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Why establishing a health baseline is a “critical starting point for achieving future health goals”

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Raise your hand if you want to be more successful at achieving health goals, such as losing weight or lowering your cholesterol levels, and maintaining a healthy lifestyle. Perhaps it's time to consider creating a health baseline. "A health-care baseline is essentially where you are "at" on the broad, complex spectrum of physical, mental and emotional health," explains Mary James, MD, an internal medicine physician at Stanford. "This can be a critical starting point for achieving future health goals."

On Thursday, James will deliver an in-depth talk on the benefits of partnering with your primary care provider to establish a health baseline as part of the Stanford Health Library lecture series. Those unable to attend can watch the presentation online here.

In anticipation of the event, I contacted James to learn more about why its important to have a basis for comparison, beyond the ever-fluctuating number on your bathroom scale or if you're able to fit into your skinny jeans, to use in measuring progress in meeting your health goals. Below she discusses how assessing the state of your health now can pay off in a longer, more active life in the future.

What is a health baseline?

Your baseline has two basic components: existing illness and potential future illness. Your current baseline has been shaped by your medical, social and family history and is constantly being influenced by common factors in everyday life. Although some components of your healthcare baseline are more modifiable than others, it is important to have an accurate understanding of your current health status.

Why is it important to determine your personal health baseline?

You may be thinking, “I’m healthy – I take no medications and never go to the doctor. Why should I start now?” There are two fundamental components to good health. They are: appropriate treatment for current illness and appropriate preventative care to reduce health decline in the future. While most people actively seek care for the former, we often forget about the latter. Although the data is mixed on whether “routine check ups” are beneficial, there is strong evidence behind many of the preventative maneuvers that are typically discussed and ordered at these visits. Taking appropriate preventative health-care steps can help you avoid the need for prescription medications, hospitalizations and procedures and can help ensure a longer, healthier life.

How can establishing a health baseline help you be more successful in reaching personal wellness goals?

Many wellness goals start with changes in diet and exercise. Your primary care provider can help determine how to start making these changes in a safe, effective manner. Are there exercises you should avoid due to chronic back pain? Is it okay to start running if you have high blood pressure? Is it safe for you to start a vegan diet? What is a safe amount of weight to lose?

Wellness also includes mental and emotional health. Your primary provider can help determine what treatment is most appropriate for common conditions such as depression and anxiety. Maybe you’ve been feeling “down” lately – is this true depression that warrants medical treatment, or is it safe try a new yoga or meditation class first? These are just a few of the many things that can be assessed and addressed as part of your health baseline. Together, you and your primary care provider can prioritize health problems and determine effective interventions.

Once you’ve developed a baseline, how often should you repeat the assessment?

Follow up is variable once a baseline is established. Individuals with more complex medical conditions may require more frequent visits. Evidence suggests that some individuals need no further follow up for three years. Regardless, it is important that everyone stays up to date on preventative services such as immunizations, screenings (mammograms, colonoscopies, etc) and any lab testing indicated by your risk factors.

Can you share some examples from your experience working in a clinical setting of how creating a health baseline helped patients be more proactive in improving their health?

In my current practice, I help care for a diverse geriatric population. It is in these patients that you can see the long-term effects of decisions regarding health and lifestyle. A lifetime of obesity often manifests as debilitating arthritis pain in joints that have been bearing too much weight for too many years. Uncontrolled diabetes can lead to loss of vision, kidney damage and loss of limbs. But I also see the positive outcomes that can result from remaining proactive about health and wellness goals. Some patients in their 80s and 90s lead vibrant, more active and happy lives than many people decades younger. By establishing a baseline, patients can begin the process of preventing disease and taking preventative steps to achieve their goals for future health.

Previously: Living loooooooonger: A conversation on longevity, Tick tock goes the clock – is aging the biggest illness of all? and NPR highlights Google's Baseline Study and what it might teach us about human health
Photo by Richard Masoner

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