight is crucial for businesses aiming to cater to this demographic effectively.

Daphne Luchtenberg: It seems like some aspects of customer service are evolving significantly, while others remain unchanged. What do you envision for the future of customer contact centers?

Eric Buesing: As I’ve noted before, I expect a significant shift toward self-service options, predicting that 50 percent of current phone volumes will transition to these channels within the next five years. This shift will likely be driven by improvements in how customer issues are addressed, enhancing interactions with chatbots and virtual assistants to a more meaningful level. Some enthusiasts even believe that virtual voice assistants will become more empathetic than humans, as they won’t carry frustrations from previous interactions. Looking ahead, I’m optimistic about the improvements in service quality. There’s a prevailing acceptance of mediocre service when people call in, often expecting delays and potentially unhelpful responses. However, I foresee a future where service excellence becomes a hallmark of distinguished brands, significantly influencing customer loyalty and brand preference.

Simultaneously, the importance of human interaction will not diminish, especially for critical service moments. If phone volumes reduce by half, the quality and impact of the remaining interactions will become more crucial. I envision a future where customer service agents evolve into “superagents” or “journey managers,” equipped with advanced tools to provide informed, accurate, and empathetic support.

Daphne Luchtenberg: That sounds promising. Brian, would you like to add anything?

Brian Blackader: To summarize, I believe that leading organizations will focus on three key areas over the next five to ten years. First, they will streamline resolutions and enhance self-service capabilities for simpler issues, leaving more complex matters to customer service. Second, echoing Eric’s point, these organizations will empower their agents—whom we might call super agents—with sophisticated tools that aid in resolving customer issues effectively, fostering loyalty, and delivering exceptional experiences, possibly even with minimal training.

Lastly, the concept of an omnichannel experience will be crucial. While this has been discussed for over a decade, truly successful organizations will offer a seamless customer experience across all platforms—whether in-store, over the phone, through chat, or even via underused channels like video, and potentially augmented or virtual reality for specific scenarios. This consistency will ensure that no matter how a customer chooses to interact with a company, the great ones will be able to make sure that that experience is consistent across all the different ways you might contact them.

Eric Buesing: Brian, I really appreciate the concepts of omnichannel and optichannel, which refers to using the optimal channel for resolving issues. Currently, customers face a confusing array of options—social media, YouTube, websites, apps, calls, chats, and more. It’s not transparent which channel is best for their needs, leading to random choices. However, with the optichannel approach, it will become clear to customers which channel is most effective for their specific issues.

Daphne Luchtenberg: So, this would also mean that customers will grow more sophisticated at selecting the right tools for their needs, correct?

Eric Buesing: Exactly. It boils down to whether it’s simpler to handle an issue ourselves or to call for help. As long as calling remains the easier option, that’s what people will choose.

Daphne Luchtenberg: We’ve discussed many important points today. Before we conclude, Eric, where should leaders look for inspiration as they move forward?

Eric Buesing: Leadership in this area really requires courage. I’m often underwhelmed when we are asked, “Hey, do you have a North Star vision? What do you want out of your customer care, your servicing function?” The answers are often very incremental: “I’d love to see a 5 percent improvement in this. I’d like our budgets to be down, our handle times to go down, and our customer satisfaction score to go up slightly.”

We need to think bolder than that. Being a courageous leader means having a plan and setting an aspiration that is difficult and makes people uncomfortable, and then seeing it through. It’s one thing to say, “Hey, we want to cut our volume by 50 percent.” It’s another challenge to actually go after it.

In many ways, it requires collaboration outside of the contact center. The contact center is the receiver of somebody else’s problem. There has been a breakdown somewhere else in the customer journey, either by a product that didn’t deliver, a service that didn’t meet expectations, or an experience that was subpar. That drives volume.

So how do we look upstream and tackle those issues? How do we bring together the organizations or business units within an organization that need to come together to resolve them?

Daphne Luchtenberg: Yeah, I love that. Brian, what do you think?

Brian Blackader: In my interactions with customer care leaders, I’ve noticed they typically align with one of two approaches. The first group is action-oriented; they want to start immediately and tackle tasks head-on. The second group prefers to strategize, aiming to develop a North Star vision and a detailed road map, as Eric mentioned. It’s crucial to combine both approaches.

Creating a North Star vision and a road map is essential to avoid merely making incremental changes and to thinking in the long term. This involves making necessary investments and managing change over time. However, it’s also important to recognize that presenting such plans isn’t new to boards, and there might be limited patience for long-term results. Therefore, I advise leaders to also focus on achieving quick wins. By demonstrating early successes, you can build credibility within the organization and show tangible progress.

Additionally, I want to emphasize the importance of voice communication. Despite advancements in technology like chatbots, many customers still prefer calling. If these calls go unanswered, customers might escalate issues to regulators. With today’s technology nearing the capability to automate voice interactions effectively, there’s a significant opportunity to enhance customer experiences through this channel.

Eric Buesing: Adding to Brian’s points, another aspect we briefly touched on is transforming the role of contact centers from purely service-oriented to also encompassing sales. While “sales” can sometimes be perceived negatively, it shouldn’t be feared. Customers expect a high level of service that not only addresses their immediate issues but also anticipates their needs. This could involve better use of current products or introducing superior ones. The contact center is uniquely positioned to not just solve problems but also to provide valuable advice and recommendations. This shift from aggressive selling to thoughtful consultation can significantly enhance customer satisfaction and loyalty.

Daphne Luchtenberg: Fantastic, Eric. I couldn’t have said it better myself. Thank you so much.

Here’s a few things that I loved about the conversation today to think about as we close: first, this idea that customer service and contact centers are not a game you win, but rather a game you choose to play. Secondly, that gen AI is changing that game, albeit not as quickly as we might have expected, including through ways such as voice automation. And finally, there’s no better place in the contact center to build and deepen customer relationships and to give them better experiences during those moments that really matter.

Πηγή: mckinsey.com