If you ask most people to tell you what health means, or simply ask, what is health, you will come up with some interesting findings. I know, I’ve asked plenty of people. Most troubling to me are three observations.
- Most people will say words to the effect that health is not being sick.
- Very few people can talk about health without actually talking about disease.
- The above applies equally to most so-called health professionals.
The concept of health as a truely positive state seems to be beyond most people’s grasp. Perhaps that’s because the experience of health, real health, is also beyond their grasp.
The World Health Organization (WHO) defines health as "a state of complete mental, physical and social wellbeing and not merely the absense of disease or infirmity." See that? Yes, a positive state. The WHO even goes so far as to explicitly state that health isn’t simply not being sick.
Now the U.S. government program Healthy People 2010 is an eye opener. One might expect the Department of Health And Human Services to know what health is and to at least get the rhetoric right. They do fine to a point. The Centers for Disease Control and Prevention (CDC) are aptly named. However, their National Center for Health Statistics (NCHS) loses the plot.
The NCHS describes Healthy People 2010 as "a comprehensive, nationwide health promotion and disease prevention agenda. Healthy People 2010 contains 467 objectives designed to serve as a road map for improving the health of all people in the United States during the first decade of the 21st century." In magnificent bureaucratic form it is said to have: "Two overarching goals–increase quality and years of healthy life, and eliminate health disparities–serve as a guide for developing objectives that will actually measure progress. The objectives are organized in 28 focus areas, each representing an important public health area."
Well these focus areas seem pretty important. Presumably, they must be where all the health action is to be found. If you think that then brace yourself for a disappointment. When the NCHS talks about health it too makes the error of confusing disease, pathology, morbidity and environmental threats to wellbeing with health. It’s like they have no clear idea at all about just what health, that wonderfully positive state, really is. Here are their focus areas.
Focus Areas at a Glance (28)
1. Access to Quality Health Services
2. Arthritis, Osteoporosis and Chronic Back Conditions
3. Cancer
4. Chronic Kidney Disease
5. Diabetes
6. Disability and Secondary Conditions
7. Educational and Community-Based Programs
8. Environmental Health
9. Family Planning
10. Food Safety
11. Health Communication
12. Heart Disease and Stroke
13. HIV
14. Immunizations and Infectious Diseases
15. Injury and Violence Prevention
16. Maternal, Infant, and Child Health
17. Medical Product Safety
18. Mental Health and Mental Disorders
19. Nutrition and Overweight
20. Occupational Safety and Health
21. Oral Health
22. Physical Activity and Fitness
23. Public Health Infrastructure
24. Respiratory Diseases
25. Sexually Transmitted Diseases
26. Substance Abuse
27. Tobacco Use
28. Vision and HearingFrom: http://www.cdc.gov/nchs/about/otheract/hpdata2010/2010fa28.htm
It isn’t that the people at NCHS have lost the plot so much as have never really known the plot. This program follows on from earlier ones that have run for decades. Guess what, there have been no serious outbreaks of health anywhere. They are doing no more than the proverbial rearranging of deckchairs on the Titanic.
Without a very clear understanding of health, including all of its determinants, it is impossible to effectively define health targets. Without such clarity any hope of significantly progressing towards health goals is little more than a pipe dream.
The NCHS’s present focus is really on disease in several areas of its manifestation. But disease is not health. Even the absense of disease is not health. Locked within their disease paradigm, with its associated misplaced belief in and reliance upon so-called scientific medicine, the front for the pharmaceutical industry, they are doomed to failure.
This will please Big Pharma, keep many people employed in the health sector (really the misnamed disease sector) and generally allow for the status quo. Meanwhile, people will keep suffering and dying earlier than necessary, be killed by medical errors in the tens of thousands every year and more government initiatives will be dreamed up by bureaucrats.
If you are comfortable in that system then good luck to you. You’ll need some. If not, then do something for your health now. Take action before it is too late. Some people never wake up from that pipe dream.
The recommended daily allowance (RDA) levels for vitamin B12 should be increased by 500 per cent according to Danish researchers whose findings were published in the January 2006 issue of the American Journal of Clinical Nutrition (Vol. 83, pp. 52-58). They found that in order to correct all vitamin B12-related variables a RDA of 6 micrograms is needed.
Currently the RDA in Europe is only 1 micrograms for adults, while the US dietary reference intake (DRI) is 2.4 micrograms. RDAs are established at a level considered to be the minimum amount of the vitamin required to avoid the risk of developing vitamin deficiency disorders.
Vitamin B12 is necessary for:
- stimulating RNA synthesis in nerve cells,
- strengthening neurotransmitters, and increasing concentration and memory,
- myelin formation (the covering around the nerve cells),
- protecting arteries in the brain by metabolizing homocysteine,
- nervous system health,
- growth and development,
- the production of red blood cells,
- healthy digestive function, and
- detoxifying cyanide from foods and tobacco smoke.
Food sources of vitamin B12 include: brewer’s and nutritional yeast, liver, clams, eggs, meats, fish, and dairy products. Some vitamin B12 is available from sea vegetables, such as, dulse, kelp, kombu, and nori.
The current study involved calculation of dietary and supplemental intake of vitamin B12 for 98 post-menopausal women with an average age of 57 using three-day diet records, a method that does not rely heavily on memory and widely believed to give the most valid estimated of intake. Volunteers were divided into quintiles depending on B12 intake, then researchers measured four different vitamin B12-related serum markers.
Despite the range of intake varying from three to 15 micrograms, the researchers observed that the curves leveled off at a daily intake of about six micrograms for all variables analysed. Hence, a daily vitamin B12 intake of six micrograms appears to be sufficient to normalize all of the vitamin B12-related variables and this may be more adequate for the general adult population than the current RDA.
B12 is often deficient in vegans (strict vegetarians) because the predominant source of B12 is animal products. It is also prevalent among the elderly population. Further details about vitamin B12 are available at Healthy Vitamin Choice.
Half of Americans aged 55-64 years have high blood pressure — a major risk factor for heart disease and stroke — and two in five are obese, according to Health, United States, 2005, the Government’s annual report to the President and Congress on the health of all Americans. The report was prepared by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics from data gathered by State and Federal health agencies and through ongoing national surveys.
The report features an in-depth look at the 55-64 age group, which includes the oldest of the baby boomers. In 2011, the oldest of the boomers will be eligible for Medicare, and by 2014, the ranks of Americans aged 55-64 will swell to 40 million, up from 29 million in 2004.
"Controlling high blood pressure and obesity is crucial for health, and particularly for baby boomers as they grow older," said HHS Secretary Mike Leavitt. "It’s time to act against both conditions so more Americans can live longer, healthier lives."
Dr. Julie Gerberding, CDC Director, urged 55-64 year-olds to take careful stock now of their health, including such vital measures as weight, cholesterol level, blood pressure, risk of heart attack and any signs of diabetes. "The late fifties and early sixties are a crucial time of life to focus on disease prevention. It’s never too late to adopt a healthy lifestyle to enjoy a longer, healthier life," she said.
Although many adults in their late fifties and early sixties enjoy good health, others are dealing with chronic and debilitating diseases and lack of health insurance. The report finds that minorities — primarily blacks and Hispanics — are more likely to fall into those categories.
The report also notes that 11 percent of Americans aged 55-64 years lack health insurance — compared with the national average of Americans under age 65 without health insurance (16.5 percent). Eighty-three percent of married adults aged 55-64 years had private health insurance, compared with 60 percent of widowed, separated, divorced, or single adults in that age group.
The report also outlines how the United States spent $1.7 trillion –15 percent of the gross domestic product — on health care in 2003. That works out to $5,671 for every man, woman, and child.
Other highlights:
- More than a quarter of all adults suffered lower back pain in the past 3 months. Fifteen percent dealt with severe headaches or migraines (more commonly a problem for women). Fifteen percent had neck pain.
- Life expectancy at birth in 2002 reached 75 for males and 80 for females. At age 65, life expectancy was almost 82 for men and 85 for women.
- Two-thirds of high school students exercised regularly but only one-third of adults were physically active in their leisure time.
The above data are taken from: Health, United States, 2005, With Chartbook on Trends in the Health of Americans. 550 pp. (PHS) 2005-1232. GPO stock number is 017-022-01592-7. This report may be purchased from the Government Printing Office. Supplied by the Department of Health and Human Services.
What are referred to as report highlights above appear to me more like population health low lights. The tragedy is that the vast majority (in fact, almost all of it) of the morbidity documented in the report is totally avoidable. The problems are largely lifestyle related.
The good news is that lifestyle change is both preventative and curative in nature. This is in contrast to the orthodox medical approach which relies upon surgeries and toxic chemicals in an attempt to cover up signs and symptoms or traumatically manage the result of prior failures.
Look at the big picture folks. Regular modern, so-called scientific, medicine just does not work. It is not the solution you need.
If you are concerned about heart disease and stroke, along with its precursors of high cholesterol and blood fats (hyperlipidemia) and high blood pressure (hypertension) then address your lifestyle needs, especially nutrition, exercise and stress management. You could start with a free report on heart attack and stroke prevention.
Asserting that "physician performance failures are not rare and pose substantial threats to patient welfare and safety," experts in medical error are calling on state medical boards and healthcare organizations to institute a formal monitoring and prevention system for catching "problem doctors" before they do further harm.
Research has shown that "the vast majority of mistakes and injuries can be attributed to faulty systems that cause injuries or lead even competent, careful people to make errors," the authors write. And hospitals have begun to embrace principles of "human factors engineering" to correct these system-induced errors. But individual problem doctors still pose a considerable threat to patient safety.
"Performance problems are more widespread than people recognize; it’s not just the small number of doctors disciplined annually by state medical boards, which is something like a half a percent of the nation’s practicing physicians," said Dr. Lucian Leape, co-author of the article and recognized as the founder of the "medical error movement" with his authorship of the landmark 1994 JAMA paper, "Error in Medicine’. "Up to one-third of doctors may have a condition that impairs their performance at some time during their career, and most of them get little help for it." Leape is an adjunct professor of health policy at Harvard School of Public Health.
The article "Problem Doctors: Is There a System Solution?" appears in the January 17, 2006 issue of The Annals of Internal Medicine. The article is co-authored by Dr. John A. Fromson, an assistant clinical professor of psychiatry at Harvard Medical School and chairman of the department of psychiatry at MetroWest Medical Center. Dr. Fromson was responsible for setting up the Massachusetts Medical Society’s program for dealing with impaired physicians.
The authors describe a menu of underlying causes for physician performance deficiency including mental and behavioral problems such as depression, anxiety, substance abuse and personality disorders, physical illness, including age-related and disease-related cognitive impairment, and failure to maintain or acquire knowledge and skills. Contributing to these problems for physicians in particular are environmentally-induced problems such as fatigue, stress, isolation, and easy access to drugs. While the rate of physical illness and alcohol dependence for physicians may be similar to the general population, there may be higher rates of mental illness. For example, the rate of suicide is 40 percent higher in male physicians and more than two-fold higher in female physicians than in the general population.
"The problem now is that typically little or nothing is done about recognized performance problems until someone is hurt or there is a malpractice suit. The doctor may then be warned by the chairman of the department, but it’s often informal and without specific remediation assistance," said Leape. "If problems continue, then the physician is disciplined or reported to the state board. The exception is alcohol abuse. Most states have good programs for helping alcoholic doctors. But for all of the other problems, we need a system to enable us to intervene much earlier, before a patient is injured. Doctors have not done it because they have not wanted to be critical of colleagues, and there was no mechanism short of curtailing practice or taking a doctor’s license away. But everyone knows at least one doctor with a problem: it’s the elephant in the room. What we need to do is set up a regular system to identify these problems early and offer physicians help."
According to the authors’ estimate, when all conditions are considered, "at least one third of all physicians will experience, at some time in their career, a period during which they have a condition that impairs their ability to practice medicine safely."
The authors propose that "the current ad hoc, informal, reactive approach to physician performance problems be replaced with a routine, formal, proactive system of monitoring that uses validated measures to focus strictly on clinical and behavioral performance."
To create a model system an institution would:
- Adopt explicit performance standards of behavior and competence, standards set at the national level.
- All physicians would be required to acknowledge that they have read and understand the standards and will follow them and understand that persistent failure will lead to loss of privileges and dismissal.
- Adherence to the standards would be monitored annually by formal evaluation, and results of the evaluations should be provided confidentially to each individual. And if there are deficiencies, the department chairman would be responsible for prompt response, including further evaluation, counseling or referral for treatment.
- In cases that threaten patient welfare, department chiefs and hospitals would take immediate action to limit practice during assessment and rehabilitation.
- Finally, assessment and treatment programs must be available for management of all underlying cause of substandard performance: substance abuse, psychiatric problems, behavioral problems and lack of competency.
The authors note that while the monitoring programs must take place at the local level, hospitals do not have the resources to develop the measures and the methods needed for implementing these systems. The authors therefore call for a national effort by the Federation of State Medical Boards, the American Board of Medical Specialties and the Joint Commission on Accreditation of Healthcare Organizations to ensure safe, competent medical care for patients by developing standards, measures, and methods for a physician performance monitoring system.
Provided by Harvard School of Public Health on 1/16/2006
According to Stephen Fox, lead activist in the push to ban aspartame in New Mexico, 22 of the 42 members of the New Mexico senate signed a letter to Govenor Richardson asking for an executive message on the aspartame bill. In the House, the Majority Leader and the Chairman of Finance also signed the letter.
The letter was submitted to Govenor Richardson on January 24 and states:
Our very serious concerns derive from the proven neurodegenerative and carcinogenic effects of aspartame, which result from the two of aspartame’s metabolites, methanol and formaldehyde. The effects have been fully reported by the National Institute of Health. Physicians have also documented these effects extensively.
These bills are intended to prevent such neurodegenerative and carcinogenic damages to the health of all New Mexicans. They deserve to go through Committee Hearings, wherein they can be addressed in the brief testimony by physicians.
If you have previously expressed your views to the legislators in support of this action, please consider thanking those who signed the letter. They have demonstrated real concern for your health when the health bureaucrats charged with that responsibility have failed you.
Successful passage of the bills is by no means assured however. It will need an Executive Message from the Govenor. Stephen Fox says, "I must make clear that without the Executive Message, the bill may fail.Governor Richardson is being heavily lobbied by Ajinomoto, the world’s largest manufacturer of neurotoxic and carcinogenic food additive poisons: aspartame and monosodium glutamate as well."
Continued messages of support for the bills should be directed to Govenor Richardson as soon as possible. A link to an online form to contact the Govenor is available here http://www.organicconsumers.org/aspartame1.cfm for your convenience but any means of contact is fine.