By life stage ยท 19 tips
More screening tests start after 40. Also tips for your body and for insurance and arranging ahead for older relatives.
For every 10 mmHg drop in blood pressure, the chance of a major cardiovascular event falls by about 20%, stroke by 27%, heart failure by 28% and death by 13%. Among Chinese people aged 35 to 75, 44.7% have high blood pressure, and only 7.2% have it under control.
For a few dozen CNY and one tube of blood, you can find prediabetes while you still have no symptoms at all. The official U.S. screening advice is to test people aged 35 to 70 who are overweight or obese. If the result is normal, repeat it every 3 years. The U.S. counts a body mass index of 25 as overweight, relaxed to 23 for Asian Americans; the Chinese standard is 24.
A stool blood test that costs a few dozen CNY, done every year or two, lowers the chance of dying of colorectal cancer by about 16%, and by 25% for people who completed at least one round. For people invited to have one colonoscopy, the chance of getting colorectal cancer over the next 10 years falls from 1.20% to 0.98%.
A mammogram every 2 years for women aged 40 to 74 is explicitly recommended in the official U.S. screening advice. For women 75 and older, and for adding ultrasound or MRI for dense breasts, the official conclusion is that the evidence is not enough. When a checkup package charges extra for those, you can skip them.
In the Linqu, Shandong trial, followed for 22 years, people whose H. pylori was eradicated were about half as likely to get stomach cancer later, and about 40% less likely to die of it. The test costs one or two hundred CNY, and eradication means two weeks of pills.
Among people 45 and older at high risk of stomach and esophageal cancer, those who had a gastroscopy were about half as likely to die of these two cancers. But people who choose to get checked already take better care of their health, so this number runs too high. By the strictest way of comparing, esophageal cancer deaths are only about 20% lower, still within the margin of error. For people not at high risk, the guidelines do not advise screening.
After hepatitis C infection there can be no symptoms for decades, and one antibody test tells you. Once confirmed, an oral drug for 8 to 12 weeks clears the virus in at least 95% of people. People whose virus is cleared later have about 60% lower risk of death and about 70% lower risk of liver cancer. These drugs entered medical insurance in 2019, with prices down by 85% or more on average.
In a phase 3 trial, this vaccine blocked 97% of shingles, about the same across age groups. The drawback is 3000 to 4000 CNY for 2 doses, entirely out of pocket. What that money buys is a 97% reduction in cases.
Among adults in China with chronic kidney disease, only about 10% know they have it. People with diabetes who have their urine and blood tested every year can be found earlier. For those found to have high urine protein, taking a drug like dapagliflozin cuts the combined cases of kidney function worsening, reaching dialysis or death by about 40%, and deaths by about 30%.
People who do 30โ60 minutes of strength training a week have a 10% to 20% lower chance of dying over the same period than people who don't. More than that is not better. Doing strength and aerobic exercise together works best.
For every 10 mmHg drop in blood pressure, the chance of death falls about 13% and stroke about 27%. Each 1-unit drop in LDL cholesterol on a statin lowers the chance of death by about 10%. People who take their medicine on schedule have a 30% to 45% lower chance of death than people who often miss doses. Get blood lipids tested every 2 to 5 years before 40, and every year from 40.
For people whose blood sugar is high but not yet diabetes, eating less, moving more and losing a little weight can cut the risk of getting diabetes by 30% to 60%. China's Da Qing trial followed people for 30 years, and those who did this had about a quarter lower chance of death and lived about a year and a half longer on average. But similar trials in the U.S. and Finland did not see a difference in death rates.
The chance of dying is lowest at a BMI of 20โ25. At a BMI of 27.5โ30 it is about 20% higher, at 30โ35 about 45% higher, and at 35โ40 nearly double. For East Asians with a BMI above 25, each 5 points higher means about 40% higher risk.
Beyond 100 g of pure alcohol a week, the more you drink, the earlier you die. 100 g of pure alcohol is about 2.5 L of beer. People who drink 100โ200 g a week at age 40 lose about half a year of life; those who drink 200โ350 g lose 1 to 2 years; those who drink more than 350 g lose 4 to 5 years. For overall health, the best amount is none.
Sleep apnea means that after you fall asleep your breathing keeps stopping or getting shallow, you wake up gasping, and you are sleepy during the day. With a breathing machine, daytime sleepiness clearly eases and crashes while driving fall by about 70%. But trials did not find that it prevents heart disease or lets people die less; you wear it to be alert during the day.
For middle-aged and older people whose knees hurt from wear and tear, arthroscopic cleanup or cutting out a piece of the meniscus is no better than sham surgery. In sham surgery only a few cuts are made in the skin, yet the people who had it ended up with about the same pain and walking as those who had the real operation. The benefit lasts a few months at most, and it can bring blood clots in the legs. Keeping up leg exercises makes the knee hurt less, and losing weight on top of that if you are overweight makes it hurt less still.
Term life insurance covers only a fixed number of years, and if the insured person dies in those years, the family receives a lump sum. It is for family members who live on your income, for example when the mortgage isn't paid off and the children are small. If no one depends on you, you don't need it. Children don't earn money, and the law even limits how much a death policy on a child can pay.
The premiums you pay do not all come back as payouts, because part goes to the insurer's costs and profit. So what's worth buying is cover for losses that rarely happen and that your family couldn't pay for if they did, such as a serious illness, injuring someone while driving, or the death of the family's earner. Small losses your savings can bear are left to the emergency fund.
While the older person's mind is still clear, spend a few hundred yuan at a notary office to have a written document made that states who will be their guardian in the future. Without this document, once the older person can no longer make decisions, the order set by law applies: first the spouse, then parents and children, then other close relatives. If family members fight over it, the residents' committee (ๅฑ ๅงไผ), the village committee (ๆๅงไผ), the civil affairs department (ๆฐๆฟ้จ้จ) or a court appoints one.
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