Suboptimal Health and the Economic Impact to Healthcare from the Perspective of PPP Medicine

Suboptimal health status (SHS) is the physical state between health and disease, characterised by the self-reporting of general malaise and ambiguous health complaints in the absence of a diagnosable condition. Suboptimal health (SH) is considered a “subclinical, reversible stage of pre-chronic disease”. The suboptimal health status questionnaire-25 (SHSQ-25) is a robust, non-invasive and cost-effective health measure for the assessment of SH. Detection of SH predicts an individual’s risk of developing certain chronic diseases, enabling the prescription of tailored interventions and improved health outcomes from the perspective of predictive, preventive and personalised medicine (PPPM). This book chapter explores the origins of SH and demonstrates how SHS offers a significant economic impact to healthcare. Recent studies suggest that SH is associated with chronic stress, with those with higher SH scores also having higher levels of both psychosocial stress and cortisol than those with lower SH scores. We show how SH stratifies persons into high- and low-risk groups for CVD, demonstrating that high SH scores are associated with risk factors (such as high cholesterol and endothelial dysfunction). Chronic diseases are a serious, global threat to human health. Effective disease prevention measures, such as SH, that can reduce their burden by the smallest proportion have the capacity to significantly mitigate their economic impact on health systems. This is especially important considering the World Health Organisation urgent calls for evidence-based, cost-effective disease prevention strategies to alleviate the burgeoning costs and complications of chronic diseases. In both developing and developed countries, the cost of inaction far outweighs the cost of action. The SHSQ-25 enables targeted interventions and valuable resources to be directed to where they are actually needed, conferring significant economic impacts to healthcare. This book chapter evidences SH as the new gold standard in the global fight against chronic diseases.