Source: Schroeder SA (2007) "We Can Do Better — Improving the Health of the American People" NEJM v357:1221-1228.
We also know that behaviors can directly affect genes. Exercise and eating healthy can turn on good genes and turn off bad genes. I would venture to guess that over 1/2 of early mortality is attributed to behaviors.
Why are we spending 2.2 trillion dollars a year on 10% of the problem? Because we don't like to be told no. We have a right to treat our temple like a pile of trash. As long as someone else foots the bill when the walls come crumbling down.
Why are we spending 2.2 trillion dollars a year on 10% of the problem? Because we don't like to be told no. We have a right to treat our temple like a pile of trash. As long as someone else foots the bill when the walls come crumbling down.
HH,
ReplyDeleteAs this key article mentions, smoking cessation is a major factor in improving health care. New York City Mayor Bloomberg is an ardent anti-smoking activist who has reduced teen smoking to 8.5 % from 21% and helped 200,000 adults or 20% of the adult smoking population to quit smoking. This was done by 1) raising the cost of cigarettes to at this point $10/pack through taxation which not only helps adults to quit but makes it much less likely for teens to start 2) rigorous enforcement of the law prohibiting teens from purchasing cigarettes by hiring below age teens paying them $7.50 per hour to attempt to buy cigarettes and having the venue cited if the illegal sale occurs so that today there is a 93% compliance rate 3) aggressive anti-smoking advertisements, 4) periodic offers of free nicotine replacement patches. Bloomberg has also donated $375 million (with Bill and Melinda Gates throwing in another $125 million) to help with smoking cessation in 3rd world countries.
The Bloomberg program in NYC needs to be replicated throughout the nation and doctors can do much to rally around the plan. Let's start with Massachusettes.
David MD
I forgot to add the fifth element to the Bloomberg smoking cessation plan which is the banning of smoking in public places including bars. So these five elements of Bloombergs plan needs to be replicated nationwide (along with dealing with obesity and lack of exercise) if we are to succeed in improving the health for Americans.
ReplyDeleteDavid MD
i see no ploblem raising the tax on cigarettes, alcohol, (and i drink wine), any kind of junk food (yes, again), fast food, etc, etc...and, as Dr. Happy mentioned, making the "good stuff" , ie, fresh fruits and veggies cost less...because it is truly a shame how much the "good stuff" does cost. Compare the Double Cheeseburger (Hi Dr, Drac!) to a salad with grilled chicken....the price is hugely different...is it any wonder hardly anyone orders "healthy"? Bah.
ReplyDeletetracy:
ReplyDeleteIs there evidence that the thing driving the decision of bad food over good for most people is the cost? Convenience makes sense (when I get really rushed for time, I end up eating an awful lot of lousy but convenient food), but cost? Is a salad at McDonald's that much more than a burger and fries? At most restaurants I go to (better than McDonald's!), you can get a more healthy meal or a less healthy one for about the same price, but plenty of people would rather get the breaded fried thing with fries than the salad with grilled chicken. Similarly, it's not like someone who can afford a bag of chips and a soda can't afford an apple and a banana, in general.
As a simple datapoint, it's cheaper to get a glass of water at McDonalds than a soda, and about the same price to get an iced tea or a soda. But lots of people get sodas, which are pretty much all horrible for them, and most aren't even getting diet sodas. This doesn't look like it's about cost, but about unhealthy but yummy things winning over healthy things that aren't as tasty.
Hey albatross
ReplyDeleteJust made a quick call...
Double Cheeseburger 1.19
Small Fries 1.00
Medium Fries 1.77
Salad (Ceaser, Ranch, etc) with grilled chicken (1/2 breast) and choice of dressing (what do you want to bet no one gets low fat?!)
4.59
But, you're right, the yummy stuff probably does win over.
Sigh. Someone tell me to get a life!
PS i have had the salads...they are quite good...! (with LF dressing!)