Is anyone truly healthy?

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A comprehensive long-term study examining population-level health data in the United States has unveiled shifting health trends and their evolving relationships with mortality risk factors.

Led by Associate Professor Jennifer Kuk from the School of Kinesiology and Health Science at the Faculty of Health, this research provides valuable insights into the dynamic nature of health risks and their impact on mortality over time.

Changing Landscape of Health Risks

The study, recently published in PLOS One, analyzed data from two distinct periods, 1988 to 1994 and 1999 to 2014, covering individuals aged 20 and older.

Researchers assessed 19 different risk factors and adjusted the data for age, sex, obesity category, and ethnicity. The key findings shed light on the evolving landscape of health risks:

Low Prevalence of Risk-Free Individuals: Less than 3% of the population exhibited none of the 19 risk factors, emphasizing that the majority of individuals have room for improvement in their health-related behaviors and conditions.

Paradoxical Trends: The study revealed paradoxical trends in risk factors and their relationship to mortality.

For example, smoking rates decreased over time due to successful public health campaigns, but the overall risk associated with being a smoker increased. This shift could be attributed to heightened awareness of smoking risks and the associated stigma.

Obesity: Despite a rising prevalence of obesity, the risks associated with it have declined. This indicates that advancements in the treatment and management of obesity-related health issues have effectively mitigated mortality risks.

Diabetes and Hypertension: Rates of diabetes and hypertension have increased over time, but the associated risks have decreased. Improved medical interventions and management strategies may account for this decline.

Physical Activity: Reduced physical activity has become a more significant risk factor, highlighting its growing impact on health outcomes.

Mental Health Medications: While not a significant risk factor in the 1980s, taking mental health medications was associated with increased mortality risk in the later dataset.

Education: Not completing high school has emerged as a health risk factor over time, whereas it was not considered significant in the 1980s.

Implications and Considerations

The study underscores that most individuals can enhance their health by addressing various factors such as diet, exercise, smoking, alcohol consumption, and drug use.

However, it also emphasizes that societal factors, including food insecurity and low education, can limit health choices for many individuals. Recognizing and addressing these societal challenges is essential when assessing health risk factors.


This long-term study offers valuable insights into the evolving landscape of health risks and their complex relationship with mortality. It highlights the dynamic nature of health trends and the need for continuous efforts to improve public health.

Understanding these shifting risk factors can inform more effective interventions and policies to promote healthier lifestyles and reduce mortality risks in the population.

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The research findings can be found in PLOS ONE.

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