Fixin' Healthcare

Visual Technology

2012-01-08T11:30:00.002-05:00

Technology is proving to be useful for education. There are examples of online education from grade school through universities. Visual technology can be especially useful for people to perceive how somethings are and how they function. Medical schools can make use of this for anatomy when bodies are in short supply or in altered states. One of the biggest challenges for health care is public education and this type of technology can be helpful. In that regard, health education can start at an early age and continue through life. It would be a healthier, longer, more productive and probably happier life.

Some Lessons From Finland

2012-01-03T11:29:00.002-05:00

In the 1960s Finland had the world's highest rate of deaths from coronary heart disease and the Province of North Karelia was the highest. The North Karelia Project was launched in 1971 to address this situation. Prevention was chosen as the most effective public health solution. "The general idea was to transform the social and physical environment of North Karelia. After an initial 5-year period, the project was extended locally, and its findings diffused nationwide to promote prevention throughout Finland. An integrated approach to prevention was central to success of the project. The risk factors for cardiovascular disease-unhealthy diet, smoking and physical inactivity-are risk factors for many chronic diseases. Rather than a number of vertical disease specific programs, an integrated approach targets the main common behavioral risk factors." Thinking advanced from a focus on risk factors for individuals into a broader emphasis upon the needs for society, environment and community to be supportive for health and to enable healthy living, i.e. a more comprehensive approach based on health determinants. Social marketing was an important aspect of the North Karelia Project. Dramatic changes were observed in risk-related lifestyles and risk factors in the people of North Karelia and this was associated with substantial reduction in population-wide rates of cardiovascular disease. With the nationwide roll-out of activities, the prevalence of risk factors and death due to cardiovascular disease began falling throughout Finland.

The North Karelia Project was adapted by cardiologists at Mayo Clinic for implementation in Olmsted County, Minnesota and in 2002 it served as a model for initiating Healthy Greenville 2010, which has evolved into LiveWell Greenville. Communities with similar public health projects are New York City, Savanah, Louisville, Oklahoma City and Chicago. A recent report indicated a five percent decline in obesity among school children in New York City.

Education is directly tied to health status and it is interesting that Finland has demonstrated success with reform of its educational system.

Orientation and Direction

2011-12-28T14:29:00.000-05:00

A year goes and another comes. Reviewing the past is often done to put a fine point on progress but I do not look back to measure progress. Orientation and direction are what I seek. It is a matter of what and why more than where, when and how much or how far, but it is a road map nonetheless. Progress is of little value if it is not in the correct or desired direction, as well as the right distance or amount. When the unknown exceeds the known, as it so often does, process occupies the center of attention with the expectation that process, properly executed, will lead to a designated goal. But the value of process is determined by periodic evaluation of orientation and direction. It is easy to be lost and not know it.

Looking back for orientation and direction can refresh the wisdom gained from experience and cultivate the humility that comes with recognition of life as a mystery. The correct or desired direction can change and the change can be subtle at the start but drastic over time. For example, it can make a huge difference whether the goal of a health system is the best health status possible or the best medical care possible.

After fifty-one years of active involvement in various aspects of the medical profession, I seek orientation and direction to understand better the basis of good health and the role medical care serves in achieving and maintaining good health. It might seem after fifty-one years to be an odd quest but the issues are complex and I surely believe the answers have eluded American society with tragic consequences.

Pass the Health, Hold the Doctor

2011-12-20T18:06:00.000-05:00

It is a common assumption that health status depends upon the availability of doctors and hospitals. I can understand that doctors and hospitals want people to believe health status depends upon their services. Also, medical schools would be in favor of producing more doctors, as well as the hospitals and communities that want to start medical schools. Let us not forget that medicine is an industry but it is an industry oriented to sickness. Is sickness, even sickness well treated, the best pathway to better health status? Perhaps it might be better to plan on less sickness.

A recent study of Texas Medicare claims data revealed a disparity in colonoscopy screening between white, black and Hispanic populations with whites receiving more screenings. In those communities with more doctors, the disparity was even greater in favor of white patients. Placing aside the question as to whether the number of colonoscopies is necessary regardless of race and ethnicity, this is one of many studies showing that more doctors frequently do not yield the desired result. That is to say the result desired by patients and the community.

Meanwhile, the data continues to accumulate that better health status depends on much more than doctors and hospitals. Some communities have come to realize improving health depends upon things involving life in the community. Kansas City, Kansas is an example but there are a growing number of other communities seeking more health for the care and sense there is a more effective way.

Obesity Rate Declines In New York City Schools

2011-12-16T09:47:00.000-05:00

There are those who believe that obesity cannot be controlled. And there are those who believe that government should not serve in a "nanny" capacity. Of course, that depends upon what defines a "nanny" government. But unhealthy lifestyles and poor diet are a plague on the individual and society. It is not easy to control the situation but it can be done. The efforts in New York City schools appear to be yielding results. The number of obese NYC school children declined by 5.5 percent over the past five years. Other cities and towns can follow the example. It will save lives and it will save money.

More Transformation

2011-12-09T10:49:00.001-05:00

My last post touched upon the concept of transformation. Some might think it is an introduction to the transformation of medical care but it is an introduction to the transformation of society to achieve improved health status of the population and the individuals within the society. Medical care, even reformed medical care, cannot do that. It is time for the United States to wake up and accept the implications of the health outcomes resulting from a health system usurped by medical care.

The United States spends more on medical care and derives less benefit from it than almost every other industrialized nation. Meanwhile, social support programs, public health and primary prevention are afterthoughts of a medical care system. What are the outcomes? The US ranks in the bottom half of comparable nations for life expectancy and infant mortality. But we are winners when it comes to obesity and chronic metabolic diseases. These problems are not cured but many of them can be prevented.

An interesting viewpoint is presented by combining what countries spend on medical care with spending on social services, like rent subsidies, employment-training programs, unemployment benefits, old age pensions, family support and other services that can extend and improve life. In that analysis the US no longer leads among comparable nations. "America is one of only three industrialized nations to spend the majority of its health and social service budget on health care." And in the US that health care budget is overwhelmingly spent on medical care. The study revealed that countries with high health care spending relative to social spending had lower life expectancy and higher infant mortality than countries that favored social spending.

Changing this situation will not be easy. Far from it. Reallocating medical care funds to social services is a start. That alone will change society. But addressing the social, commercial and political environment that promotes unhealthy lifestyles resulting in much of the chronic disease requires transformation of American society. Without it we are becoming a nation of metabolic cripples.

Transformation

2011-12-08T13:30:00.001-05:00

Disruption in society imposes upon people the necessity to learn how to live in new and changing conditions. Although many of these conditions are external to people, transformation, when it comes, comes from the changed mind-sets of people. When enough people reach a similar alteration in mind-set, the collective response becomes a driving force in a new direction generating momentum and inertia. Some call this paradigm shift but many things are labeled paradigm shifts that do not transform society. Transformation of a society is rare and it results in a different and sustained way of life.

Home Health Care

2011-12-05T09:20:00.001-05:00

All of the tools for home health care are available. Now, we need health care personnel who are prepared and ready to use them. Dr. Resnik is correct that the most recent period of health care was controlled by hospitals, insurance companies and pharmaceutical companies. Health professionals are molded to function in that environment but that environment has peaked out with diminishing health status for increasing expenditures of money and effort. There will be a period of adjustment while the public accepts this new reality and the training plus organization of health professionals catches up.

Vegetables and Fruit and Strokes

2011-12-02T09:54:00.001-05:00

Chemical reactions are constantly occurring inside human cells. These reactions create what are called free radicals, which are unpaired electrons. These little devils are chemically reactive and capable of causing tissue damage. Vegetables and fruit contain antioxidants that neutralize these free radicals. Ah ha, a high technology right at our finger tips.

A Swedish study reveals that a diet high in vegetables and fruit is associated with reduced incidence of stroke even in those with a prior history of heart disease. Interestingly, several studies have demonstrated that supplements containing antioxidants do not offer the same protection. Maybe it is the antioxidants in vegetables and fruit, maybe it is other compounds and maybe it is all of the above, but reducing the incidence of strokes is among many reasons to eat more vegetables and fruit. You already knew that, didn't you?

Commercial Fruit Juice

2011-12-01T13:17:00.001-05:00

Consumer Union, the publisher of Consumer Reports, analyzed fruit juices, mostly apple and some grape, in the grocery stores and found high levels of arsenic plus some lead. This speaks to the issue of pesticides used by fruit growers. Ten percent of the samples contained arsenic levels higher than the federal standard for drinking water and one-quarter tested for lead higher than the FDA standard for bottled water. Generally, commercial fruit juices are very sweet and much of the nutritional value decays over a period of days after juicing. It is better to use whole fruit and wash it well with a vinegar solution and you can prepare your own fruit juice.

Exercise and Mental Function

2011-11-30T11:45:00.001-05:00

This article reports on a study that reconfirms the benefits of exercise upon mental function and offers a mechanism as to how it works. There can be no denying that regular, sustained physical activity has all sorts of positive effects on health. Start slow and build up in duration and intensity. It's called physical conditioning. Try it, you'll like it.

Stop Smoking

2011-11-30T10:08:00.001-05:00

As a nonsmoker I have little understanding of the desire to smoke or to continue smoking. However, I do understand the terrible toll smoking takes on health. New studies indicate that better and more prolonged therapy to stop smoking can be successful, even among those who don't desire to stop. The conclusion is to treat smoking like a chronic health condition or disease. Probably not an unreasonable approach to the problem.

Weight Management For Children

2011-11-28T12:18:00.001-05:00

Obesity in children is a growing problem that proves difficult to control in our society. This article describes a successful program at Stanford University involving the family. The objective for children is to achieve a healthy weight in a healthy way over time. There are no secrets, it's just a matter of doing it. Most families need help.

Got Arthritis? Keep Moving.

2011-11-28T11:47:00.001-05:00

Anyone with arthritis knows that movement is painful but they also know that inactivity increases the pain. Unfortunately, many people with arthritis are not physically active. In study of 1000 people age 49 to 84 years, ninety percent were not exercising (20 minutes of moderate activity daily) and forty percent of men plus sixty percent of women were total couch potatoes. There are practical reasons that regular physical activity helps arthritis plus it is beneficial for general health (cardiovascular, pulmonary and metabolic). Enough said, lets go for a walk or jump in the pool.

Nutritional Supplements

2011-11-28T11:32:00.001-05:00

It is best to assume that a healthy diet provides everything human metabolism needs. However, people don't always eat a healthy diet and even if they do nutritional supplements are considered insurance. A recent study published in the Archives of Internal Medicine 2011; 171(18):1625-33 explored the hazard for increased mortality in a group of women average age 61 years. In summary, supplemental iron was associated with the highest risk and calcium with decreased risk.

Room For Improvement

2011-11-28T11:14:00.001-05:00

Plant based whole food contains everything human metabolism needs for normal function. Increasing the consumption of vegetables and fruit and decreasing intake of processed food plus animal protein and fat is the double whammy of health. But it is slow to happen. In a survey of high school students by the National Center for Disease Control and Prevention (NCDC), only 16.8% ate fruit and 11.2% ate vegetables at least four times daily. And most were not engaging in 30 minutes of physical activity daily. This is in comparison to the recommended 1.5 to 2 cups of fruit and 2.5 to 3 cups of vegetables daily. One cup is equal to a medium apple or 12 baby carrots.

Willpower

2011-11-28T07:38:00.001-05:00

The debates about willpower and the influence of lifestyle on health are of vital importance to each individual and the nation. Is it "woe is me" or "get up and get moving"? Evidence indicates that willpower is a mindset and it can be cultivated but it is hard work. Something to think about. Personally, I don't believe, or want to believe, there is nothing I can do about how I live. However, no one says it is easy.

The Business of Gluten Free

2011-11-27T10:36:00.001-05:00

Celiac disease is a significant health problem and gluten sensitivity is more widespread than previously thought. As people become more aware of the condition, more diagnoses are made and companies respond by making gluten free products. Vegetables and fruit provide everything in abundance that human metabolism needs and without any gluten.

Fight the Fat Gene

2011-11-23T08:28:00.001-05:00

Scientists believe they have found a gene that predisposes people to accumulating body fat and it is distributed widely throughout the population. But they also discovered that physical activity (exercise) can modify expression of the fat gene. In other words, genetics is not entirely fate. Healthy lifestyles make a difference and exercise (physical activity) does not have to be running and weightlifting. Eat more plant based whole foods and keep moving. And may the force be with you.

Cancer Is A Word With Multiple Meanings

2011-11-22T14:16:00.001-05:00

The word cancer can be terrifying but it has multiple meanings. There are different types of cancers in different organs. Some cancers progress slowly and some rapidly. Cancer may not be cured in many cases but modern therapy can manage it as a chronic disease. Anyone with cancer needs to be educated about their condition and what to expect. In addition to any need for therapy specific to the cancer there is need for special diligence in regard to a healthy lifestyle. The body has mechanisms for combating cancer that require support with a healthy diet, exercise, adequate sleep and stress relief.

An Attitude of Gratitude

2011-11-22T10:20:00.001-05:00

Cultivate an "attitude of gratitude". Studies shows it leads to less anxiety and depression, sounder sleep, better health and a kinder behavior toward others. Kindness usually wins in the long run. History shows that toughness is the ability to take a beating, not give a beating.

Numbers Don't Lie, Do They?

2011-11-21T13:04:00.001-05:00

The symptoms of hypothyroidism are often vague and difficult to evaluate. Blood tests are a helpful guide but they also may be misleading. With the increasing reliance upon technology and the limited time spent with patients, mistakes can happen and often do. It is always good advice to listen to the patient and evaluate the laboratory results accordingly. Experienced physicians frequently utilize the laboratory and imaging for confirmation of what they already suspect. However, all the findings must be considered and inconsistencies cannot be ignored.

One Size Fits All

2011-11-17T08:47:00.001-05:00

The same healthy lifestyle habits that reduce the risk for heart disease also reduce the risk for cancer. The same is true for diabetes and probably many other diseases. As far as primary prevention is concerned, one size does fit all. And it is all in your hands every day, all day. Just learn how to do it and join an environment consisting of other people who live it and promote it. Many communities are developing such an environment and welcome your participation.

Tough Love

2011-11-16T08:02:00.001-05:00

Everything old becomes new again. Small groups, trust, tough love and competition produce weight loss. Health is a community affair that is paid for with time, energy and concern for others. Nothing is ever learned so well as to teach others. Good health depends upon behavior and healthy behavior is achieved day by day with constant reinforcement. Yes, we are our brother's keeper and they are ours.

Brown Rice

2011-11-11T08:01:00.001-05:00

Brown rice is filling and it is a healthy food. Here are many recipes for using brown rice.

Community Health

2011-11-11T07:42:00.001-05:00

"Health is a community affair". This article reports on the Saddleback Church using small groups to assist people with losing weight and improving health. I am confident that companionship and losing weight relieved depression better than antidepressant medications. Reducing risk for diabetes, hypertension, heart disease and cancer can be added to the list of benefits. No doubt about it, community health is God's work.

Dietary Sodium

2011-11-10T09:24:00.001-05:00

There is controversy about whether limiting sodium in the diet improves health. Some data indicates that limiting sodium interferes with health but these recommendations might include amounts of sodium as low as 1,500 mg daily. The issue for the most part revolves around the large amount of processed food in the American diet containing high levels of sodium. A better way of addressing the problem of high sodium is to eat more plant-based whole foods containing higher amounts of potassium and eat less or no processed food. That will improve health, reduce weight and lead to feeling better with a greater sense of energy. The results speak for themselves.

Exercise To Slow Aging

2011-11-09T15:51:00.001-05:00

Here is more evidence that exercise helps avoid losing muscle mass and strength, as well as avoid the decline from vitality to frailty. It is never too late to start and keep it up.

Five Ways To Reduce Risk For Diabetes

2011-11-09T10:54:00.000-05:00

Each of these five ways will reduce risk for diabetes by 30% and all five together reduces risk by 80%. It's not a bad deal because diabetes is no fun and it will kill you.

A View of Medical Care

2011-11-08T14:08:00.000-05:00

This interview with the chancellor of the University of California San Francisco paints a picture of how science and medical care will explain disease and lead to cures and prevention. It is not a new view of health. This is the pathway followed by biomedical research and medical care for the past century with increased attention since World War II. Progress has been significant but slow and expensive. Meanwhile, the public believes success is imminent and places their faith in medical care. It is not so much a belief in science as a form of wishful thinking. When you suffer with a disease, any hope is comforting. The tragedy is the lack of attention to the highest technology in health. The human body and the control of the technology in the human body through lifestyle can prevent disease and reduce the severity of disease. This is available immediately with amazing results. In many ways the faith in medical care clouds the vision of health care in the form of primary prevention and public health resulting in less than optimal health status. Health care is for everyone, medical care is for those who need it.

Insurance Is Not A Health Provider

2011-11-08T12:24:00.000-05:00

David Brooks is my favorite political commentator because he seeks the balanced and practical (prudent) approach to problems. And he is willing to say that we cannot be sure about the outcomes of many proposed solutions. In this article he expounds upon Mitt Romney's proposals for Social Security and Medicare. Addressing the Medicare, I agree with Mr. Brooks that the fee-for-service payment system is a central problem for medical care not just Medicare. But don't look for insurance companies to solve that or any other health problem. Health insurance is not a health care or medical care provider and it does not work like other insurance. Sharing risk is a problem when there is no differentiation between health care and medical care.

No issue in the United States is more important and more misunderstood than health. The current concept of health is robbing the nation of vitality and treasure. People fear sickness more than they trust the pursuit of good health. Medical care has usurped health care and public health is relegated to a secondary role. The expansion of medical care and health (medical care) insurance has created an enormous business enterprise with the objectives and values of commerce. That warps health and health care to the detriment of health status. The goal of national health policy must be to achieve and maintain the best health status possible by reducing sickness, disease and disability. In that context medical care is the default system for those who need it, which I propose is significantly less than the current utilization.

Now, envision a nation with better health status, more vitality and less medical care. That vision would consist of a transformed society. More like we think we are than what we are.

The Freshman 15

2011-11-08T10:35:00.002-05:00

The freshman 15 pound weight gain is a myth. On average the gain is more on the order of three pounds. As a myth, the freshman 15 takes its place among all the other myths about health and the economy. However, a three pound weight gain is not something to be ignored as it may be the start of something bigger.

Heartburn

2011-11-08T10:11:00.001-05:00

"Heartburn", acid reflux, GERD and hiatal hernia are diagnoses associated with chest pain due to food and/or drink. Although an abnormality of the anatomy is assumed to be the culprit, more often than not the symptoms will regress with a change in diet. One of the common causes of the symptoms is regular and diet sodas. Highly processed food is another common cause. Perhaps the diagnosis should be poor diet. A diet consisting of plant based, whole foods is the best protection against "heartburn".

Air Pollution - continued

2011-11-07T10:08:00.000-05:00

This article gives an overview of the status of air pollution in the US. Certainly, it is better than it used to be but pockets (areas) of trouble continue to exist. Everyone should realize air pollution is a serious health hazard and be vigilant to the status in their area. Urban and industrialized areas are at greater risk.

Inactivity Boosts Cancer Risk

2011-11-04T07:26:00.001-04:00

Physical inactivity boosts the risk for cancer. Walking is good and keep moving. Watching television and sitting at a computer not so good. The same advice applies to reducing risk for artery and heart disease. No one can do it for you but having someone to do it with is helpful. Like most things in life it starts in the head not the legs. Keep thinking about it, you can do it.

Shared Lives

2011-11-02T09:39:00.000-04:00

Each of us shares our bodies with numerous microbes. The estimated ratio of microbes to human cells is 10 to one. Microbes contribute to metabolism and healthy function of the body. Evidence is growing that lifestyles (diet and perhaps exercise and sleep) determines the mix and amounts of microbes. Antibiotics have a major impact upon the bacteria that invade as well as those that inhabit our bodies. There are so many things we don't know about this aspect of health, as well as health in general.

Nursing Home

2011-11-01T12:23:00.000-04:00

Long-term care for the elderly is one of the vexing problems of society that each of us has to deal with sooner or later either as a participant or as a son or daughter with a parent who needs such care. For the most part it is not a positive experience and it is expensive. This description of "Green Houses" is an example of trying to do it another way. I wish them well.

The Quandary of Finding a Small Tumor

2011-11-01T11:33:00.002-04:00

What to do about the incidental finding of a small tumor? If it is on the skin, the answer is easy but in the pancreas much more difficult. This is a quandary that has become more common with more frequent scanning with higher resolution scanners.

Houston, We Have A Problem

2011-11-01T08:10:00.000-04:00

People who work in public health have known for a long time that education is linked to health status. Those of us who worked in large public hospitals (Grady, Parkland, etc.) have seen how poverty and lack of education impact health. Education is on the national agenda and it will take time to have an impact on the problem. Other issues such as immigration will influence this effort. It makes no sense not to educate the children of immigrants, illegal or not. Even the Texans understand that. Meanwhile, medical care and private health insurance will have little impact on the status of health for the population as a whole.

Mainaining Weight Loss

2011-10-31T09:27:00.001-04:00

Losing weight is difficult but maintaining weight loss is another difficult task. Perhaps even more so. The effort is life-long. Try physical activity. Keep in mind the physical activity does not have to be weight lifting and/or running. Walking is good. Brisk walking and walking up hills is even better. Be persistent and consistent. 10,000 steps is four or five miles depending upon the length of your stride. Most people walk one to two miles daily. KEEP MOVING! Your life depends upon it.

Air Pollution

2011-10-31T08:44:00.003-04:00

Air pollution is associated with lung cancer in non-smokers. Asthma, pulmonary insufficiency (inflammation, fibrosis and poor oxygenation) and cardiac disease are also associated with air pollution. This ia another of those areas where public health can serve to prevent disease.

One Reason for Hope

2011-10-29T11:38:00.001-04:00

One of the reasons I have hope for better health in the U.S. is that corporations and communities recognize the validity of lifestyle to achieve primary prevention. This article reports upon the efforts by Dow Chemical. Cleveland Clinic is another example as are Greenville, SC, Savannah, Georgia, Louisville, Kentucky and Oklahoma City. Health is a community affair. Go team!

From Farm To Fork

2011-10-29T11:23:00.001-04:00

The search for the source of an E. coli outbreak shows the number of items in a salad and the difficulty in identifying the culprit. Infectious agents and contaminated food are a constant threat requiring personal vigilance, strong regulation for food safety and public health response. Personal vigilance includes cleaning vegetables and fruit plus care in preparing and storing food. Public policy for food safety deserves high priority. An effective and efficient public health system saves more lives than medical care.

Long-Term Care

2011-10-28T09:58:00.001-04:00

I can understand how the Class Act failed before it began but this is a real problem with no easy solution. Currently, long-term care is a dysfunctional system and it needs a new ways of looking at the problem. There should be a call for new system concepts at the community level. All of us need to think about our situation when that time comes. It is more than a financial problem.

The Cost of Health (Medical) Care

2011-10-28T09:25:00.000-04:00

This article outlines some of the parameters of health care cost. Keep in mind that health care is medical care and it is a business and an industry in the U.S. It is a marvelous business and a powerful industry. The focus of medical care is illness, disease, injury and disability. As such, medical care is the default not the primary choice. Reform needs to focus upon achieving and maintaining the best health status possible. When people learn that health care supersedes medical care, the population will be healthier and there will be less need for medical care. GO TEAM!

Post Weight Loss

2011-10-27T08:17:00.002-04:00

Losing weight and maintaining the loss are difficult, related and separate efforts. People who lose weight find it slowly returns. Weight loss causes metabolism to slow and appetite to increase. Constant vigilance is needed but very difficult to maintain. Another strategy is periodic intensive attention to adjustment of weight. It helps to engage in some type of regular physical activity with periodic episodes of more vigorous exercise. In any case, no one should ever say that weight loss is easy and those who are successful should be praised. Everyone should be encouraged to continue in their effort.

Mammograms In the News Again

2011-10-25T11:00:00.000-04:00

A new study reveals that mammograms don't save as many lives as people think. Early detection and secondary prevention are an extension of medical care and they are just as expensive as medical care. But do they yield the expected results? This question will continue to be examined and I expect the results to show that the lives of some people are saved. Don't expect this to yield cost savings and do expect some morbidity and even mortality associated with the process of early detection and treatment. Some of the treatments will be unnecessary but that would not be obvious before the fact. My concern is that medical care, including early detection and secondary prevention, distracts from the attention and effort directed to primary prevention. Certainly, more needs to be learned about primary prevention but a workable body of knowledge is available. Application of this knowledge to populations and individuals will save lives and increase the quality of life.

When Is Doing Nothing the Best Medicine?

2011-10-22T14:00:00.000-04:00

They also serve who only stand and wait. Every drug, every surgical procedure, every diagnosis and treatment is a two edged sword that cuts both ways. Benign neglect can lead to tragedy but so can aggressiveness.

Hope and Expectations

2011-10-17T12:45:00.000-04:00

Diseases are given costly crowns
And health is forsaken: what nod to cost is this?

People expect many things from medical care, sickness has a way of doing that, and medical care does save (extend) the lives of many who suffer from disease and injury. But medical care seldom cures disease or restores function. Even so, hope springs eternal and there are always avenues to promote hope. For most chronic and deadly diseases there is more hope for prevention than cures. That involves promoting health rather than a disease and there is no money in such an effort. When you think about it, that would be refreshing.

Philosophy and Health

2011-10-17T11:02:00.000-04:00

This article asks if philosophy is the most practical major in college. Maybe, maybe not. But when it comes to health philosophy is extremely practical. Note that the reference is health not medical care. Health is about living and how life is addressed and lived. It requires a lot of thought. Much of that thought is passed from one generation to the next but each individual must generate and pursue their own thought about life and how to pursue it. No amount of medical care can substitute for the lifestyle of a society or an individual to achieve the best health status possible.

A Vegan Dinner Party for Autumn

2011-10-16T11:57:00.004-04:00

This description of a vegan dinner party for autumn by Melissa Clark sounds so delicious that I had to share it. One doesn't have to be vegan to enjoy some the items and dishes included here. The Hummus With Crisp Maitake Mushrooms looks to be appealing.

Wages, Compensation and Medical Care

2011-10-14T11:23:00.000-04:00

First of all, what people call health care is medical care. Medical care is expensive and it eats up more of people's compensation than they are often aware. The charts in this article don't excuse anything but they do tell an interesting story about where the money is going.

Heart Disease Declining

2011-10-14T09:05:00.000-04:00

The CDC (National Center for Disease Control and Prevention) reports a decline in heart disease from 2000 to 2006. The details include a higher incidence in men than women and the states with the highest incidence are Kentucky, West Virginia and Louisiana. The age-adjusted mortality rate for heart disease has steadily decreased in the U.S. since the 1960s. The more recent decline in incidence is a result of public health and the longer trend in decreased deaths is due to medical care.

Something Like This

2011-10-13T11:56:00.000-04:00

CareMore is an organization that begins to make some sense about the organization of medical care. When the same thing is done at the community level to address primary prevention through cradle to grave health promotion and disease prevention it can be called a health care revolution.

A.D.H.D.

2011-10-13T10:36:00.001-04:00

Whether or not A.D.H.D. is a misdiagnosis, I believe it is, the point is well taken that drugs are a business and too many children are on prescribed drugs, as well as the adult population. Drugs are often an easier answer than addressing the underlying problems but they don't solve the problems.

Lots of Room For Improvement

2011-10-13T09:20:00.000-04:00

Medical care is so large and health is so poorly managed in the U.S. that plenty of room exists for improvement. This article reports on such a situation for the group of people who are recipients of both Medicare and Medicaid. The article goes on to indicate the concerns and opposition to change. Also highlighted is a more basic structural problem that sooner or later must be addressed. Why should health insurers be the ones to deal with this? They are financial people, not health care providers. But, then, they are responding to the inadequacies in the training and organization of health care providers. These issues are on the table along with proposals to correct them but none of this goes far enough to solve the basic problems - too much medical care and not enough health care, too much specialty care and not enough primary care, too much fragmentation and not enough integration. These issues can be managed at the community and state level.

Preventive Medicine

2011-10-13T08:52:00.000-04:00

This article reports on a comprehensive program at the Cleveland Clinic to achieve and maintain good (better) health. It works! There is some concern expressed about forcing people to be more healthy. How about the moral implication of joint liability for health costs contained in health insurance when a significant portion of the population pursue habits and lifestyles known to be unhealthy?

A Cause and a Statement

2011-10-13T07:59:00.000-04:00

Hospitals and health groups are using their purchasing power to push for products that are safer and more friendly to the environment and the climate. This includes recyclable products and elimination of chemicals dangerous to people, the environment and the climate. Other industries are also doing this. It is good business, as well as humanitarian. Every little bit makes a difference. Gridlock in Washington is a sideshow that need not inhibit progress. Politicians like sure bets and they will jump on a train pulling out of the station. Maybe that is the way it should be, but not all the time.

Modifing Expression of Genes

2011-10-12T12:41:00.000-04:00

Genetics is a road map but it is not destiny. A gene associated with increased incidence of heart disease can be modified in its expression. Eating vegetables and fruit lowers the risk for heart disease for people with this gene.

Exposure to Chemicals

2011-10-12T10:50:00.000-04:00

The environment and everyday objects contain chemicals that can be harmful to health. It is wise to be vigilant and keep informed about potential hazards. This is a complex topic with a lot of information and many points of view. For example, I drink filtered water but avoid water in plastic bottles. The avoidance of plastic bottles is out of concern about disposal of the plastic bottles. I recycle but the plastic bottles are an expense. So many points of view and so little time.

Strenuous Exercise

2011-10-12T10:04:00.000-04:00

Strenuous exercise relieves the signs and symptoms of Parkinson's Disease. Casual physical activity does not achieve the same results. The effects are on both muscles and the brain. In all likelihood the same effects apply to normal muscles and brains.

Vitamin and Mineral Supplements

2011-10-12T09:41:00.002-04:00

Vitamin and mineral supplements may do no good and in high doses may harm health. It is best to get what is needed from a diet consisting of a variety of plant-based whole foods and let the body sort everything out. Remember the highest technology you will ever encounter is your own body.

Early Diagnosis and Secondary Prevention

2011-10-11T11:19:00.001-04:00

Early diagnosis and secondary prevention can lead to a lot of good but they can also lead to problems. This article presents an overview of the situation with attention to mammograms and PSA. False positives and over-diagnosis are among the pit falls. Psychological stress and mental anguish are prominent concerns. Dr. Welch puts it very well: "When it comes to breast and prostate cancer screening, there are no right answers, just trade-offs."

Cancer Rehabilitation

2011-10-11T07:33:00.000-04:00

Rehabilitation is a broad concept that needs wider and deeper application in society. Physical fitness fits under a broader concept of rehabilitation. This article reports on a cancer rehabilitation program at Walter Reed National Medical Center. A "prospective surveillance model" involves early and regular follow-up to address problems early and promptly. Results are better and costs are lower.

Community Health

2011-10-10T11:24:00.001-04:00

This is another example of how community can determine health status. The community has a major influence upon health disparities and, of course, differences in economic well-being.

Body Microbes

2011-10-10T10:19:00.000-04:00

The tremendous number of microbes that occupy and share our body most likely have an important role in the status of health. There are some therapies being implemented and these may provide useful information. However, this field of study will prove to be complicated with much to learn. It will be useful to keep abreast of the available information and principles because many decisions will involve how we conduct daily life.

Prostate Cancer

2011-10-06T10:22:00.002-04:00

This article is a good review of the competing dialogues about screening for prostate cancer. Medical care has embraced the concept of early diagnosis and secondary prevention of more advanced disease. The field is in its infancy and the secret may lie with the type of treatment afforded these conditions. Meanwhile, it will pay to keep up with the outcomes from past and current state of the art.

Farm (Food) Policy

2011-10-04T10:14:00.001-04:00

This article is a good review of the cross-bind between government policy for agriculture, food, health and the economy. It is a government of special interests and you give money to get money and you give money to get money and you give money to get money ..... Change would be disruptive and society would be very different but all indications are most people would be healthier. Don't hold your breath waiting for the change, it would not be good for your health.

Local Health/Medical Care Projects

2011-10-04T10:03:00.001-04:00

There are lots of opportunities for local health/medical care projects to improve health status and lower medical care costs. An example of such a project exists in Memphis between a hospital system and approximately 400 churches. This project is a good platform to expand into more primary care prevention and stimulate additional networks into similar action.

Vitamin D Levels

2011-10-04T08:30:00.002-04:00

A review of the literature reveals that low vitamin D levels are associated with abnormal blood pressure, insulin resistance and coronary artery disease. It is not known if supplements can improve these health problems but vitamin D may be one of the few supplements worth taking.

Exercise and Cancer

2011-10-03T09:20:00.001-04:00

Regular physical activity is associated with reduced risk for cancer. This should not be new or startling news but it is worth repeating just in case you need another reason to get moving. Remember that walking is physical activity and physical activity is exercise but you need to do it all day, everyday. I'll see you out there.

From Farm To Food

2011-10-02T09:31:00.001-04:00

There are many places and processes along the route of a chicken from farm to food where salmonella and other pathogens can hide and grow. The only place and process you can count on is your kitchen and your cooking. Thoroughly wash your hands between handling of different foods, thoroughly wash counter tops between preparation of different foods and cook to 165 degrees Fahrenheit. Be aware of state and local health department oversight of restaurants.

Learning Curve for Medical care

2011-10-01T09:49:00.000-04:00

This article describes some of the problems experienced with metal on metal hip replacements. The learning curve in medical care has always been steep but the extent of intervention today makes it so much more risky and costly. Early implementation seems glorious but should be done with great care. And listen to those nagging voices who urge caution.

Turkish Hummus With Yogurt

2011-09-30T10:43:00.000-04:00

I don't often put recipes on this blog but that is a shortcoming in the consideration of promoting healthy lifestyles. Anyway, here is what looks like a good recipe that is good for you.

Too Much Medical Care

2011-09-30T10:35:00.003-04:00

There are pressures to deliver too much medical care and not enough to promote good health and prevent disease. Sooner or later society will have to recognize the difference between health care and medical care and design communities to promote and develop primary prevention available to everyone as a low cost process of living.

Simple Solutions

2011-09-30T10:19:00.001-04:00

Simple straight-forward solutions are often the best but capitalism, marketing, consumerism and regulations just cannot leave well enough alone.

Locally Grown Food and Farmers Markets

2011-09-28T14:07:00.002-04:00

Locally grown food, small-scale farmers and farmers markets are a trend across the country. Some corporations are assisting with the trend. Michelle Obama deserves credit for the energy and attention she brings with the Let's Move campaign. I agree that tailoring the Food Stamp program would be beneficial in many ways. Should Food Stamps be utilized for sodas? I think not.

Antibiotic Resistant Infections

2011-09-28T12:25:00.001-04:00

Infections caused by bacteria resistant to antibiotics are a major problem. This article is the first proposal I have seen that proposes the problem be addressed by means of a business model. It seems everything theses days involves or is related to a business model. Oh, well.

Community Transformation Grants

2011-09-28T11:44:00.000-04:00

HHS announces $103 million for a Community Transformation Grant program. The purpose of the grants is to change the way communities promote health. Smoking cessation, healthy eating, physical activity and disease prevention are emphasized. I agree with Ken Thorpe that this is a step in the right direction for building community infrastructure for prevention.

Obesity

2011-09-28T09:24:00.004-04:00

This site gives a good review of obesity with excellent graphics to illustrate the problem.

Exercise and the Brain

2011-09-28T08:38:00.002-04:00

Exercise develops the mitochondria in the brain as well as muscle. Regular, frequent, aerobic exercise of moderate or more intensity might just rank at the top of the health scale. Those who engage in such exercise will be inclined to eat better, cease smoking (if they are smokers) and sleep better.

Obesity and Smoking

2011-09-28T07:38:00.000-04:00

This article compares the public health effort to reduce smoking with reducing the consumption of junk food. No doubt, obesity is a much more complex problem than smoking. The campaign to stop smoking has not been completely successful but it is a good start and the momentum can be helpful to obesity. Both problems will be well served by sustained, comprehensive community efforts. Make no mistake, however, successful programs for smoking and obesity will change the community and the health system in ways we can hardly imagine. I have to believe it can be done. The struggle will be immense and prolonged.

Vitamin B12

2011-09-27T09:51:00.001-04:00

In general, supplements cannot compensate for a good diet consisting primarily of plant-based whole foods. However, if a deficiency is found, it should be addressed. A study published in the journal Neurology reveals that low blood levels of vitamin B12 is associated with decreased brain size and reduced cognitive ability. Low B12 may be associated with a vegetarian diet, older age, anti-acid medications and the medication metformin.

Coffee Helps With Depression

2011-09-27T09:17:00.005-04:00

"Ounce for ounce coffee delivers the strongest dose of caffeine." A study published in the Archives of Internal Medicine reveals that, "generally, the more caffeine a woman drank, the more likely she was to be in good mental health."

Biker's Lung

2011-09-26T15:04:00.001-04:00

A study in London reveals that bike commuters inhale more than twice as many carbon particles as pedestrians who make a comparable trip. Inhaled particulate matter, especially small particles, is associated with lung and heart disease. Maybe the Asians who wear surgical masks during their day out in the city have the right idea.

Climate Change and Health

2011-09-26T14:45:00.002-04:00

This article discusses seven ways that climate change influences health. None of them are good.

Preventable Deaths

2011-09-26T08:40:00.000-04:00

My message is the development and widespread use of health care consisting of health promotion and disease prevention coupled with the appropriate use of medical care; both working together. Recent data shows the U.S. lagging 16 other high income countries in the incidence of preventable deaths. This speaks to the need for a health system that prevents health problems plus identifies and treats health problems. We have a long way to go.

Public and Community Health

2011-09-25T11:07:00.000-04:00

Friends, Americans, patients, come lend me your ears:
I come to defend medical care, not to praise it.

I defend medical care from criticism and attack. The defense is justified because medical care saves lives of the sick and injured. I cannot praise medical care due to its low capability to cure disease. Because we expect more from medical care than we should and neglect health care, the consequence is promotion of sickness and development of medical care as a business enterprise. But medical care is not health care. Health care would balance the health system and gradually reduce the need for medical care. The focus on health promotion and disease prevention provides a goal of good health. Medical care would continue to be available, if necessary, and expensive but it would be the alternative not the goal.

The Culture of Food

2011-09-25T08:57:00.003-04:00

This article outlines nicely the culture of food and the excuses used to support it.

New York City

2011-09-23T11:40:00.001-04:00

The future of better health involves health promotion and primary prevention of disease. This is public health and it will be best implemented at the community level. There are communities across the United States proceeding with this effort. Mayor Bloomberg and New York City deserve credit for pioneering this field of endeavor. It was not always easy.

If anyone knows of similar efforts in their community, I would appreciate receiving information about the project.

Time Banks

2011-09-21T08:43:00.000-04:00

Time banks are a local method for people to share services. This article discusses some health benefits of time banks. What with the state of the economy and the high cost of medical care, time banks just might be a way to moderate both problems at the margin. It would be a way to promote more community involvement in health promotion and prevention.

Level of Physical Fitness

2011-09-21T07:50:00.002-04:00

Moderate exercise on a regular basis is good for health but the level of fitness depends upon the intensity of the exercise. The level of fitness involves cardiopulmonary capacity and muscle strength.

No One Said It Would Be Easy

2011-09-20T09:37:00.000-04:00

The health of individuals is enabled by the knowledge, attitude and determination of the community to support healthy lifestyles. Medical care can support people who suffer with chronic metabolic diseases but it cannot cure these problems. The result is ever greater expense plus limited potential and quality of life for individuals. Public health is the most basic issue facing the world today. It can prevent and reverse many of these health problems. The "Age of Elves" has passed and the "Age of Man" has come. It remains to be seen whether "Man" is up to the task. That means me and you.

Community Is the Key To Health

2011-09-20T09:19:00.002-04:00

Across the United States communities are organizing to address the health of the people who live there. There is a sound basis to this effort. Much needs to be learned and the task will be difficult. The reward is better health and greater potential for individuals and the communities. Health is a community affair. It can be good or bad depending upon the attitude of the community and the will to follow through.

Will Power

2011-09-20T08:48:00.001-04:00

Do thin people have more will power to resist fattening food than obese people? Brain scans reveal that may be the case. But I refuse to believe that is destiny. It requires more work and better support from the community, friends and family, and it can be done. Public health needs to move front and center for individuals and the community to achieve better health.

Just Like the Old Days

2011-09-13T09:18:00.001-04:00

Physicians have often found ways to treat patients without health insurance. However, belonging to a group practice and/or a hospital network interferes with the practice of free care and reduced fees. On the other hand, group practices and hospital networks have staff dedicated to financial operations who can assist in finding financial support for health care. Many people are eligible for insurance coverage but don't know about it or have not completed the process for coverage. All in all, it is a complicated issue and like medicine and health involves human behavior.

Facing Death

2011-09-12T12:24:00.002-04:00

Who could ever know what facing death is like until facing death? But it will come to all of us one day and if there is time to contemplate, the thoughts might provide some degree of comfort and dignity. Writing those thoughts might allow that final stage of life to become one of change and growth. I am intrigued by the report of Dignity Therapy For the Dying. Over the ages many people have written their final thoughts but this is a way to assist with that task should someone chose to do so.

The Source

2011-09-04T16:29:00.002-04:00

Among the complex situations that have become problems for the United States, none surpass health and health care. There are many reasons this occurred but topping the list is lack of understanding for the situation and mismanaging the problem. Health is the issue but it was ignored to focus upon sickness. The continuing and increasing focus upon sickness elevated medical care above health care to eventually and inevitably result in stalemate with chronic disease, increasing cost and deteriorating health status. Lack of understanding for health and lack of appreciation for health care surrenders lifestyle to a culture that fosters unhealthy habits and does little to promote health. The culture and unhealthy lifestyles reinforce each other and, in turn, impact the national economy, the environment and climate. Medical care reform will not relieve this situation or solve the problems but communities across the country are initiating projects to promote health at the local level. Look there for changed mind-sets and new vision to develop and implement programs for better health.

Unintended Consequences

2011-08-20T10:54:00.002-04:00

I don't fault scientists for research on compounds to benefit health or the press for jumping the gun to report preliminary findings of scientific research. And I don't suppose I fault pharmaceutical companies for exploiting scientific research, I just wish they would discontinue advertising illness, disease and real or perceived health disorders. However, all of this influences the public mind-set to interfere with healthy behaviors and leads to unintended and dangerous consequences.

The experimental drug, SRT-1720, that prolongs the life of fat mice by reducing the amount of fat in the liver and thereby increasing the sensitivity to insulin may eventually lead to useful treatments. But I have come to fear the worst for the influence of the news upon the expectations of an obese society dependent upon drugs.

Mind-Set

2011-08-04T14:18:00.002-04:00

The chief executive of Chrysler believes that new leadership from outside of Detroit is the deciding factor in the Big Three automakers' acceptance of strict new fuel economy standards. Certainly, every industry can benefit from new thinking to address what appears to be insoluble problems. Health care is a good example. Health in the U.S. is defined in terms of sickness and medical care dominates the field. Costs spiral out of control and health status declines. The idealogues in Congress and some economists don't help by staking out extreme positions to protect or cut sick care. The dialogue has to shift from sick care to achieving and maintaining optimum health status for individuals and the population. That has less to do with medical care than the politicians think or are willing to admit.