Knowing your personal risks means tracking your family history and being aware of how factors like gender, age, race, and ethnicity can affect both your disease vulnerability and the quality of your care. White women, for example, are more likely than black women to be diagnosed with breast cancer, but black women are more likely to die from it.
If you're in a high-risk pool, consider talking to your doctor about genetic testing, which can help guide treatment decisions. (Women who are carriers of a genetic mutation associated with a more aggressive type of breast cancer, for example, might choose to get a preventive double mastectomy in an effort to cut their risk by as much as 90 percent.) But the decision to undergo testing should not be made lightly, or without the guidance of a genetic counselor. "You want people to know their risks, but you don't want them to feel like they have no control over the situation," says Locke.
Other steps, such as choosing not to drink if your relatives struggle with alcoholism or being diligent about sunscreen if melanoma runs in your family, can help tailor prevention to your individual risk profile.
Get screened and vaccined
According to a 2010 paper in the American Journal of Preventive Medicine, our lackadaisical attitude toward clinical preventive services is killing us before our time.
Using mathematical models, the authors predicted that optimal use of nine clinical interventions including colonoscopies, screening and treatment for high blood pressure, and the flu vaccine could prevent up to 100,000 deaths per year in people under 80 years old, and up to 40,000 deaths per year in people under 65. Yet only about a quarter of adults ages 50 to 65 are up to date on recommended immunizations and cancer screening tests, the CDC reports.
What's more, a single pneumococcal vaccine after age 65 and a yearly prick to fight the flu—which kills about 24,000 people annually—can drastically lower the chances of dying from these preventable diseases. The CDC also recommends the over-60 set get a shot against shingles, tetanus, diptheria, and pertussis, conditions that are both more common and more severe in older adults. It may sound like a pain, but with the Tdap vaccine, you can knock out those last three birds with one stone.
Because screening recommendations seem to change as often as the seasons, it's no wonder Americans' use of them is inconsistent. But the controversies—like the fracas caused in 2009 by the United States Preventive Services Task Force, when it shifted the recommended age to begin breast cancer screenings from 40 to 50—tend to center around what ages you should begin and end regular screenings, and how often you should be tested in between. Most experts agree that mammograms and colonoscopies (for both sexes) are important between ages 50 and 75, and that women ages 21 to 65 should get pap smears to detect signs of cervical cancer. Regular screenings for prostate cancer using the prostate-specific antigen (PSA) test, on the other hand, do more harm than good for most men regardless of age, according to the USPSTF’s recently revised recommendations. But like all screenings, the choice to undergo testing should be made with your doctor, keeping your family history, lifestyle, and personal values in mind.
Take charge
While prevention and early detection are your first line of defense against chronic diseases, appropriate and timely treatment—and adherence to that treatment plan—are just as critical. Nearly 125,000 people die each year because they don't take their medicine as directed, according to the Surgeon General's medication adherence campaign, "Script Your Future."
It's also crucial to recognize the warning signs of top killers. Stroke, the fourth leading cause of death, for example, kills 15 percent of its victims within 30 days. But it doesn't have to. A recent study found that only 51 percent of adult stroke victims had arrived at the hospital via ambulance, a statistic that unfortunately hasn't budged since the mid-1990s. This suggests that many people still don't understand the severity of stroke symptoms and may hesitate before asking a friend or family member for a ride to the ER instead of dialing 911 right away. If you notice numbness in your limbs or face, suddenly have difficulty speaking and seeing, feel dizzy, and/or have a sudden severe headache, call an ambulance immediately. With every minute that passes, so too do your chances of escaping alive and without irreversible brain damage.
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