The Age of Diagnosis: Suzanne O'Sullivan's 'immensely persuasive' read
Rather than 'getting sicker', we may be 'attributing more to sickness'

A "perplexing" feature of our age is that the more our society spends on healthcare, the "gloomier the statistics around ill health" become, said James Le Fanu in Literary Review.
Funding for the NHS has grown sixfold in the past 50 years; and while there have been clear benefits – including better recovery rates from many life-threatening diseases – it's notable that the increase in investment has not made us less sick overall. Quite the contrary, in fact: since 2010, the "number of people labelled as having a long-term health condition – whether physical or mental – has leapt by six million". In her wide-ranging book, Suzanne O'Sullivan suggests that this glut of ill health has been driven by a culture of "overdiagnosis". Rather than actually "getting sicker", she writes, we are "attributing more to sickness", so that millions who once would have been considered healthy are now classed as unwell. The costs are considerable – to individuals and to society – and O'Sullivan's assessment of how this situation came about is "masterful" and "immensely persuasive".
As O'Sullivan sees it, overdiagnosis most often occurs in two forms, said Hannah Barnes in The New Statesman. First, there's "over-detection" – where improvements in our ability to identify signs of disease lead to unnecessarily early interventions (this has happened, she claims, with certain cancers). Secondly, there's "expanded disease definitions" – an ever-greater number of symptoms being classed as evidence of a condition. O'Sullivan believes the latter is chiefly responsible for the dramatic recent rise in diagnoses for conditions such as autism and ADHD. Historically, these may have been underdiagnosed, but now the opposite is true, and "almost nobody is denied a diagnosis". This, she argues, can do "more harm than good" – leading people to attribute all the problems in their life to their "condition", when the actual solutions may lie elsewhere.
Subscribe to The Week
Escape your echo chamber. Get the facts behind the news, plus analysis from multiple perspectives.

Sign up for The Week's Free Newsletters
From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.
From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.
Long Covid is another contentious illness that O'Sullivan considers, said Adam Rutherford in The Guardian. Here, uniquely, diagnosis has "been led by the public, often via social media". Exploring such areas is "incredibly difficult", and it would have been easy to be "sneering or dismissive". Thankfully, O'Sullivan is neither; her writing is "full of compassion, care and grace". The central argument of this excellent book is that diagnosis is a tool that should be "wielded with the utmost caution".
Sign up for Today's Best Articles in your inbox
A free daily email with the biggest news stories of the day – and the best features from TheWeek.com
-
5 cartoons about the Russia-Ukraine peace talks
Cartoons Artists take on a stand-in for Vladimir Putin and phone calls with Donald Trump.
-
Donald Trump's foreign policy flip in the Middle East
Talking Point Surprise lifting of sanctions on Syria shows Saudi Arabia, the UAE and Qatar are now effectively 'dictating US foreign policy'
-
Crossword: May 24, 2025
The Week's daily crossword puzzle
-
6 lounge-ready homes with conversation pits
Feature Featuring a terrazzo-flanked pit in California and a fire-side pit in Nevada
-
Is a River Alive?: a 'powerful synthesis of literature, activism and ethics'
The Week Recommends Robert Macfarlane's latest book centres on his journeys to four river systems around the world
-
Good One: an 'intensely compelling' coming-of-age tale
The Week Recommends India Donaldson's 'quietly devastating' debut feature about a teenage girl's life-changing camping trip
-
The best lemon pepper wings in Atlanta
Feature Marinated turkey wings, a Korean barbecue sauce combo and an off-menu staple
-
Film reviews: Friendship and Fight or Flight
Feature An awkward dad unravels after he's unfriended and Josh Hartnett attempts a John Wick sidestep
-
Art review: Ai, Rebel: The Art and Activism of Ai Weiwei
Feature Seattle Art Museum, through Sept. 7
-
Book reviews: 'Second Life: Having a Child in the Digital Age' and 'Mark Twain'
Feature Navigating pregnancy in the digital age and an exploration of Mark Twain's private life
-
Richard Bausch's 6 favorite books that are worth rereading
Feature The award-winning author recommends works by F. Scott Fitzgerald, Ernest Hemingway, and more