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Fixin' Healthcare

Sunday, July 30, 2006

The Lifestyle Chronicles - Young Women And Little Children

People today grow taller, enjoy better health and live longer than their ancestors. Most of these gains are the result of public health measures, such as sanitation, immunization and better nutrition, and antibiotics effective against life threatening infections.

Dr. David Barker, a professor of medicine at Oregon Health and Science University in Portland and a professor of epidemiology at the University Southhampton in England, has examined historical data and animal studies that indicate health in middle and old age can be determined by conditions and events during fetal life (pregnancy) and the first two years after birth. The Barker hypothesis leads to a health care system that allocates resources to public health with emphasis upon pregnancy and early childhood as a means to improve and maintain optimum health status throughout life.

This would have a profound impact upon American medicine. American society through its political system and economic structure favors medical care with much of it allocated to the elderly. At best, this relieves suffering and modifies disease processes but does not cure or eleminate diseases. It is a situation that generates immense and expanding cost with diminishing returns.

If the Barker hypothesis proves to be true, don't expect such truth to create an immediate or significant change in health care. In spite of the widespread dialogue supporting science and evidence-based decision making, the political and commercial interests are heavily vested in the current medical care system and they hold the trump cards in health policy.

A public health care system is based upon community health that should emphasize pregnancy and children but does not exclude any person or group. Senior citizens want and need attention, but the medical care system is an expensive and ineffective way to give it. A public health care system can best serve the elderly by development of effective and efficient long-term care.

National health policy that promotes health would be an interesting new perspective. I wonder if the special interest groups are ready to give up sickness.

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