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
-
Why are Americans using ‘buy now, pay later’ apps to buy groceries?
Today's Big Question A 'layaway program, but reversed'
-
Trump moves to gut PBS and NPR in latest salvo against the media
IN THE SPOTLIGHT The president's executive order targeting two of the nation's largest public broadcasters comes as the White House seeks to radically reframe how Americans get their news
-
Sea lion proves animals can keep a beat
speed read A sea lion named Ronan beat a group of college students in a rhythmic dance-off, says new study
-
Splash! A Century of Swimming and Style: full of 'revelations and surprises'
The Week Recommends The Design Museum's sweeping collection of all things swimming contains hidden depths
-
The Ugly Stepsister: 'slyly funny' body-horror take on Cinderella
The Week Recommends Emilie Blichfeldt's cutting Norwegian revision of the classic fairy tale leaves no character unscathed
-
John Boyne shares his favourite books
The Week recommends The bestselling novelist picks works by Tobias Wolff, Christos Tsiolkas, and Agatha Christie
-
The Brightening Air: a 'gripping' family drama
The Week Recommends Connor McPherson's Chekhovian drama about a pair of siblings whose lives are upended by the arrival of their relations
-
6 isolated homes for hermits
Feature Featuring a secluded ranch on 560 acres in New Mexico and a home inspired by a 400-year-old Italian farmhouse in Colorado
-
Allies at War: a 'revelatory' account of the Second World War
The Week Recommends Tim Bouverie's 'old-fashioned diplomatic history' explores the often fraught relationship between world powers
-
The Friend: a 'graceful' but flawed dog movie
The Week Recommends Naomi Watts stars in 'intelligent' adaptation of Sigrid Nunez's book about a 'problematic pooch'
-
Louis Theroux returns to the West Bank for new documentary
In the spotlight The film-maker meets Jewish settlers with his signature 'faux naivety'