By Clive Lindley-Jones | July 15, 2014 9:31 am
Changing our lives: Whose responsibility is our health?
“The treatment of a disease represents an admission of failure. Prevention is the goal of medical research and clinical practice.”
Professor Peter Elwood, Cochrane Institute, Cardiff University,
Apologies to those loyal readers, who read and comment on my occasional health related blogs. I am a couple of months late in my self-appointed task of sharing ideas every couple of months, but last month got rather busy while I attended the 50th anniversary International meeting of the International College of Applied Kinesiology, (AK) in Washington D.C.,USA.
A chance for 350 clinicians from 14 countries from around the world to gather and both share their new research as well as honour and remember the genius of Dr. George Goodheart the inventor/discoverer of AK.
It is always a pleasure to learn and share amongst old friends from all over the world who share a passion with such enthusiasm.
No sooner had I returned on the red eye flight from Washingtion and done a couple of days work than, at the request of my rock musician daughter, we were off to Glastonbury. This daughter had enjoyed many gigs playing at Glastonbury in the past, (for heavy rock music fans check out her band, here. )
So before we were irredeemably decrepit wanted us to experience the atmosphere of this unique event down on the farm in Somerset. Discussions of our experiences of the Glastonbury Music Festival will have to remain for another time and place, here but although I am not particularly into music, the most fun music I stumbled across, were the lively, Melbourne band 'The Woohoo Review' a brilliant cross between Klesmer, Mariachi and Jazz, check them out here here. But enough...
Whose responsibility is our health?
On July 5th the National Health Service had its 66th birthday. With an ageing population, and the ever-increasing cost of medical interventions, there's more pressure on the NHS, which is why we need changes to services to focus far more on health prevention out of hospitals, and use the range of talented clinicians more beyond the limitations of the over pressed GP's as Goldstein and Weeks have suggested in America were they make a strong case for greater integration of
Various kites are flown by politicians, such as the idea that everyone in the UK should start paying a £10-a-month NHS "membership charge" to save it from sliding into a decline that threatens its existence. While advances in modern science and engineering have nearly doubled our lifespans in only four generations, our quality of life has not reached its full potential. We need radical change towards true preventative medicine that goes well beyond screening and public health programs.
The Emerging field of Functional Medicine, as practiced by a growing core of advanced clinicians, including here at Helix House, seeks to pinpoint and prevent the cause of illness, rather than treat its symptoms. What is Functional Medicine you may ask and surely it is no different from the prevailing medical model?
Functional Medicine, like Professional Applied Kinesiology and Osteopathy which share many of the key principles, is an integrative, science-based healthcare approach that treats illness and promotes wellness by focusing on the bio-chemically unique aspects of each patient, and then individually tailoring interventions to restore physiological, psychological, and structural balance.
Functional Medicine focuses on understanding the fundamental physiological processes, the environmental inputs, and the genetic predispositions that influence health and disease so that interventions are focused on treating the cause of the problem, not just masking the symptoms.
There are seven basic principles underlying functional medicine which include the following:
- Science-based medicine that connects the emerging research base to clinical practice.
- Biochemical individuality based on genetic and environmental uniqueness.
- Patient-centered care rather than disease-focused treatment.
- Dynamic balance of internal and external factors that affect total functioning.
- Web-like interconnections among the body's physiological processes also affect every aspect of functionality.
- Health as a positive vitality, not merely the absence of disease.
- Promotion of organ reserve.
Managing chronic diseases accounts for three quarters of our total healthcare costs, because too often we’re masking these illnesses with palliative pills and temporary treatments, rather than addressing their underlying causes. Worse, only treating symptoms leads us down the path of further illness. But with all the public discussion of the funding of the NHS, such issues are, almost never, publicly aired despite the frustrations of many well-meaning clinicians within and outside the NHS..
At one stage, governments tended to consider matters of health and disease were the concern of the individual.
‘The Great Stink’ might be seen as one landmark in our slow progress towards communal care of our health and the realization that serious public investment in infrastructure was equal or more important, than the medical treatment of disease. It was the summer of 1858 during which the smell of untreated human waste was so strong in London that the huge task of building the London sewers was taken on for the benefit of all. Gradually over the next ninety years more and more efforts were made to invest publicly in fighting disease culminating in the founding of the National Health Service on July 5th 1948.
The modern health challenges we now face as a society are both societal and individual, as a recent study by the Institute of Primary Care and Public Health show. Lead by Professor Peter Elwood, of the Cochrane Institute, Cardiff University, Healthy Living: Healthy Ageing, known as, The 30-year Caerphilly Cohort Study, was a long-term study of a large representative sample of men.
A number of ‘healthy’ behaviors were defined: non-smoking; a low BMI; regular exercise; a plant-based diet and alcohol consumption within the guidelines. Combinations of these behaviors were referred to as ‘healthy lifestyles’. In this paper the health benefits of a healthy lifestyle were examined and some interesting findings were discovered. As they say in the report;
“It is my decision whether or not I smoke, what body weight I maintain, whether or not I exercise regularly, what diet I take and how much I drink”.
All perfectly true and yet since these five healthy life style choices were chosen for the study thirty years ago, we know a lot more about, for example, the influence of social relations and social inequality on survival. Good, supportive social relations alone are at least as important as that of smoking, and much more important than heavy drinking, physical activity or obesity. So do get out there and talk to your friends and make some more!
Higher levels of income inequality damage the social fabric that contributes so much to healthy societies and can, sometimes, militate against good social relations. Now, a major new review of the evidence from almost 150 studies confirms the important influence of social relationships on health. People with stronger social relationships were half as likely to die during a study's period of follow-up as those with weaker social ties.
As the work of epidemiologists Richard Wilkinson and Kate Pickett have shown, in their brilliant book, The Spirit Level, first published in 2009;
“The weight of the evidence, and its continued rapid accumulation, make the important link between income inequality and social dysfunction inescapable”.
When discussing some of the more disingenuous criticisms of their work on equality, Wilkinson and Pickett point out in a recent article New Statesman | Yes, we are all in this together;
"In their book Merchants of Doubt, the American academics Naomi Oreskes and Erik Conway suggest that the defense of a kind of free-market fundamentalism is the most plausible explanation of why the same individuals and institutions are often involved in attacks on research in areas as diverse as tobacco control and the evidence on climate change".
You could add to this, without any criticism of good drugs and surgery medicine, the tedious attacks on all kinds of non-drug based medicine, whether they are osteopathic, acupuncture or functional medicine. The same coterie of dodgy, obtuse scientists and mendacious journalists can usually be found to have links back to the vast corruption and multi-layered conflict of interest between the practices of medicine, medical science and the $1.3 trillion drug industry.
The Caerphilly Cohort Study showed how extraordinary changes in disease rates and life expectancy can occur if individuals can just follow five, basic, healthy life choices, they found;
“Few men in our cohort followed all five behaviors, but in those who consistently followed a lifestyle which included four or five healthy behaviors experienced reductions, on average, of about 73% in new cases of Type 2 diabetes, similar reductions in heart disease and stroke, and, most remarkable of all, about 64% less dementia! Non-smoking was associated with a reduction in cancer of 39%”.
However, sadly, in the study it was also found that despite the expenditure of £280M/year on Public Health and Health Promotion in Wales in recent years, there has been virtually no change in healthy living over 30 years! As Wilkinson and Pickett show, across whole populations, rates of mental illness are five times higher in the most unequal compared to the least unequal societies. Similarly, in more unequal societies people are five times as likely to be imprisoned, six times as likely to be clinically obese, and murder rates may be many times higher.
“In a recent survey of 15,000 adult subjects in Wales, 19% of adults reported that they were following three healthy behaviors, 7% were following four and only 0.5% were following a lifestyle based on all five behaviors. Thirty years previously, when the Caerphilly Cohort Study was set up, the proportions had been almost identical (19%; 5% and 0.1%). Similar findings have been reported from studies of workers in healthcare (!) in the USA, and though better, the proportion following all five behaviors was reported to be only about 3%”.
So to conclude, we have to see changes both in individual behavior and find ways of organizing society towards greater equality. Reigning in the destructive food, alcohol, drug and tobacco industries as well as building better and more houses and encouraging good jobs.
We find ourselves with our own 21st century Big Stink!
As Wilkinson and Pickett show, see diagram, Social problems are closely linked with inequality amongst rich countries, and this is not just bad for the poor but bad for everyone. Our own malodorous predicament consists in wealthy, advanced societies with growing, destructive inequalities within, and equally huge and dangerous inequalities without.
These pernicious global inequalities suck young, desperate, individuals to risk all on treks across the Sahara or dangerous boat trips to reach the shores of richer, freer countries. While many in those advanced countries squeal at the incomes, they often fail to identify or act on the vast and growing underlying internal and external inequalities driving such epic migrations and the social anxiety and conflict such, too rapid and dramatic, upheavals, naturally tend to generate.
The challenge remains. Poverty, culture and inequality strongly militate against building the kind of society that can protect us from our own poor choices in matters of health. The world has recently tipped over to one where there are more people living in cities than on the land and more suffering from the effects of obesity than starvation. Babies born today can expect to live in a global world of three or four billion more people.
What was once the skewed, lifestyle-driven, sickness of the rich world is now rapidly plaguing the developing world. There are still enough medical mysteries out there without the majority of us killing ourselves, voluntarily, long before out time, with our own destructive personal and political choices.
Let us end this month by giving the final words to Wilkinson & Pickett;
“The health of our democracies, our societies and their people, is truly dependent on greater equality”.