Category Archives: Health Care

Academia, Health Care

Community Health Centers

Community health centers increase availability of (i.e. access to) health care and is shown by some to improve health outcomes (Taylor, 2009). Improving access to health care is achieved by placing these community health centers geographically proximate to underserved and at-risk populations. Taylor (2009) boasts improvements in health outcomes due to the number and placement of community health centers, but she provides no compelling evidence to say that any improved outcome is not directly caused by the improved access. Forrest and Whelan (2000) discuss a need to improve access to physician offices more than community health centers to improve follow-up care which continues to lack in the community health center model, though the point may be moot if the community health centers can improve the delivery of service to allow for proper follow-up. Forrest and Whelan do, however, acknowledge the value of community health centers in providing increased access to health care to underserved and vulnerable populations.

Dieleman et al. (2004) offers collaboration of health care providers in the primary care setting as a means of improving efficiency and thereby improving health outcomes. The testing instrument used during this study indicates an overall improvement of the attitudes towards role recognition, provider satisfaction, patient satisfaction, and patient health status, as well as the quality of patient care provided. In my experience with many community-based health clinics, they tend to be less than spectacular as far as quality of care, cleanliness, and patient-provider attitudes. By adding other providers into the patient-provider relationship, it would allow others to comment within the team where improvements can be made in relation to each patient-provider relationship and in a more general sense.

A collaborative holistic approach to patient care, whether in primary care, emergency care, or in critical care, will foster a sense of partnership within the team, including the patient and family, that will allow the team to truly care for the patient, will allow the patient to be invested in his or her care, and will promote a complete view of the whole patient both when sick and when well. Collaboration will, hopefully, allow improved efficiency in the provision of care while maintaining a trustworthy and committed relationship with the patient. Forging these relationships will, hopefully, help to overcome any challenges faced within our continually changing health care landscape.

References

Dieleman, S. L., Farris, K. B., Feeny, D., Johnson, J. A., Tsuyuki, R. T., & Brilliant, S. (2004). Primary health care teams: team members’
perceptions of the collaborative process. Journal of Interprofessional Care, 18(1), 75-78. doi:10.1080/13561820410001639370

Forrest, C. B. & Whelan, E. (2000). Primary care safety-net delivery sites in the United States: A comparison of community health centers, hospital outpatient departments, and physicians’ offices. Journal of the American Medical Association, 284(16), 2077-2083. doi:10.1001/jama.284.16.2077

Taylor, T. (2009, October). The role of community-based public health programs in ensuring access to care under universal coverage [Issue brief]. American Public Health Association. Retrieved from http://sylvan.live.ecollege.com/ec/courses/53027/CRS-WUPSYC6205-4570539/CommunityBasedReformupdtd.pdf

Academia, Health Care, Society

Henrietta Lacks

Grady (2010) offers the circumstances of Henrietta Lacks for discussion as it pertains to medical ethics. Henrietta Lacks was a young woman who succumbed to cervical cancer in the early 1950s at Johns Hopkins Hospital (Grady, 2010; Sorrell, 2010). Grady describes Henrietta Lacks and her family as “poor, with little education and no health insurance” (para. 10), yet she was cared for and her cancer was treated with radium, the standard treatment of the day. Despite treatment, Henrietta passed away. During the course of her treatment, however, a small sample of cancer cells were removed from her cervix for testing, and they continue to be tested to this day (Grady, 2010; Sorrell, 2010). Additionally, this line of cells, now known as the HeLa cells, has become commercialized, as they are bought and sold for millions on the biomedical research market (Grady, 2010).

Assuming no consent was given by Henrietta or her family, this raises a few questions. Did the physicians at Johns Hopkins have a right to these cancer cells? Did they have a right to transfer ownership to third parties? Does the estate of Henrietta Lacks require royalties be paid when others profit from what amounts to a donation to the public domain?

No person can own another person (or, a part thereof). This is consistent with the moral society of the United States. However, Henrietta Lacks presented herself to Johns Hopkins hospital with the express desire to rid herself of the cancer cells causing her illness. This alone could mean that the cells are refuse and able to be salvaged, and according to Fost (2010), this is agreed to be the law of the land. Fost describes the circumstances surrounding the HeLa cells as normal course of medical business, and I agree for the most part: “If tissue removed during an operation is about to be thrown out with the garbage and has no identifying information, it should be permissible to use it for research without the patient’s consent” (2010, para. 1). In this case, however, the researchers later approach the Lacks family to obtain DNA samples to discriminate between HeLa cell cultures and non-HeLa cell cultures. This mere fact offers evidence that the tissue is identifiable with Henrietta Lacks and her lineage, and I feel, as does Fost, that this is where the researchers erred, in asking for continued support of the cells by obtaining further comparative specimens for analysis yet not clarifying the misconceptions of the family. The researchers should not have requested further tissue (i.e. blood) donation without obtaining informed consent from the donors. Further, the cell line were given a name representative of Henrietta Lacks, HeLa, and she was named as the donor and widely known as such throughout the biomedical research community. Ergo, there were certainly identifying data linking Henrietta Lacks to the specimen.

Remuneration

Certainly under normal circumstances the cells should be made available for research purposes, but they should not be sold for profit, only for the costs of storage and maintenance. Any tissue freely used for medical science should be in the public domain. Further, if a specimen is found to have financial worth, I feel that the custodial researchers should set aside a royalty account allowing a small percentage of the proceeds to be returned to the donor’s estate. I also feel that if researchers have any special interest in further donation, then those donors should be offered remuneration for their donation which should be commensurate to the gains assumed to be made by their donation.

I find no issue with how the cancer cells were used initially, however, the sample should not have been attached in name to the donor. Though not required, it would have been nice if the researchers provided a royalty to the estate of Ms. Lacks, however, to thank her for her contribution to medicine and science.

References

Fost, N. (2010). A cell’s life: The immortal life of Henrietta Lacks. Issues in Science and Technology, 26(4), 87+. Retrieved from http://ic.galegroup.com.ezp.waldenulibrary.org

Grady, G. (2010, February 1). Second opinion: A lasting gift to medicine that wasn’t really a gift. The New York Times. Retrieved from http://www.nytimes.com

Sorrell, J. M. (2010). First do no harm: Looking Back to the Future [Editorial]. Journal of Psychosocial Nursing & Mental Health Services, 48(9), 2-3. doi:10.3928/02793695-20100730-07

Academia, Health Care

Quality in Interdisciplinary Critical Care Medicine

To improve the overall quality of care provided in critical care medicine, Curtis et al. (2006) promote a framework, as well as some key concepts, for measuring performance improvement outcomes within the critical care or intensive care setting. Curtis et al. introduce the reader to Donabedian’s (as cited in Curtis et al., 2006) model of improving the quality of healthcare, which focuses on “structure, process, and outcome” (p. 212). With quality improvement the focus of this article, Curtis et al. approaches the dynamics of interdisciplinary teams in the context of the multitudes of ICU variations available throughout the United States. Additionally, Curtis et al. recognize that high-quality care is dependant on both clinical and non-clinical processes, citing organizational management as a key requirement that has significant impact on overall patient care.

“Successful quality improvement programs require interdisciplinary teamwork that is incremental and continuous” (Curtis et al, 2006, p. 216).

In reading Curtis et al. (2006), I find that approaching patient care with a team approach addresses all of the available topics and more. Improving patient satisfaction requires improving performance which, in turn, creates efficiency and can improve reimbursement (especially under pay-for-performance models). On the other hand, addressing a requirement to increase reimbursement under a pay-for-performance model can ultimately lead to increases in patient satisfaction by improving inefficient processes. Overall, one of the largest benefits of operating within a team environment is the access to a larger knowledge-base, increasing the application of knowledge for all team members.

References

Curtis, J. R., Cook, D. J., Wall, R. J., Angus, D. C., Bion, J., Kacmarek, R., … & Puntillo, K.(2006). Intensive care unit quality improvement: A “how-to” guide for the interdisciplinary team. Critical Care Medicine, 34(1), 211-218. doi:10.1097/01.CCM.0000190617.76104.AC

Academia, Culture, Emergency Medical Services, Health Care, Society

Codes of Ethics

Of the three ethical codes presented by Lewis and Tamparo (2007), I align myself most with the Principles of Medical Ethics: American Medical Association (AMA). The AMA promotes honesty, integrity, compassion, respect, and most importantly, responsibility. In all manners of occupation, it is virtuous to remain honest; this is paramount in medicine. Physicians, nurses, paramedics, and other health professionals may make mistakes during their career, and it is important that these mistakes be corrected as soon as possible and understood to promote practices that may minimize the same mistake from happening. Honesty leads to integrity. Integrity is a hallmark of professionalism and, in conjunction with honesty, promotes trust. Having compassion and respect for patients regardless of political, societal, economic, or other divisions allows a provider to actually care for his or her patients rather than just deal with them. As a paramedic, I try to be as trustworthy and caring as possible to each and every patient I see. Ultimately, I understand my responsibility to my community, to fellow clinicians and technicians, to patients, and to myself. I hold ultimate responsibility for my actions and inactions, and I take care to not let these adversely effect the perception others hold of me as a professional. The AMA expects this of all physicians, and as an extension of the physicians I work for, I must strive to meet the same demands.

The Hippocratic Oath is dated in its language and demands. Though the oath can be approached as symbolism, the metaphor can be lost on some. I appreciate the Hippocratic Oath for what it is (a foundation for the ethical practice of medicine), but contemporary words, meanings, and application serve me better.

I find the Code of Ethics of the American Association of Medical Assistants lacking in context, applicability, and substance when adopted for paramedicine, my chosen occupation; therefore, I do not align as well with this code as I do with the previously mentioned codes of ethics.

Codes of ethics provide baseline philosophies that serve to direct the actions of groups. By ascribing to such, the professional belonging to such a group allows the code to guide moral judgments when the answer is unclear. In medicine, this is especially true. Medical professionals deal with life and death decisions which stretch the boundaries of personal moral beliefs. By ascribing to a notion of a slightly higher directive than one’s self, the professional can remove his- or herself from the situation with more clarity and less bias.

My personal ethics are bound by a sense of personal liberty and the responsibility of that liberty. Without responsibility, there are no consequences. Without consequence, there is no learning. I like to learn so that I may be the best paramedic that I can to the next patient in my care. For me, it is always about the next patient; they deserve the best that I can offer.

References

Lewis, M. A. & Tamparo, C. D. (2007). Codes of ethics. In Medical law, ethics, and bioethics for the health professional (6th ed.; pp. 241-243). Philadelphia, P.A.: F. A. Davis.

Academia, Health Care, Society

Understanding Cultural Disparities

Social programs are just that… social. In fact, the basis of any social program is to take part in society, both philanthropists and recipients. I think that we have forgotten what it means to be social. I like to think of a well-designed social program as an invitation extended to a marginalized community to partake in society as an equal member. Only when we see ourselves as equal in title and domain can we ever think to overcome racial and ethnical biases (not to mention other more generic stereotypes).

The Lakota Nation has certainly met with strife, both on and off the various reservations. I have always understood that they have unique problems stemming from our early misunderstandings and stereotypes of savage people. In fact, not all of us were victim to this view. It was the Iroquis, after all, after whom we modelled our constitutional governement, and it was a majority of the tribes of every Nation that have assisted us in battle even when feeling oppressed.

The Cheyenne River Sioux are affected by a poor economy, including poverty, elevated rates of unemployment, and a stagnant workforce. In addition, many Native Americans living on reservations are also prone to mental disorders, such as depression, substance abuse, and suicide. Native Americans certainly have it tough, and though many are able to find their way within and without the majority culture, whether through acculturation or community-wide boons such as gaming and resource development, many falter.

The fact that Native Americans are genetically prone to alcoholism, are sociologically prone to depression, and are overall prone to health disparities, suicide, and homicide reveals that there needs to be a solid and comprehensive approach to their problems. The Cheyenne River Sioux, however proud they might be of their culture, are not immune.

So, how do I help? First, examining the cultural and genetic aspects of Native Americans in the context of substance abuse allows me to educate myself on cultural specifics that may assist me in treating a Native American patient. Also, understanding their plight allows me to consider them politically, even from afar.

As much as I would like to hop on a plane (actually, I would probably drive, anyway) and assist the Cheyenne River Sioux hands-on, it is not practical. I do believe in charity, but I certainly do not have the resources to make a meaningful contribution. I will, however, remain a proponent from within the majority culture. I believe awareness of the problems that they face will be a key in allowing others to offer them the assistance to rise above their plights to seek happiness.

Academia, Health Care, Politics, Public Health, Society

Addressing Health Disparities

It is troubling to many people to see any person suffering in our society. It is even more troubling to see inequality extend to whole ethnic and racial groups within our society. We certainly do not want to be an unjust society, and we certainly want every member of our society to benefit from the technological gains made in the last century.

One of the more troublesome areas that many view as unjust is health and health care. It is unfortunate that some members of our society suffer from disparities in health. For instance, immunizations and vaccines for most of the common deadly pathogens are readily available, yet many people fail to immunize themselves or their family.

Immunization and vaccination programs have eradicated smallpox and polio and have all but eliminated the threat of measles in the United States (U. S. Department of Health and Human Services [DHHS], 2000). With influenza and pneumonia causing 30,000 to 41,000 deaths in the U. S., annually, the importance of vaccinating against these diseases is quite evident. Obviously, lacking immunity to a deadly pathogen is a disparate condition of health status, and Hispanic and African American populations are vaccinated with less frequency than Whites. How are these issues being addressed?

On the international level, the United Nations (2009) is addressing health disparities by attempting to eradicate poverty on a global scale. Unfortunately, many of these global initiatives have created an environment rife with economic turmoil that we are just now starting to see and understand. Though the premise of helping people out of poverty is very noble, the reality seems to be that we can only offer means for people to help themselves. Otherwise, we risk thrusting whole populations into a world they know nothing about, setting them up for failure. Poverty is based on local economy, and I believe that these interrelated problems are best addressed on the local levels with assistance from states, nations, and global endeavors. The people must direct their own path for a successful transition. They must take responsibility for their own successes and failures.

The United States addresses these concerns on a federal level, offering guidance to states and municipalities in ways to address them. One of these methods is a report from the U. S. Department of Health and Human Services. Healthy People 2010 (DHHS, 2000) has two stated major goals: 1) to increase quality and years of healthy life, and 2) to eliminate major health disparities. There are also 467 objectives in 28 focus areas designed to further these two major goals. Immunization is one of these focus areas.

According to the CDC’s National Center for Disease Statistics (2010), the goal of achieving a 90% immunization rate for children 19-35 months of age is close to being reached. The combination diphtheria, tetanus, and pertussis (DTP) vaccine (85%) and pneumococcal conjugate vaccine (75%) are the only two recommended childhood vaccines that are not being administered at least 90% of the time. According to DHHS (2000), the goal for DTP vaccination was 80% in 2000. It appears that this goal has been reached and exceeded.

Conversely, older adults, age 65 and greater, are at an increased risk of contracting illnesses that could be prevented by vaccination. “In 1999 approximately 90 percent of all influenza and pneumonia-related deaths occurred in individuals aged 65 and older” (Centers for Disease Control and Prevention, Office of Minority Health and Health Disparities, 2007, para. 2). DHHS (2000) does not state a quantitative goal for vaccinating noninstitutionalized older adults, though it does mention a need to “increase the proportion of noninstitutionalized adults who are vaccinated annually against influenza and ever vaccinated against pneumococcal disease” (p. 42). In 2000, 46% of the population in the U. S. were vaccinated against pneumococcal disease, and 64% were vaccinated against influenza (DHHS, 2000). In 2009, pneumococcal disease vaccinations increased by 15%, whereas influenza vaccinations increased by only 3% (Centers for Disease Control and Prevention, National Center for Health Statistics, 2010).

Striving to eliminating health disparities is a noble endeavor; however, the mere fact of attaining this goal contributes to the increase of health care disparity. By increasing the health care delivery model for one at-risk population, we must accept negative gains in the delivery of health care for all other populations. This is an example of the law of conservation describing the divisional nature of finite resources: when an isolated system undergoes change, its change in entropy will be zero or greater than zero (Negi & Anand, 1985). This concept is better stated as it applies to the zero-sum game of our economics today. Kathleen Madigan (2010), in a Wall Street Journal blog post, stated, “More spending in one area has to be financed by less purchases elsewhere” (para. 5).

Two conclusions can be drawn from observing this phenomena in health care. First, if people are spending their health care dollars on other staples, such as food, clothing, and shelter, then we should see a decline in the health of individuals that are making these choices. Second, within health care, in order to increase a focus on one population, an equal negative effect will be seen in all other population groups.

In all aspects of health care delivery, care should be taken to ensure just and equitable delivery of care regardless of socioeconomic factors, race, gender, religion, or creed. All people should have access to the minimum required care in order to maintain a healthy and productive life. We can counsel and educate our patients and clients to best health practices, but we cannot, however, force people to choose health over other facets of their lives.

References

Centers for Disease Control and Prevention, National Center for Health Statistics. (2010). Immunization. FastStats. Retrieved from http://www.cdc.gov/nchs/fastats/immunize.htm

Centers for Disease Control and Prevention, Office of Minority Health and Health Disparities. (2007). Eliminate disparities in adult & child immunization rates. Retrieved from http://www.cdc.gov/omhd/AMH/factsheets/immunization.htm

Madigan, K. (2010, August 3). With wallets thin, consumers face zero-sum game. Real time economics: Economic insight and analysis from the Wall Street Journal. Retrieved from http://blogs.wsj.com/economics/2010/08/03/with-wallets-thin-consumers-face-zero-sum-game/

Negi, A. S. & Anand, S. C. (1985). The second law of thermodynamics. A textbook of physical chemistry (pp. 241-289). Retrieved from http://books.google.com/

United Nations. (2009). The millenium development goals report: 2009. Retrieved from http://www.un.org/millenniumgoals/pdf/MDG_Report_2009_ENG.pdf

U.S. Department of Health and Human Services. (2000, November). Healthy People 2010: Understanding and improving health (2nd ed.). Washington, DC: U. S. Government Printing Office.

Academia, Health Care, Society

Cognitive Development

“Children are naturally curious” (Kail & Cavanaugh, 2010, p. 98), and that is a good thing. The authors are describing a premise of Piagets theory of childhood cognition development. Piaget’s theory is based stages of adaptive learning and identifies stages associated with key development: infancy, school age, preteen, and adolescence. According to Piaget, in infancy, cognition is very basic and focused on sensorimotor schemes that the child forms based on experiences. As the child ages, Piaget claimed, these schemes become more complex. During school age, children start to form schemes based less on function and more on appearance. Preteens, on the other hand, start to understand emotion, individualism, and relative constructs. Adolescents build upon these relative constructs adding abstract thought processes which continues to build their problem solving skills well into adulthood. Vygotsky’s theory of cultural impact on cognitive development stresses that the individual and the environment are interactive, and this interaction has an impact on learning. Scaffolding, or building on information already known, effectively identifies where instruction is needed. Coupling Piaget’s understanding of cognition development with Vygotsky’s understanding of learning environments, a focused efficiency in teaching could be attained.

As we age, though, physiologic neural processing slows and the brain atrophies (Thibault, Gant, & Landfield, 2007). These changes cause information processing to slow bidirectionally, that is as input and output, and accelerates a functional decline in brain activity as we age. This is not a reversal of development but a systematic failure of physiologic processes. The effects of aging on brain tissue directly effect cognition as neural networks of synapses breakdown. Though this process is inevitable, researchers suggest certain diets and moderate exercise that can mediate the damaging effects of aging on cognition (Bugg & Head, 2009; Gómez-Pinilla, 2008).

References

Bugg, J. M. & Head, D. (2009). Exercise moderates age-related atrophy of the medial temporal lobe. Neurobiology of Aging. Advance online publication. doi:10.1016/j.neurobiolaging.2009.03.008

Gómez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9, 568-578. doi:10.1038/nrn2421

Kail, R. V. & Cavanaugh, J. C. (2010) Aging: A lifespan view (Laureate custom ed.). Mason, OH: Cengage Learning.

Thibault, O., Gant, J. C., & Landfield, P. W. (2007). Expansion of the calcium hypothesis of brain aging and Alzheimer’s disease: Minding the store. Aging Cell, 6(3), 307-317. doi:10.1111/j.1474-9726.2007.00295.x

Academia, Health Care, Public Health, Society

Cultural Influences on Health Disparities

Disparities in the availability, access, and delivery of health care are a great and growing concern. Some of the factors leading to disparite health include race, socioeconomic status, and gender (Chen, Martin, & Mattews, 2006). Chen et al. describes how race and socioeconomic status are major factors in the United States, based on the Healthy People 2010 data (U.S. Department of Health and Human Services, 2000). According to the results of this study, our public health efforts seem to be misguided. As the researchers of this study indicate, “race and SES effects on child health are best understood in concert, rather than separately” (p. 705). The differences in race and socioeconomic status are a factor only to White and Black children when looking at prevalence rates for activity limitations and circulatory conditions, as illustrated by Chen et al. in Figures 1 and 2. These figures show that higher education actually has a small but negative effect on the health status of Asians and Hispanics while having a dramatically positive effect on Blacks. Additionally, in Figure 3, Chen et al. show a significant negative effect of education on incidence rates for acute respiratory conditions. There is no significant relationship for the same with regards to Whites or Blacks.

This study shows that there are certainly correlations between race, economic status, and differences in the health status of children in America, but these factors might only be relative. We need to understand if other factors can be identified as causative. In order to explain how Whites and Blacks share correlations while Asians and Hispanics share correlations, we might consider the length of time each population has been exposed to American culture. Whites and Blacks have been in America for over 300 years while Asians and Hispanics have migrated more recently. In addition, there is also evidence of attitude and preference differences for minorities towards health care, though the Institute of Medicine (2002) marginalizes this phenomena in their study.

As a health care provider and regardless of the causes of disparities in health status, it is advisable that I understand these causes so that I may better direct a patient’s care with a holistic understanding of the patient.

References

Chen, E., Martin, A. D., & Matthews, K. A. (2006). Understanding health disparities: The role of race and socioeconomic status in children’s health. American Journal of Public Health, 96, 702-708. doi:10.2105/AJPH.2004.048124

Institute of Medicine. (2002). Unequal treatment: What healthcare providers need to know about racial and ethnic disparities in health. Retrieved from http://www.nap.edu/html/unequal_treatment/reportbrief.pdf

U.S. Department of Health and Human Services. (2000). Healthy people 2010: Understanding and improving health. Washington, DC: Author.

Academia, Emergency Management, Health Care, Public Health, Society

Immunization and Infectious Disease Mitigation

Cultural Models of Immunization and Infectious Disease Mitigation

The members of some communities, such as Puerto Rico, do not understand the scope and severity of some infectious diseases until they become infected (Pérez-Guerra, Zielinski-Gutierrez, Vargas-Torres, & Clark, 2009). The lack of a basic understanding of illness and infection poses a roadblock to mitigating disease transmission within the community. For Pérez-Guerra et al., the perception of severity and mitigation is important as they investigate the difference in attitudes towards dengue infections because dengue cannot be controlled by vaccine and must be mitigated by community participation in mosquito abatement activities. Other infectious diseases, however, can be controlled by vaccine, but efforts to limit infection are met with ignorance or misconceptions (Lau, Griffiths, Choi, & Tsui, 2010; Leask, Sheikh-Mohammed, MacIntyre, Leask, & Wood, 2006).

Public health officials, in concert with community leaders, should seek to educate affected communities about the infectious diseases they face along with effective mitigation strategies and the importance of vaccination, if available. Coreil (2010) describes the importance of cultural models in “[gaining] a deeper understanding of the cultural context of behavior” (p. 83). If behaviors are not understood, then it will be difficult to redirect them. Reaching out to community leaders has the added effect of allowing the leaders to alter the message just enough so that it might be effectively communicated to the community.

Providing a cultural health model allows for a larger scope of audience while effectively tailoring the message so that most of the target audience will appreciate the nature of the message. Approaching health behaviors from a cultural stand-point also offers the advantage of allowing peer support to propagate messages through out the community. This might be especially true when dealing with a multitude of subcultures where the message might better be disseminated via interpersonal means. Eventually, the message will be received by many individuals who will begin to have discussions with others in the community. For communities where individuals are not likely to speak to each other regarding personal health-related matters, the cultural health model allows a general message to reach each individual.

References

Coreil, J. (Ed.). (2010). Social and behavioral foundations of public health (2nd ed.). Thousand Oaks, CA: Sage.

Lau, J. T. F., Griffiths, S., Choi, K. C., & Tsui, H. Y. (2010). Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infectious Diseases, 10(139), 1-13. doi:10.1186/1471-2334-10-139

Leask, J., Sheikh-Mohammed, M., MacIntyre, C. R., Leask, A., & Wood, N. J. (2006). Community perceptions about infectious disease risk posed by new arrivals: A qualitative study. The Medical Journal of Australia, 185(11/12), 591-593. Retrieved from http://www.mja.com.au/public/issues/185_11_041206/lea10999_fm.pdf

Pérez-Guerra, C. L., Zielinski-Gutierrez, E., Vargas-Torres, D., & Clark, G. G. (2009). Community beliefs and practices about dengue in Puerto Rico. Pan American Journal of Public Health, 25(3), 218-226. doi:10.1590/S1020-49892009000300005

Academia, Health Care, Society

Living Longer and Happier Lives

As we age, we tend to question our mortality and how much longer we have left to live. Not that we can do much about this in order to extend our lives by this time, but if we question our health earlier, we may be able to affect positive change in order to have a longer and more productive quality of life. Dan Buettner (National Public Radio [NPR], 2008; TED, 2009) discusses how difficult it can be to control the effects of aging, but he also offers some options based on his observations of what are termed blue zones. Blue zones are geographic and cultural areas of the where people tend to live longer and healthier lives.

Buettner (NPR, 2008; TED, 2009) describes simple measures that can contribute to increasing a productive life. More importantly, he has uncovered what they do not do. The people who live in these blue zones, according to Buettner, do not tend to take daily supplements, pills, or extracts. Instead, continuous and simple movement for exercise coupled with a sensible cultural diet seems to have the biggest impact.

One of the observations that I have made over the years is that as physical movement declines, physical and emotional strength wane. For example, an otherwise healthy 70 year old woman who accidentally falls and breaks her hip decreases her life expectancy drastically unless physical rehabilitation is utilized to regain her activity level (Keene, Parker, & Pryor, 1993; Lyons, 1997). It is vitally important to maintain a healthy level of activity throughout life.

Diet is very important. Buettner (NPR, 2008; TED, 2009) credits adding nuts to the diet for an average increase of three years of life. The way in which our bodies use energy is very important, and we must supply it with a fuel that is efficient. A wholesome diet, I believe, is the best diet, especially if divided by five or more meals a day.

We cannot have a conversation about improving overall health without addressing some of the unhealthy vices that we tend to indulge in. Instead of outlining each and every thing that is detrimental to our health, I will say that moderation should be the way to combat the effects of vices. We need to enjoy life, and I feel that the mere enjoyment leads to a longer and healthier life; therefore, to strictly limit indulgences would seem to be counter-productive. Moderation should certainly be the way in which to address these issues.

We all want to live longer and healthier lives, but genetics does play a role. There are some aspects of our lifestyle that we are finding that we can change for the better, and the alternatives are not that bad. So long as we live healthy lives, we can enjoy life more completely.

References

Keene, G. S., Parker, M. J., & Pryor, G. A. (1993). Mortality and morbidity after hip fractures. British Medical Journal, 307, 1248-1250. doi:10.1136/bmj.307.6914.1248

Lyons, A. R. (1997). Clinical outcomes and treatment of hip fractures. American Journal of Medicine, 103(2), S51-S64. doi:10.1016/S0002-9343(97)90027-9

National Public Radio (Producer). (2008, June 8). Can ‘blue zones’ help turn back the biological clock? [Audio podcast]. Retrieved from http://www.npr.org/templates/story/story.php?storyId=91285403&from=mobile

TED (Producer). (2009, September). Dan Buettner: How to live to be 100+ [Web Video]. Retrieved from http://www.ted.com/talks/dan_buettner_how_to_live_to_be_100.html