More Health For the Care or More Care for the Health

Over-testing and over-treatment of patients is not new and no one should expect it to stop soon. Already there is a call to produce more physicians in response to health care reform. The question is whether health care reform or more physicians will improve health status. As for the cost, there is no doubt that will increase.

Ten Great Public Health Achievements

The May 20th Weekly Morbidity and Mortality Report form the CDC listed ten great public health achievements in the U.S. 2001 - 2010.

1. Vaccine-Preventable Diseases
2. Prevention and Control of Infectious Diseases
3. Tobacco Control
4. Maternal and Infant Health
5. Motor Vehicle Safety
6. Cardiovascular Disease Prevention
7. Occupational Safety
8. Cancer Prevention
9. Childhood Lead Poisoning Prevention
10. Public Health Preparedness

These are commendable achievements and they must be sustained. The continuing frontier and perhaps the biggest challenge for public health is the arena of primary prevention through changes in behavior. Nutrition and exercise (physical activity) are at the core but control of stress and sense of well-being are involved also. There is a reliable body of knowledge to support these efforts but scaling them up to populations is a challenge. A growing number of communities are rising to this challenge. We should watch and support them.

A Plant Based Whole Food Diet

The China Study by T. Colin Campbell is a good book for those interested in better health and weight control. It truly is the most comprehensive study of nutrition ever conducted. The conclusion is to adhere to a plant based whole food diet. I recommend the book and the conclusion.

Data and Health

Health care is a field that functions on personal interaction but it is a data driven activity. It is necessary to know what works in any given situation and what causes harm. Computers allow the collection and distribution of data that will continue to make health care more effective and safer. It will also distinguish between health care and medical care, which will trend toward better health status at lower cost.

Medical Science and the Unknowns

Biomedical science is far from being exact and along with medical care suffers from the vastness of the unknown. This can lead to conflicting advice and confusion for patients and the public at large. Although officials at the Centers for Disease Control (CDC) criticize the finding of a European study that low salt diet increases risk for death from heart attack and stroke and does not prevent high blood pressure, the study does highlight a lack of agreement and controversy regarding the control of salt in the diet. Another example comes from the Fred Hutchinson Cancer Research Center in Seattle where they found men with the highest blood levels of D.H.A., an omega-3 fatty acid, were 2.5 times more likely to develop high grade, aggressive prostate cancer than those with the lowest blood D.H.A. levels. This is in direct contradiction of the evidence that omega-3 fatty acids help to prevent artery and heart disease. Of course, each of these studies involve groups of people and there are sure to be variations among individuals that might explain these contradictions. And there might be factors in the design and observations of the studies that explain the contradictions. With time more of the unknowns will be identified.

Community Health Centers

Low cost primary medical care is in short supply and it will be scarce for the foreseeable future. One of the proven ways to meet this need is community health centers. This article discusses the current situation concerning community health centers. Much of the future of health care can be addressed by development of community based primary prevention (lifestyle), enhanced public health and community health centers.