September 1st, 2009 by Gwenn Schurgin O'Keeffe, M.D. in Better Health Network, Health Tips
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Nielson Wire yesterday posted a summary of a Scarborough Research study that may surprise you. According to the study, teens actually know what “being healthy” means. As reported by Nielson Wire, “92 percent percent of teens aged 13-17 say that health and a healthy lifestyle are important and when asked to give themselves a “health report card,” 76 percent of teens gave a grade of B- or higher.”
Also of interest in the report is where teens get their health information. As opposed to using social networking, as we’d expect them to do given how important a role it plays in their lives, teens turn to parents first and then true internet searches second.
(source: Nielson Wire as seen in Scarborough Research report)
I don’t doubt that on some level our teens know they need to live a healthier lifestyle and desire to do so. But, all we have to do is look around any of our towns to know the majority of our teens are not living they healthy life…not yet. So, why the discrepancy? What needs to happen to help teens live the healthy life they desire?
The discrepancy may have a few root causes:
1. Unhealthy families: many of these kids have parents with weight issues…the apple doesn’t fall too far from the tree so they may not be getting the encouragement to “live healthy”.
2. Lack of time for true exercise – while many teens are in sports, sports participation isn’t the same as true exercise and many kids don’t burn the calories many parents think they are burning.
3. Not knowing how to be more healthy.
4. The hurried child syndrome where childhood has become so busy there isn’t time for proper meals.
5. Not understanding their own bodies unique nutritional needs. The needs of a growing teen are different than they were when they were younger kids, especially as growth slows down. Our teens need help learning to eat more like adults and to eat in moderation and with the concept of “balance”. This will only happen if we lead by example and also have open conversations with them about food. This will also only happen if we serve food they enjoy eating!
How can we help our teens live the healthy life they desire?
1. Talk to your teen and really listen! Find out how your teen wants to eat and exercise. A friendly world of warning…it may differ from your own views but if that is how your teen wants to be healthy, help your teen with that goal because the teen years are the start of the eating and exercise paths for life.
2. Lead by example. Look honestly at how you eat and exercise and do what you need to to be more healthy.
3. Slow down the pace of the family week so there is time for family dinner each and every day.
4. Get every one in the kitchen cooking. I’ll be writing a lot more on this as the year goes on but I can tell you that a family who cooks together, becomes more healthy together!
5. Have your teen help you with the weekly family menu planning.
6. Consider a gym if you can afford it…teens love working with trainers and joining classes. Most communities have programs that are very affordable as do the local YMCAs.
7. Don’t by the junk if your teen asks you not to…that’s like having cigarette packs on the table when someone is trying to quit smoking.
8. Keep healthy snacks around such as fruit, veggie sticks, granola bars.
9. Talk to your pediatrician and address any medical issues if there are any that may be interfering with becoming more active.
10. Be encouraging!
The teenage years are when our teens are supposed to spread their wings and amaze us. If good health is where their wings are trying to take them, then our job is to hop on that path and tackle any obstacle in their way.
*This blog post was originally published at Dr. Gwenn Is In*
July 23rd, 2009 by Olajide Williams, M.D. in Health Policy, True Stories
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Stroke is the leading cause of adult disability in the United States and the third leading cause of death. Worldwide, stroke is the second leading cause of death. Like heart disease and cancer, serious stroke disparities persist in America. African Americans have a relative risk of stroke death that is 4 times higher that whites at ages 35-54, 3 times higher at ages 55-64, and 2 times higher at ages 65-74.
The reasons for this are the focus of my two blog posts.
Over the last decade, most of the research dollars spent on stroke has focused on treatment and recovery. Researchers have spent millions trying to come up with new blockbuster treatments that reduce stroke burden or reverse it’s disabling impact. Therapeutic clot-busters have emerged with narrow time-windows within which they must be administered. Relaxing these time constraints have been the subject of even more research, and stroke recovery laboratories explore brain re-learning, neuronal plasticity, and cellular regeneration.
While I believe that we must continue to remain leaders of new and innovative treatments of disease, there is no doubt in my mind that the best return for our healthcare dollars is prevention. It is the only thing that can reign in the runaway disparities in healthcare and reduce the physical and economic burden of disease among all Americans.
But prevention is complex. It is much more challenging than administering a clot-buster or taking a cholesterol-lowering drug. Prevention involves the entire community – the whole ecosystem. It involves the child or individual, his parents and grandparents, his schoolteachers, his neighborhood stores and local parks, his local government policies, his primary care physician, his local community clinic or hospital, his employment status, his wallet, and lastly, his genes. Compare this to treatment, which involves having access to particular medical interventions such as a drug or surgical procedure.
Stroke prevention can be subdivided into primordial prevention (preventing stroke risk factors like high blood pressure, diabetes, and obesity, from developing in the first place through healthy living), primary prevention (preventing a first stroke by treating identified modifiable risk factors like high blood pressure etc), and secondary prevention (preventing a second stroke from occurring by controlling risk factors and administering specific treatments like taking a daily aspirin or having surgery to open up clogged arteries in the neck).
For the purposes of this post, I will focus on primordial prevention. To begin, I will re-introduce the root causes of disparities outlined previously:
- Educational status
- Employment status
- Insurance status
- Income level
How do these factors influence primordial prevention? How do they interact to define ecological conditions within a specific community? How did they contribute to the young boy’s adolescent stroke? To begin, I will list factors endemic to the young boy’s environment:
1] Low Health Literacy – the “hidden dragon” of all treatable risk factors; so often underestimated and so dangerous to the beholder.
2] Unacceptable numbers of uninsured – the “crouching tiger” threatening to tear down the entire health system
3] Poor access to care – an unforgiving predicament.
4] Limited access to healthy and inexpensive food
5] Ubiquitous access to unhealthy and cheap food
6] Low levels of non-occupational physical activity or leisure-related exercise
7] High tobacco and alcohol consumption.
8] Chronic persistent stress levels that overwhelm coping mechanisms.
In a study by Mauricio Avendano and Maria Glymour, wealth and income levels were shown to be independent risk factors for stroke. Another study by Glymour, Avendano, Haas, and Berkman showed that childhood social conditions (southern state of birth, parental Socio-Economic Status or SES, self-reported fair/poor childhood health, and attained height) predicted stroke risk in black and white adults. Moreover, adjustment for adult SES, in particular wealth, nearly eliminated all the disparity in stroke risk between black and white subjects
The ecological conditions that shaped the young boy’s physical and limbic traits are examples of an uneven playing field. He was born into it – just like I was born into my little world. The sporadic binging on cheap ubiquitous fast food whenever his mom had a little money and the absence of playtime ultimately led to his childhood obesity. The complex conditioning of his limbic needs led to a psychological fragility that was encased by a shell of defensive behavior that in-turn caused truancy. Substance abuse was around the corner waiting patiently for him. By age 15, the young boy was already a user; with open arms he was welcomed into “the hustle”. Mom was broken. One could see it in her eyes. She no longer worked. She no longer cared. That is, until her son had a stroke when he was just 17-years-old – the day the drought ended, and she cried.
It was a hemorrhagic stroke. The high blood pressure in his brain arteries caused by accelerated atherosclerosis – the consequence of his substance abuse (tobacco, alcohol, cocaine), type-two diabetes, and undiagnosed hypertension – was what caused the stroke. The stroke was so large that it shifted half of his brain across the midline of his skull, crushing it against the inner-table on the other side. Fortunately (some would say), the kid survived. Unfortunately, he wanted to die – 17-years-old and nursing home bound, unable to speak or swallow or move his right side.
The stroke was the final blow dealt by a cascade of disparities all too common in America.
July 22nd, 2009 by Olajide Williams, M.D. in Health Policy, True Stories
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Disparities in healthcare are composed of several interconnected layers – multiple layers joined together like the bricks of a divisive wall, separating better health from poor health. And while we must acknowledge the pre-eminence of personal responsibility, we must also address the uneven distribution of mountains and valleys on the American playing field.
Disparity sometimes begins before one is born; before one is conceived – it may begin in-utero, with the absence of adequate prenatal care, with maternal co-morbidities and high-risk behavior, long before one is old enough to assume personal responsibility within an “inherited” landscape or community that is filled with steep climbs and dark valleys. Many of us are familiar with root causes of healthcare disparities – the four components or foundational bricks that sustain physical and economic health in capitalist societies.
- Educational status
- Employment status
- Insurance status
- Income level
Individual or combined deficits in these components typically lead to accumulating disadvantages within which good health is considered an outlier. It is often these environmental factors, and not genetic ones or racial ones that are largely responsible for the disproportionate morbidity and mortality we witness all over America – especially in Harlem – the site of my neurological practice.
A young child is born on Malcolm X Boulevard in central Harlem. He is the most beautiful baby I have ever seen. And yet, his passage into the world is not without hardship. His single mom, a sixth grade dropout, did not have health insurance even though she worked two minimal wage jobs. She did not receive adequate prenatal care. Indeed, the only time she visited the hospital was to fix the broken bones in her face she sustained from domestic violence. Fortunately, she escaped from that life by fighting back with everything she had. Even her child was born through conflict – amidst the peril of eclampsia. It was a stormy delivery in a safety net hospital. Luckily, she survived and the beautiful baby boy thrived.
The early years of the child’s life were spent with grandma, until she died when her grandson was only 9-years-old. Mom had nobody else to help her, and there were no breaks in Harlem. She could not afford the childcare she needed to keep her second job, which she fought so hard in vain to keep. She became homeless. After squatting with her son in an old boyfriends house for a period of time, they finally moved into a housing shelter and were placed on a waiting list for section 8.
Mom was born poor; she had no successful role models; no good yardsticks with which she could measure herself against. Everyone around her seemed resigned to the status quo, which they would refer to as “the hustle”. She did not make it to high school; she fought for her minimum wage; she had no health insurance; and yet she worked hard to provide basic needs for her and her son. Each brick of disparity – educational status, employment status, insurance status, and income level – formed a wall so tall that it was hard to imagine how she would get to the other side.
Depression crept in – an irrepressible feeling of worthlessness and hopelessness. A feeling that no matter how hard she tried she would always fail. Most of her girlfriends were already on the streets or in jail. Their children had dropped out of school to join gangs or resort to petty crimes. She promised her own mother long before she died that she would never resort to crime. She would fight a good fight for her son and herself. But depression dug deeper, breaking her will, piece by piece until she finally succumbed to the twin pressures of emotional and economic desperation.
We all have limbic needs. For some, these needs are nurtured by loving hands that paint lasting portraits of hope inside our souls. Expressions of hope hanging on the walls of our heart chambers: a mother’s attention; a father’s approval, a caregiver’s warmth, a schoolteacher’s encouragement. For other’s, there is insufficient nurturing – these limbic needs are not met; rather, they are torn down – left out in the cold, often on impoverished streets – unanchored, undermined, forced to adapt alone in a Darwinian society.
In my next post, I will finish this story. I will describe the boy’s life and his ultimate stroke in an attempt to show the interconnectivity of health and the four components of healthcare disparities.
July 18th, 2009 by EvanFalchukJD in Better Health Network, Health Policy
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I belong to a terrific organization that brings together C-level executives, once a month, to discuss issues each of us face. It’s called Vistage. One of the subjects we talked about yesterday was health care. It was like a focus group made up of seasoned, senior executives from many different industries.
The discussion revealed the tremendous divide between what ordinary Americans think about health care and what policy makers in Washington are doing. It’s a combination that is almost certain to ensure that whatever reform passes may make our problems worse, rather than better.
At the meeting were about 30 executives, representing everything from financial services, commercial real estate, manufacturing, high technology, pharmaceuticals, insurance, retail, non-profits, travel and others. Although all thought health care costs were in a state of crisis in America, I did not hear anyone say this was the case in their business. To be sure, some complained that health costs were high, and that there were few alternatives available. But others described changes they had made to their plan designs that had actually reduced their corporate health expenses.
We talked about the proper role of government, the comparative worth of systems in other countries, the responsibility of people to take care of their own health, end-of-life care, over-treatment, the uninsured, access to care, comparative effectiveness, and our own expectations of what the system should do for all of us. There was no consensus among this group of 30 business leaders as to these subjects and what we should do about them, other than that they are important topics that we need to address. I suspect this is true outside of this group, too. Indeed, the huge collection of issues that fall under the category of health care reform is something I’ve pointed out before.
But the President and leaders in Congress want debate on health care to end. They want a a bill to pass in the next couple of weeks.
Most of the group members were surprised to hear that Congress had already drafted legislation and was getting ready to vote on it.
It’s a remarkable thing. We are in the midst of trying to redesign the largest health care system in the world, and we’re barely debating the merits of it. How many members of Congress will have read the 1,1018-page bill once they vote on it? How many Americans will understand what implications it has for their health care if it — or something like it — becomes law?
The President often says that the status quo in health care is “not an option.” The trouble is, the status quo in health care is a rapidly changing thing. Today, every day, employers and doctors and so many others are busy making real, meaningful changes to our health care system. Not by waiting for committees of Congress to pass legislation, but by getting together and doing things that improve the quality and cost of care and the lives of patients. We need to be listening to their stories, and learning from them. Congress hasn’t done this, and can’t now.
There is an opportunity to build a real consensus around the important issues we talked about yesterday. We can transform our health care system in ways that make all of us proud. But it can only happen by working through these hard questions, not by hurrying to pass a bill before the August recess. Those who say we have a once in a generation chance to reform health care today may be right, but not for the reasons they think. By passing bills without consensus on this deeply important and emotional issue, they are ensuring that no one will really want to try to reform health care again for a very long time.
Which leaves us very much where we started. I will continue to do my part to share the important stories of how real people are making real reform. The political attention to reform may end sometime this year, but the reality of people trying to figure out what to do when sick will continue.
*This blog post was originally published at See First Blog*
June 2nd, 2009 by admin in Better Health Network
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I don’t have to tell you that in this economy everyone is looking for ways to cut costs. One place many people are choosing to save pennies is by choosing generic, or store brands, instead of name brands at the supermarket.
The Food Marketing Institute reports these stats:
- 93% of retailers plan to increase the number of store-label products in upcoming months.
- 15% of supermarket sales are store labels compared to 14% in 2008 and 11.5% in 2007.
- 10.8% increase in store label sales in most recent fiscal year. Manufactured brands grew by 2.5%.
The average family spends $98.40 weekly on groceries. If you have children, you will spend well over $100. So saving even a few dollars each shopping trip can add up.
Can you tell a difference in the store brand vs the manufactured brand? I personally will purchase store brand for many things like milk, bread, cheese, butter, etc. I have tried some of the store brand cereals and not found them to be as good as the manufactured brand. It all depends, though, on the product and the price. If a manufactured brand is on sale or if I have a coupon, it is much cheaper to go with that than the store brand.
Did you know that many of the store brands are actually made by national brands and relabeled for the store? This varies by store and product, but often those paper towels that are store brand are the same as the manufactured brand.
What do you think? What do you purchase in the generic, or store brand? Do you notice a difference?
This post, Going Generic, was originally published on
Healthine.com by Brian Westphal.
