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Wednesday, July 17, 2019

Define "health"

Excellent article at STATnews:
It's time to change the definition of 'health'

The WHO defines health as a state of “complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The Centers for Disease Control and Prevention, along with a range of WHO partners, endorses this definition...

A definition of “complete” health as the absence of disease leaves little space for people with chronic diseases and for managing them in new ways. Together, the increasing numbers of Americans over age 65 (currently 51 million) and even over age 85 (currently 6.5 million), with more than 617 million over age 65 worldwide, along with transformations in disease definitions and treatment, amplify the dissonance between the experience of living long and the definition of health...
Read all of it.

When I signed on to Kaiser-Permanente (Medicare Advantage) in June after our move to Baltimore, I self-rated my "health" as only "fair" on their intake form forced-choice Likert scale question. It's way more complicated than that. But, I do know one thing; were we still under pre-Obamacare "medical underwriting," people like me would be declared "uninsurable" irrespective of our rank-ordered self-assessments.
My "health," like that of many people close to my age (I would speculate) comprises a multidimensional distribution exuding highs and lows and averages along various axes. Given the stresses of the past few years (my 2015 prostate cancer dx and tx; losing a second daughter to cancer; my 2018 open heart SAVR px; our fractious April 2019 transcontinental move), I continue to ail a bit physically. But, I have never been more intellectually and socially engaged notwithstanding. Cognitively, I have to keep on being a (post-mid) "life-long unlearner." Socially, I have to give, give back.
I'll be adding this STATnews item to my list of "definitions" in need of closer scrutiny. 
Q: "What's the definition of a 'well person'?"
A: "A patient who has been inadequately worked up."

Recently at THCB: 
Landmark Results Achieved in Aging and Chronic Disease: Danish Group Extends Disease-free Life by 8 Years

New Scientific Breakthroughs Can Provide a Longer Healthier Life
Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biology that causes chronic disease and aging. These same medications will likely produce similar results in patients with congestive heart failure, chronic kidney disease, arterial disease, history of heart attack, hypertension, and angina. Simple medical interventions can extend healthy lifespan today.

Better Chronic Disease Management Can Improve Health and Lower Costs
90% of health care costs come from chronic diseases and aging which are both related. The same biochemistry that causes aging causes chronic disease. Eating processed food, gaining weight, smoking cigarettes, and sitting on the couch accelerate aging and chronic condition development. Those activities switch on genes that should be quiet. Eating real food, avoiding cigarettes, activity, lisinopril, losartan, atorvastatin, metformin, (and spironolactone) are now proven to extend healthy life by 8 years in patients who are at high risk of health catastrophes and early death! These medications all cost $4 a month except for atorvastatin which is $9 a month. The benefits continue even when best practice treatment stops probably because these treatments block signaling from dangerous genes that are inappropriately and persistently turned on…
 Nice. Again, read all of it.


On my iPhone...

Read this book.

Cited it here (scroll down).


It's hot in Baltimore this week.

apropos, see KHN's "Climate Grief."

I know it bums me out.

More to come...

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