America has learned how to keep people alive while allowing them to spend more of their lives sick.
We can manage chronic disease for decades and extend life expectancy through medical advances. Yet the country has found itself waiting for people to become ill before teaching them how to protect their health.
I see a health care culture that has become exceptionally skilled at responding to disease. Prevention, meanwhile, remains an obligation people are expected to remember between appointments, if they remember it at all.
Medical breakthroughs are celebrated while overlooking the years in which healthier habits and early intervention could change a person’s entire life.
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We tell people to schedule annual checkups, as if 12 months of daily decisions could be accounted for in a brief appointment.
What happens during the other 364 days? How do people learn to recognize risk, understand their options, and build habits that protect their health before symptoms force them to pay attention?
These are the years we keep wasting. Young adults who feel perfectly healthy have little reason to think about chronic disease. Older adults who remain active may see wellness programs as something they can postpone.
I have spoken with seniors who feel well enough to believe they do not need preventive support yet. But the point, as I tell them, is to help them keep feeling well.
By the time illness becomes impossible to ignore, some opportunities for intervention may already have passed.
Healthy Choices, Educated Decisions
Prevention is a daily practice built on healthy choices, educated decisions, and an honest understanding of the options available.
It involves nutrition, exercise, sleep, stress management, and knowing when to seek professional guidance. It also requires asking difficult questions about the environment in which we make those choices.
Consider food. Convenience has become a powerful force in American life, while affordability often determines what families put on their tables.
CDC data published in 2025 found that ultra-processed foods supplied an average of 55 percent of calories consumed by Americans aged one and older during August 2021–August 2023.
Among children and adolescents aged 1–18, the figure was 61.9 percent.
Highly processed products are easy to find, easy to store, and often cheaper than healthier alternatives. We cannot expect people to make healthier choices consistently while ignoring the economic and commercial conditions shaping their decisions.
Our priorities deserve scrutiny. Companies can benefit from products designed for long shelf lives and repeat purchases, while families carry the long-term consequences of their everyday consumption.
Understanding the Patient
Personal responsibility matters, but the public’s health is also shaped by what is affordable, accessible, and aggressively marketed.
A society that makes unhealthy choices easier at every turn should not be surprised when preventable illness becomes widespread.
The same disconnect follows patients into the health care system. A provider can prescribe an appropriate medication without knowing that it costs a patient hundreds of dollars each month.
A treatment plan can look excellent on paper and fail immediately against a full-time job, childcare responsibilities, or a complicated dosing schedule.
Patients are then left to manage the financial and practical consequences of recommendations they may struggle to follow.
Health care professionals must understand the person as thoroughly as they understand the diagnosis. What does this patient want their life to look like? Which treatments fit their goals, circumstances, and finances? Are we helping them live well, or arranging their lives around an endless sequence of appointments?
Start Prevention Early
These questions become more pivotal as chronic illness strains families, hospitals, and public resources. In rural communities, limited staffing and vulnerable health care facilities can make access to essential services especially precarious.
Across the country, rising care needs place pressure on patients, employers, insurers, and taxpayers. Medical advances may extend a person’s life span, but the number of years lived in good health deserves equal attention.
Reaching 100 means little if the final decades are dominated by an inability to enjoy daily life.
Imagine a health care system in which prevention starts early, nutritious food is accessible, clinicians have time to understand their patients, and treatment decisions reflect individual goals.
More people could preserve their independence, families could spend less time navigating crises, and health care resources could be directed toward the care people genuinely need.
Continue along our current path, and more people risk developing chronic conditions earlier, facing insurmountable costs, and spending their later years managing illnesses that might have been delayed or better controlled.
The responsibility for changing course rests with patients, clinicians, industry leaders, and policymakers. Patients can ask what they can do today to protect their future health.
Providers can make preventive conversations a routine part of care, explain the financial and practical consequences of treatment, and revisit whether existing plans still serve their patients.
Patient Advocates
Food manufacturers and policymakers must also take seriously how product formulation, pricing, marketing, and public policy shape population health.
Health care professionals, in particular, must reclaim their role as patient advocates. I believe in the old-school family doctor who knows a person’s history and understands their circumstances.
We need more of that relationship at a time when health care can leave people feeling like numbers moving through a system.
Health care leaders and policymakers must make prevention a measurable priority, invest in early intervention, and demand that care plans account for patients’ real lives.
Providers must challenge a system that rewards treating illness while giving insufficient attention to preserving health. Every patient should leave a medical appointment with a clearer understanding of how to manage existing conditions and protect their future well-being.
America does not need to abandon medical innovation. It needs to stop treating innovation as a substitute for the fundamentals. We should not have to wait for a diagnosis to start caring about our health.
The question is whether the country will act while people still have the opportunity to change their trajectory, or keep waiting until prevention becomes a far more expensive form of crisis management.
Rachael Rivero is an acute-care nurse practitioner and founder of Kansas Care Connect, which provides chronic-care management and remote-monitoring services and could benefit from greater investment in preventive care. The views expressed in this article are her own.