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Controlling Health's Destiny

Recent research shows that people can lower their chances of developing an array of chronic illnesses by taking simple, proactive measures.

By ARICKA FLOWERS

Diabetes. Cancer. Heart disease. Stroke. These diseases are among the most common killers in America, but health officials say this doesn't have to be the case. Recent research shows that people can lower their chances of developing an array of chronic illnesses by taking simple, proactive measures.

"Seven of 10 Americans who die each year die of a chronic illness," cited U.S. Surgeon General Vice Admiral Richard Carmona, M.D., M.P.H, F.A.C.S., in a 2003 speech to the National Recreation and Park Association. "Most of these diseases are preventable by following relatively simple steps: healthy eating, being physically active and not smoking."

Tobacco use still reigns as the leading cause of cancer in the United States. According to the surgeon general, more than $75 billion dollars is spent each year in direct medical costs due to tobacco-related illnesses. Tobacco also accounts for about 440,000 deaths annually.

Carmona has launched an attack on tobacco use by applauding corporate and local government attempts to ban smoking in public areas. In August, he commended Pizza Hut and KFC's declaration to shut down smoking areas in their restaurants.

"The toxins in cigarette smoke go everywhere the blood flows," Carmona stated last summer. "An estimated $92 billion in productivity losses occur annually from deaths due to smoking; and when combined with [the] billions in medical-related expenditures, the total economic toll exceeds $167 billion each year in the United States."

What is most disturbing is that tobacco use is not the only destructive behavior many Americans have developed. Illnesses related to obesity are quickly becoming the number two cause of death in America.

"More than 300,000 Americans will die this year alone from heart disease, diabetes and other illnesses related to obesity," says Surgeon General Carmona. "The good news is that obesity and its co-morbidities are preventable through healthy eating, nutritious foods in appropriate amounts and physical activity. The bad news is Americans are not taking steps to prevent obesity and its co-morbidities."

Americans may not realize the impact their behavior has on their health because of the less than aggressive approach Western medicine has taken in prevention. According to former U.S. Health and Human Services Secretary Tommy Thompson, of the $1.4 trillion America spends on direct medical services, only 5 percent goes towards preventative education and measures.

Dr. Samuel Epstein, emeritus professor at the School of Public Health at the University of Illinois at Chicago, chairman of the Cancer Prevention Coalition and author of the new book Cancer-Gate: How to Win the Losing Cancer War, says the amount of money health organizations allocate for preventative funding directly affects the way Americans respond to their doctors' pleas for them to exercise and eat right.

"It seems that we are losing a winnable war against cancer," Epstein says. "One must point out that the National Cancer Institute and the American Cancer Society are focused on telling people to stop drinking and to start exercising and eat right in order to help themselves stay healthy. But less than 4 percent of their money goes towards prevention other than the lifestyle faction. These organizations are fixated on damage control, screenings, diagnosis, treatment and treatment-related research with indifference to prevention."

This means that the constant barrage of messages to exercise and maintain a healthy diet is simply not enough. It's evident in the case of cancer. After years of prodding by health advocates, the government began informing the public about tobacco's health hazards. Eventually the tobacco industry was forced to disclose that information, as well, causing a number of smokers to put out their cigarette butts for good. Although the percentage of men with lung cancer has decreased, the overall national cancer rate has not decreased. This is because some cancer rates have more than doubled in the last few decades. The National Institute of Health reports that childhood cancers increased a whopping 70 percent between 1975 and 2002. Brain cancer increased by 50 percent and adult leukemia jumped by 60 percent during the same time span.

"What one has seen is a national escalation in the incidence of non-smoking cancer," says Epstein. "If you plot the overall increase in the incidence of cancer on a graph and relate it to the budget of the National Cancer Institute, which went up thirtyfold since the Nixon administration, you would see a parallelism between the increase in the budget and an increase in the incidence of cancer. So that means the more money you spend, the more cancer you get. Those results can only be attributed to the lackadaisical attitude towards prevention."

The U.S. surgeon general seems to think this blas? attitude may be a fundamental problem in American medicine. "There is no greater imperative in American health care than switching from a treatment-oriented society to a prevention-oriented society," declares Carmona.

Why have aggressive prevention measures been nearly non-existent in past? Epstein says it has everything to do with who's heading the organizations and committees that allocate funds to prevention research.

"When you look more deeply at the claims of success in prevention, it's difficult to say that we are not dealing with conflicts of interest," he says. "When President Nixon declared a war on cancer in 1974, he appointed a cancer panel of outsiders to determine cancer policy for the National Cancer Institute. In the 1970s, the president of the panel was Benno Schmidt, an investment banker. But he was more interested in promoting pharmaceutical drugs with no real interest in prevention."

If you look at the history of those who have led the national disease foundations and institutes, an apathetic attitude towards prevention tends to be the status quo. The National Cancer Institute continued to be influenced by officials who had either personal or professional stock in petroleum, pharmaceutical companies and even tobacco. For example, from 1998 to 2002, the American Cancer Society's public relations firm, Shandwick International, represented tobacco giant R.J. Reynolds. Meanwhile, the American Cancer Society receives thousands of dollars a year in donations from corporations like DuPont, British Petroleum, industrial waste companies, pharmaceutical and various cosmetic companies. Many health advocates say the corporate world's willingness to open their checkbooks is nothing more than a ploy to lobby politicians and the medical community in order to keep the laws that affect them in a lax state. Epstein says this has everything to do with where the money goes and what these organizations tout as victories in preventative medicine.

"The National Cancer Institute and the American Cancer Society have never provided the public with information on the health impact of chemicals in food, household and cosmetic products, the environment, air or water," Epstein laments. "The mindset to ignore the dissemination of such information is [perpetuated] by longstanding institutional and personal double standards. If you look at cancer mortality rates and the more than $30 billion dollars that have been spent on the illness over the last 30 years, you will notice no overall improvement in the saving of lives. The overall mortality rate has barely changed over the last 30 years. So we see a massive escalation in spending and static mortality rates.

"We haven't seen much by way of advances in treatment either," Epstein goes on to say. "The most resources for cancer research are spent on promoting ineffective drugs for terminal disease. There are a periodic series of claims by the National Cancer Institute that they are making progress and seeing remarkable strides in treatment, but none of these claims have shown any real success. For example, there is no evidence of any real benefit of chemotherapy in advanced cases."

Meanwhile, less that one-tenth of a percent of the money spent on total cancer research is geared towards investigating environmental causes. This is alarming when research has shown that air pollutants, bad drinking water, pesticide-contaminated crops and livestock, exposure to other chemicals like cadmium and lead and a host of other environmental causes have been attributed to the incidence of not only cancer but a slew of other serious diseases like asthma, heart disease, lead disease and even birth defects.

Since the beginning of his tenure in 2003, Carmona has continued to emphasize the importance of screenings and personal responsibility when it comes to achieving and maintaining good health. He also mentions oral care when touting the importance of prevention.

"The prevention message we've been emphasizing all over America is as applicable for ensuring oral health as it is for avoiding chronic conditions," states Carmona.

"American students miss millions of hours of school and adults miss millions of hours of work each year due to dental disease," says Carmona. "By improving our nation's oral health, we improve our nation's overall health."

Although dental care doesn't usually come to mind when thinking about national medical expenditures, oral services accounted for more than $70 billion in 2002, according to the Department of Health and Human Services. That figure doesn't account for services rendered by other health care providers or other expenses incurred by treating conditions caused, indirectly, by poor oral health.

Healthy People 2010 is a nationwide initiative aimed at improving the nation's overall health by the end of the 21st century's first decade. This plan is a carry-over from the Healthy People 2000 initiative, which hoped to attain the same goal ten years earlier.

Healthy People 2010 analyzes information from recent studies, as well as older ones, and attempts to determine and suggest health guidelines that not only prevent some illnesses, but also promote early detection and save lives. A much more sedentary lifestyle combined with poor eating habits and smoking contribute to the causes of the sharp spike in deaths due to heart disease and cancer between 1900 and 1997, both of which increased more than fivefold.

The initiative's information places the deterioration of the nation's health squarely upon the shoulders of the individuals who make up the population. But, at the end of the day, a combination of personal accountability and governmental intervention are both essential if we are to beat these diseases. Keeping toxic substances out of our food, air and water fall under the responsibility of our government. The public must be educated about carcinogens in consumer products and the workplace.

"The United States is losing the fight against cancer because of the indifference and low priority that is directed towards prevention," says Epstein. "There can really be no progress in incidence or mortality until it gets the attention it deserves."

As the surgeon general continues to trumpet the benefits of Healthy People 2010, the public must do its part to become healthier through conscientious eating, avoiding tobacco, exercising, regular health exams and recommended screenings, and keeping track of their family's medical history.

The Woman's Guide for Tests and Screenings

It's imperative for people to have the recommended health screenings for their age group in order to assure that they will, more than likely, continue enjoying good health.

Although women and men share many of the same screenings in their age group, there are a number of screenings that are designed specifically for each sex. Here's a look at what women should be screening themselves for at each decade of life:

In the 20s:

  • annual check-up that includes blood pressure along with a screening for digestive track problems by way of a fecal occult blood test
  • a screening for sexually transmitted diseases if they have more than one partner and/or are engaging in unprotected sex
  • a chicken pox vaccination, if they've never had the chicken pox, and a tetanus booster
  • an annual dental check-up and cleanings every 6 months
  • a skin exam for those who are fair-skinned or have a family history of skin cancer
  • an annual BMI test to determine the patient's chances of developing heart disease or stroke
  • annual PAP smear and pelvic exam to screen for uterine, ovarian and cervical cancers as well as a clinical breast exam (women should be performing their own breast self-exams each month)

In the 30s:

  • cholesterol screening to determine risk for heart disease; if the results come back negative, the test should be repeated every 5 years
  • continue to have all the recommended screenings they should have began in their 20s

In the 40s:

  • echocardiogram, or stress test, to determine the patient's heart health
  • annual eye exam to screen for glaucoma
  • annual mammogram for early detection of breast cancer
  • continue to have all the recommended screenings they should have began in their 20s and 30s

In the 50s and older:

  • colonoscopy every five years to screen for colon and rectal cancer
  • bone density scan to determine risk for osteoporosis; those at lower-risk can start at age 65
  • continue to have all the recommended screenings they should have began in their 20s, 30s and 40s

Although this guide is a great start towards maintaining good health, it is in no way the final say in the number of screenings you should get each year. Your individual health care provider can help you set up a personal plan of action that takes into account the medical history of both you and your family.

A Man's Guide for Tests and Screenings

We've all heard the stories. You know, the ones where doctors diagnose a lethal or terminal illness just in the nick of time. Where a typical trip to the doctor's office for routine tests winds up uncovering a dangerously clogged artery or a colon polyp that, prior to its discovery, caused the patient little to no problems. So just what are these life-saving routine tests? Health officials recommend that all patients have their doctors perform health screenings that are appropriate for their age group and gender.

Here's a look at what men should be screening themselves for at each decade of life:

In the 20s:

  • annual check-up that includes blood pressure along with a screening for digestive track problems by way of a fecal occult blood test
  • a screening for sexually transmitted diseases if they have more than one partner and/or are engaging in unprotected sex
  • a chicken pox vaccination, if they've never had the chicken pox, and a tetanus booster
  • an annual dental check-up and cleanings every 6 months? a skin exam for those who are fair-skinned or have a family history of skin cancer
  • an annual BMI test to determine the patients chances of developing heart disease or stroke
  • at least annual testicular self-exams to detect early signs of cancer

In the 30s:

  • cholesterol screening to determine risk for heart disease; if the results come back negative, the test should be repeated every 5 years
  • continue to have all the recommended screenings they should have began in their 20s

In the 40s:

  • echocardiogram, or stress test, to determine the patient's heart health
  • annual eye exam to screen for glaucoma
  • annual prostate-specific antigen, or PSA, for all African-American men and Caucasians with a history of prostate cancer
  • continue to have all the recommended screenings they should have began in their 20s and 30s

In the 50s and older:

  • colonoscopy every five years to screen for colon and rectal cancer
  • annual rectal exam
  • all men should start having the prostate-specific Antigen, or PSA, annually
  • continue to have all the recommended screenings they should have began in their 20s, 30s and 40s

Though this guide is a timeline of screenings that the majority of doctors would recommend, this is in no way the final say in the number of screenings you should get each year. Your individual health care provider can help you set up a personal plan of action that takes into account the medical history of both you and your family.--Aricka Flowers

Published: October 01, 2005
Issue: November 2005