Why is the US so unhealthy? Part II

Continuing on from the last post on health, the next most important factors are probably alcohol consumption and smoking.  Does anyone think that these things are good for you?

 Well, in moderate amounts, alcohol appears to have some benefits including: increase to longevity; lower chance of cardiovascular disease; reduce risk of stroke; less likelihood of contracting Type II diabetes; and other benefits.  This article has a more complete list along with extensive references.  Not every doctor and researcher agrees with this advice, but these benefits only accrue with moderate drinking (1/day for women and 1-2/day for men).  This article from WebMD suggests that any amount of drinking raises the risks of certain types of cancer, especially if you already have other risk factors

But if you drink more than a moderate amount your chances of death increase.  There are approximately 79,000 deaths a year attributed to excessive alcohol use making it the 3^rd leading lifestyle-related cause of death.  Here is the CDC fact sheet on alcohol use.  It is important to understand if you use alcohol moderately, you are abusing it, or if you suffer from alcoholism.  Use this guideline to see if you have a problem.

It is up to each individual to determine if they can benefit from alcohol consumption since it is a major part of many lifestyles and cultural events.  Personally, I don’t think that the benefits outweigh the detriments.  It is expensive, adds calories and increases the odds that you will eat more, is linked to several diseases, and  increases the chances of having an accident (not just in a vehicle).  On the benefit side, my family already lives into their 80s and has an extremely low rate of cancer and heart disease.  So, all-in-all I think that I am better off not drinking, but you decide for yourself.

On to smoking.  I couldn’t find any current source that suggested that smoking was good for your health, unlike the advertisements in the 1920s through the 1950s.  Here is a retrospective article from Time magazine that is amusing in light of our current knowledge.  I don’t really see the point in elaborating on this particular topic.  It’s bad for your health and that of those around you – stop doing it.

The last major area of health improvement includes several small items that individually contribute little, but together can increase overall health; several of which were mentioned in this link from my previous post.

• Retirement, before age 65 anyway, seems to lower longevity by a fair amount.  It is not clear why this is, and more research is needed, but this article has some interesting facts.

• Flossing you teeth would seem to have little effect on your overall health, but some recent research shows that to be untrue.  Heart disease, arterial plaque, and even diabetes have been linked to the same bacterium that causes gingivitis.  So not only can you save your smile, not have to worry about your dentures falling out, but also save your life by flossing every day.

• Sleeping enough has been linked to weight gain, high blood pressure, and decreases the effectiveness of your immune system (and you are grumpier).  The National Highway Traffic Safety Administration estimates that sleep deprivation is responsible for 100,000 car crashes each year.  Work-place accidents are as much as twice as common with poor sleep habits.

• Stress, especially in today’s fast-paced environment, can have a huge impact on your health.  The causes of stress or myriad, but the effects on the body are the same as our flight-or-fight reflexes.  In this state the body increases adrenaline and cortisol which ups heart rate, blood pressure, blood sugar; all of benefit if you need to run away from a threat, but much lees beneficial in a meeting.  Stress increases your risk of other problems and makes ones you already have worse.  It has been linked to heart disease, depression, gastrointestinal ailments, and memory impairment.  Here are some ways to manage your stress.

• Social interactions have been shown to increase your life span and reduce the incidence of depression.  The reasons for this are not clear, but considering that humans are social animals, it stands to reason that we need to interact with others.  Read more about that here.

 

None of these things are going to let you live forever, but combined they may extend your life, and the quality of your life, quite a bit.  My main point about staying healthy was to decrease medical costs, and most of the things I have described are cheap or free.  If everyone does what they can to lower their own healthcare costs then shouldn’t market forces drive down the costs of doctors, hospitals, and insurance?  Even if it doesn’t, it still seems like a worthwhile effort.

Why is the US so unhealthy? Part I

In my second post I was complaining about cost of health care in the US, which is ridiculously high.  My goal was to point out that as a component of the overall healthcare costs our personal choices play a large part.  To be sure, insurance, pharmaceuticals, hospitals (and doctors), and lawyers all have portions of the blame, some much higher than others.  But it is my opinion that the single most important thing a person can do to keep their own healthcare costs down is to stay healthy.  It is understood that many people have medical issues over which they have little control, but it is also true that in many cases they would be of less impact, or more easily manageable, if those people had better overall health.

None of this is rocket science – the basics are pretty simple – doctors and scientists have been saying these same things for over 50 years.  Diet and exercise is number one, followed by moderation of alcohol and no smoking, finished with things like flossing, sleeping, and sunscreen.  Ultimately though, every person is completely responsible for their own health, with advice provided by doctors, nutritionists, etc.  

Be more informed and be healthier.

People lived healthy, happy lives long before we had MRIs, advanced drugs, or arthroscopic surgery, and for the most part so can we.  Certainly we have a better chance of living into our 90s now than they did 200 years ago, and infant mortality has dropped, in most first-world countries, to near zero, but a lot of people lived a lot of years without extensive, expensive medical care.  It almost seems like the medico-legal-pharmaceutical complex is forcing us to be sicker so that they can rush to the rescue (or in the case of lawyers, rush to court).

There is a lot, perhaps too much, information available today on how to live a healthy lifestyle.  Given this over-abundance, how can you know what is the most important?  Read everything you can find and consider whether it makes sense to you.  I am including several web sites that I think have interesting and important material, but it is up to you to understand what information is most beneficial to you.  This first one is a very general guide of dos and don’ts.

First, and perhaps most important to good health, is proper nutrition.  Certainly, you should eat enough but not too much, of the right foods in the correct proportions, to stay healthy.  Fast, or processed, foods are one of the worst things we have ever devised.  Now don’t get me wrong, I have eaten, and still occasionally eat, fast food.  But over the last several years I have tried to cut back on this habit and have seen dramatic weight loss and overall health increase.  I have long had the opinion that if you could see how our ancient ancestors lived, and how and what they ate, you could learn a lot.

This article very closely matches my thoughts on how we have evolved to process different foods, and added some to my understanding of why we seems to have problems with processed foods – even bread is a processed food.

The gist of the article is that for several hundred-thousand years we lived as hunter-gatherers (HG), and have adapted to those kinds of foods that were available in that style of living.  The cooking of food started long enough ago that we have adapted to it, but it still seems that the less we cook the better off we are.  Harvested grain consumption was a relatively recent change to our diet which is why there are problems with it, although this is a somewhat new theory.  Dr. Oz has gone so far as to compare highly processed carbohydrates to cocaine, both in its addictiveness and in its damage to the body.

So we have natural foods, processed as little as possible, which should be eaten in moderation; no binging and no starving.  In fact, recent studies have suggested that eating less per meal and increasing meal numbers is better overall for health.  This aligns nicely with the HG lifestyle; snacking on fruits, nuts, seeds, and perhaps fresh vegetables while on the hunt.

Along with the types of food, the quantities of it, and the frequency of eating, I want to add drinking water.  Everyone has heard that you should drink 8 glasses of 8 ounces of water every day, but there is some controversy surrounding this advice.  I personally think that this is good advice and try and follow it, but each person has to decide for themselves.  Additionally, the consumption of caffeinated, highly sugared, or alcohol-added drinks frequently cause the body to lose more water.  At any rate, here is an article listing the benefits and has recommendations – as always, decide for yourself.

The second major health style concern is exercise.  Imagine how fit you would be if you had to chase down your food every day, or gather all of the fruits and vegetables you need.  Even as recently as 100 years ago, it appears that farmers and ranchers were generally healthier than the average person today.  How could anyone not see that the more active you are the better your overall health would be?

How much exercise is enough is a highly debated number, which depends on several factors including but not limited to: current and optimum weight; amount of activity during work hours; physical and medical conditions; etc.  I think that it is obvious from looking at statistics collected by experts, that we as a nation don’t get enough exercise.  But many of those experts have arrived at some guidelines for, if not preparing for a triathlon, at least maintaining general fitness.  So somewhere between 30 and 90 minutes per day seems to be the right amount.

I think that this is one of the things that each person has to determine for themselves.  If you are exercising at some specific level and duration, and you feel good, aren’t gaining or losing weight (unless that is your goal), then you are probably getting enough.  But keep in mind that if you perform exactly the same exercises every day, your body will become accustomed to it and, over time, you will not be gaining as much benefit.  Many fitness experts suggest that you vary the type of exercise that you do over some schedule, for instance: hiking or biking alternated with weight lifting or resistance exercises (which is what I do).  The combination of cardiovascular exercise and some amount of weight or resistance training seems to have the most long-term health benefits.  I like this article on principles and techniques of resistance training.

Let’s again imagine our ancestors, climbing hills, running after prey, throwing rocks or sticks, or beating an animal to death, every day of their lives.  We clearly don’t get enough exercise.  I will continue on this thought tomorrow.

Why is insurance so expensive? Or, where does all of the money go part 2.

I don’t think that anyone will argue that insurance is expensive.  The idea of insuring something is not new; the Chinese understood the concept as much as 4,000 years ago, the Babylonians codified it in 1750BC as part of the Code of Hammurabi, and Benjamin Franklin helped to popularize and standardize property insurance in the 1750s. 

The insurance business has (probably) always had a companion industry – insurance fraud.  It is estimated that over $30 billion dollars are lost every year due to either hard fraud, which is a fabricated claim or a fake injury, or soft fraud, occurring when claims are padded or businesses misrepresent work done to get lower premiums.  All of this costs the average, honest person by the overall rise in premiums to offset the losses.  Now, assuming that every US citizen is paying for their own insurance, this would cost an extra $100 per person per year.  Since we know that not everyone has, or can afford, insurance it is much higher.  Here are six humorous but, poor attempts at fraud brought to you from Cracked.com.  Here is an article explaining the different forms of insurance fraud.  If everyone worked together to help stop fraud we would all benefit from lower premiums.

I no longer think that the insurance industry, as a whole, is evil, but I also don’t think that they ignore the opportunity to make the most money possible.  It seems like the different plans are overly complicated with; deductibles, co-pays, out-of-pocket expenses, coinsurance; and different plans for health, vision, dental just to name a few health related items.  It gets even more complicated when you add in life, disability, home, auto, renter, and probably ten more areas that I can’t imagine. 

Another issue I see is that you don’t really have the right choices available when you go to purchase your insurance.  It seems more like a fast-food franchise instead of a nice restaurant, where you have to order a number 2 and you don’t get to add onions or leave off the mayo.  Or, another analogy might be cable packages, which have never made sense to me – why can’t I just get the exact channels I want?  Who makes up those packages?

[/Rant] Another insurance area that I have never understood is the various disaster policies.  It must be horrible to have your home, car, possessions all destroyed by a hurricane.  I have friends and family that were affected by Katrina and Rita, so I know it can be bad.  But, no one forces people to live on the coast, they choose to do so.  It seems unfair, to me, that my insurance rates are increased to help pay for replacing all of those homes and businesses, right where there is likely to be another hurricane in just a few years.  The same thing goes for people living in the flood plain of a major river.  I can see why it is attractive for farmers – the soil is rich BECAUSE it is on a flood plain.  Don’t get me started on people buying mobile homes in Oklahoma! [/Rant]

But what can we do?  Although it is possible to live without insurance it is a huge risk.  A single hospital stay can devastate your finances, the loss of transportation can mean the difference between having a job and not, and losing your home...

Most of the experts suggest that if possible, shopping around for the best deal can save money.  Although this is not as easy for health insurance, it is possible to do for home and auto policies.  Many of the larger companies offer reductions for coverage on home and auto bundled together.  For those people who don’t have health coverage through their employer, you can save a lot by getting exactly the coverage you need based on your current health and lifestyle.  This link has some articles describing what some of your options are.

In the auto insurance world there are more choices, but the buyer needs to know some basics about the kind of coverage they will need.  This WSJ article has some information and links that will help fill in the blanks.  There is more info and some suggestions for lowering your auto insurance expenses in this CBS News article.  If you are interested in finding out how much money you could save every year by NOT owning a car, see this calculator based on Bureau of Labor Statistics data.  Most people need a vehicle so it makes sense to buy one that costs as little to insure as possible.  This Kiplinger article lists the top ten (or bottom ten) choices for 2011.  There is also a link to older cars.

With home insurance costs can also be lowered by a number of factors described in this article from the Insurance Information Institute.

To summarize:

• Protect yourself and others by reporting fraud
• If possible, shop around for the best policy for your needs
• Bundle home and auto insurance
• Prepare for home or auto purchases with insurance in mind