Why Prevention Matters
My last few columns have been rather personal…I thought you might enjoy the more scientific side of Dr Barry for a column or two. Since I make my living trying to talk people into taking better care of themselves I thought I should review with you the real enemy…its not the insurance companies, the government etc…its what will kill you prematurely and what you can do to make a difference. The cdc says that 30% of cancers, heart attacks, strokes etc are preventable. Other sources say that you can make an even bigger difference than 30% but thats still a huge number compared to what you can get from pills etc.
What’s killing americans? If we don’t know what is killing us we don’t know what to focus on in your health. We are looking for opportunities to cut down your risks of the top killers through lifestyle modification / behavioral intervention. There is something we can impact on for all of these. Below is the very latest data from the CDC as to the top causes of death in America each year (Cause/Number of People).
Heart disease: 596,577
Cancer: 576,691
Chronic lower respiratory diseases: 142,943
Stroke (cerebrovascular diseases): 128,932
Accidents (unintentional injuries): 126,438
Alzheimer’s disease: 84,974
Diabetes: 73,831
Influenza and Pneumonia: 53,826
Nephritis, nephrotic syndrome, and nephrosis: 45,591
Intentional self-harm (suicide): 39,518
So, lets look at these issues one by one and see which ones we can have an impact on.
Heart DIsease…the number 1 killer!!! We can intervene with changes in blood pressure, cholesterol levels, smoking status, diabetes control, diet and exercise and meds…heart disease is of course also in part genetic but we cant do anything about this component…yet!
Cancer ….There are a lot of different recommendations from different organizations but the most common cancers.breast, lung, colon, skin, prostate, bladder, have screening tests which can be done at the appropriate intervals. Yes we can survey for cancer but we can also try to impact your cancer risk with diet and exercise and stopping smoking.
Chronic lower respiratory disease is basically smoking and pulmonary fibrosis. Between Chest X Rays and Spirometry ( breathing tests ) we can get a good measure of your lung status. Since this category really is COPD / Emphysema / Chronic Lung DIsease…this is another modifiable lifestyle issue since most of this is smoking related. It doesn’t matter how many times you have failed to quit smoking in the past there is more we can do here if you want it !!
Stroke….the modifiable risk factors here are smoking, hypertension, diabetes, and cholesterol. All of these we can work on and modify.
Accidents…Driving assessment …fall risk /evaluation…Alert bracelet…Need for physical therapy…carbon monoxide detector…staying off the roof after the age of 70 etc.
Dementia…You can have your memory assessed using nationally validated tools, but this is just checking for the problem. The most important intervention you can take to prevent memory loss seems to be exercise. Physical exercise is most important and mental exercise may be helpful as well. Medications have heretofore been widely used but have had only marginal results overall. So the name of the game remains prevention!
Diabetes…The single most important issue in managing your diabetes is your commitment…to diet…to exercise…to taking your meds…so much of this is under your control and therefore modifiable.
Flu and Pneumonia…You should have a list from your doctor regarding your shot status. I believe in routine immunizations. When an injection can cut down your risk of dying from one of the top causes of death for as long as 10 years…I want that shot. Luckily those shots are the flu shot and the pneumonia shot.
Nephritis…basically kidney failure…still affects lots of people and there are well recognized modifiable risk factors…Once again being: smoking, cholesterol, hypertension, diabetes…easy to measure…easy to work on…easy for you to make a difference in your outcome.
Suicide…What a terrible thing that 40,000 people decide to kill themselves every year. Did you know that each year there are more suicides than homicides. Unfortunately we don’t have a strong mental health care system in this country…Depressed or anxious? Here…take a pill. See a counselor and come back in 3-6 months. Hard to make a change in your mental health with this system. Again, I think people need more time to work out their problems with a professional than we are giving them now under our current system. Change is hard and changing your feelings is hard and it comes from inside…not outside. Yes, once again I think the right diet and a good exercise plan will make a difference in how you feel and what you think.
So, we have reviewed the top killers. You can take action regarding all of them. You can make a difference in your health. It makes me laugh when I hear Upstate’s commercial…“knowing changes everything”, because knowing doesn’t change a damn thing. You KNOW you should quit smoking…you KNOW you should lose weight…doing something…taking action…that changes things. How to help people make those changes…take that action, etc. That should be a very high priority for every health care professional you see. Nothing wrong with hunting deer or rabbits but what about hunting down and killing your bad habits!! Now there’s a challenge!!
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