Our focus has been on a single virus lately—as it should be—but we should not neglect the many other health concerns that challenge our health care system. We are fed a variety of graphics in the media that mostly serve to feed a specific narrative. Rarely is the whole picture presented. A friend share a graphic that showed the reported weekly death of a select number of diseases. Of course, COVID-19, which has yet to run its full course, was presented as a very steep (and rising plot) again the more “gentle” plots of diseases like the flu, the flu and pneumonia [which seemed redundant of the flu curve, given that the data were for the same period (2017-2018), and the latter appeared simply to be the plot of flu deaths + pneumonia deaths], the 1957-1958 Asian flu (with pneumonia) [which was interesting since it was a bimodal plot—“why?”, I wonder], car crashes [rather low and steady, by comparison], and heart disease and cancer. I was particularly drawn to the cancer and heart disease death rates. These were steady around (an average of) 35-38 deaths per million! Given that the plots are of deaths per million over a year’s time, I think it is prudent to look at the area under the plots rather than the shape alone. [COVID-19 deaths, after all, can (and, I pray, will) more dramatically than they rose, demonstrating a comparatively small number of deaths.] Given this perspective, we should be particularly alarmed by the cancer and heart disease plots. We talk about “flattening the curve” of the coronavirus (as we should), but these curves are flat!! The are unnecessarily high and flat. [I might also argue that the deaths due to car crashes are also unnecessarily high.]
While cancer may, arguably, be out of one’s control, heart disease is most certainly a product of our unhealthy lifestyle (excepting, of course, congenital heart disease and disease that may result from environmental circumstances beyond one’s limited control). We can affect the number of deaths owing to heart disease—if we choose. Cancer research and prevention must also be a priority. (I am particularly disheartened by the lack of funding and progress in pediatric cancer treatment and research!) We can also take more personal responsibility for our overall health, and, thereby, cancer and heart disease prevention. I see plot like the one discussed, and I dare to ask the questions: “Who is at fault?” and “What can be done?”
It is easy to say that the solution in universal health care (which I don’t consider the same as universal access to health care). The solution, however, lies in our preventative actions as a society and as individuals.
Teaching Pathophysiology & Exercise, I have come to a simple (albeit overly simplified) solution to the majority of health problems that plague our country. I believe the simplest path to minimizing the risk of most (if not all) major medical conditions is found in the advice to: 1) exercise and 2) don’t smoke. This alone can improve risks and positively affect prognoses.
I think there has come a time to make it inconvenient, if not impossible, to smoke tobacco (and/or vape) and be inactive. I think it is time to invest in physical education and sports (and not just the “revenue” sports like football) in our schools—rather than cutting programs—and make physical activity fun and accessible for all children. I think it is time to admit that school nutrition programs are overall horrible. I think it is time to admit that obesity is a tremendous physical drain on society and not a “right”. (I am by no means endorsing fat-shaming, but I am suggesting that we be asked to pay for our own burdens to society. Where obesity is a symptom of poverty, poor education, and a lack of access to quality foods and nutritional information, we are obligated as a society to remedy this as a matter of social justice.) We need to rethink community planning (urban, suburban, and rural) and plan active communities—access to safe parks, playgrounds, sporting fields, tracks, walking/running paths, bike lanes, etc. There should be no road improvements without consideration of pedestrian traffic. I can go on, but…. The point is, we have a communal responsibility for the collective health of the population. We cannot address health-care-for-all without first addressing preventative health care (or health-for-all).
I wish I had the answer for how to get all of America physically active and healthy. It is a matter of motivation—specifically, self-motivation. This is no easy task. We are all personally responsible for our health—no matter our circumstances. This is a hard pill to swallow (the only pill I prefer, personally, to swallow), but it has to be prescribed. We have to want to be healthy.
It is impossible to have a healthy society without making it more inconvenient (and costly) to be unhealthy than healthy.
There are countless people who are suffering with medical problems (and the associated costs) because of circumstance well beyond their control. There are some who are paying the price for their own or someone else’s poor judgement. This is unfortunate, and these people cannot be neglected. For most of us, there is time and opportunity to change our futures. We need not be a population that ages poorly—overweight/obese, frail, weak, with heart and respiratory diseases, etc.—and is vulnerable to diseases such as COVID-19 or, even the common cold and flu.
I keep hoping that we will transit from this pandemic a changed people. I am hopeful but not optimistic. The best I can do is model better behavior and affect my circle of influence. I am a Spiritual person (or try to be), however, and I trust that each of can have a dramatic influence beyond our close circle, if that influence can spread (yes, like a virus). Change begins with oneself.
Be your best today; be better tomorrow.
Carpe momento!