Spending, Countries, Habitat and Health

Without health it is difficult to have fun, pleasure, wealth, freedom and drive for reason and responsibility. At times in pursuit of above mentioned things we lose our focus on health and lose health! This is true at individual and country level.

Which country has the best health care system?
Does spending more on healthcare ensure better health?
What is the optimum funding for healthcare?
How health is a linear and non-linear function?

The above questions require research and data collection and analysis. And it will always be a work in progress. Three articles published in Lancet throw some light and make us ponder on health.

Wealth But Not Health In USA The article speaks about the now well known fact that US spends more on health care per person than other G7 countries.
Americans especially American women are having declining health for 30 years.  Americans fare badly not only at life span but also at infant mortality, low birth weight, injuries and homicides, teenage pregnancies and sexually transmitted infections, drug-related deaths!, obesity, diabetes and heart disease, chronic lung disease, HIV/AIDS prevalence.  The data if segregated according to region and economic level will be more revealing about the disparity in health condition.
I suspect there is a great inequality in health care access and outcome within US. This despite the fact that US spends 18% of its GDP on health. The leading European countries range between 9.5 to 12 %. And they have better metrics to show. One thing which i dare to conclude without digging into the data  is that probably the level of inequality is less as of today. It will be interesting to note the metrics 5 and 10 years from now as austerity measures get implemented.

Cuba spends on healthcare and has results to show for it also.

What are the lessons for other countries? What model should one follow? How should the government intervene or give incentives for better health. This especially true for young nations like India and China which will have its major population moving above 50 years in coming decade or two.

The Lancet article mentions the following remedies for US.

"Why are Americans at a health disadvantage compared with those in other countries? The fragmented US health-care system, and, in particular, poor access to health care and to primary care, are partly to blame. Lack of insurance, or inadequate insurance, restricts access to health care for many Americans. But the system is not the only problem. Unhealthy behaviours abound in the USA, particularly overeating, drug abuse, and other risk-taking activities such as not wearing motorcycle helmets, drinking and driving, and using firearms. Social and economic conditions in the USA contribute to high incomes for some, but to high poverty and income inequality for others, and to low standards of education. Welfare safety nets are not as robust as they are in other countries. Moreover, cities in the USA are often built around car use, which discourages physical activity and contributes to obesity."

Also it seeks implementation of National Prevention Strategy.

The report mentions the following things:


The Strategy’s seven Priorities are designed to improve health and 
wellness for the entire U.S. population, including those groups 
disproportionately affected by disease and injury. 
• Tobacco Free Living
• Preventing Drug Abuse and Excessive Alcohol Use 
• Healthy Eating
• Active Living
• Injury and Violence Free Living
• Reproductive and Sexual Health
• Mental and Emotional Well-Being


My opinion:

1. Behaviors are difficult to change. People who fight fires are normally the heroes and not the one's who prevent fires! We need to glorify fire prev-enters.
2. Corporate's, government, schools, colleges should stress on healthy living. Incentives and recognition should be given to healthy people. Ideal Blood pressure individuals in different age groups, Best Glycemic control in a particular quarter, Best Aerobic capacity person, etc etc.
3. Role of viruses in causing infections, chronic diseases and cancers should be highlighted. Vaccinations should be explained.

We need not have to wait to implement these strategies in Emerging Countries. Every nation stands to benefit by rewarding healthy living.

Other articles to read:
1. Guardian
2. UC Atlas
3. PBS Newshour-How US Compares

A slightly different view!

So what are you going to do to stay healthy?

Smoking!

We all know that smoking is injurious to health. But we find it difficult to quantify it. Also the observational bias impairs our ability to assess the damage caused by smoking. People who are dead because of smoking are never gonna come and tell us they dies of smoking. Also we do not see them at work place or parties. The people young and old whom we are are the one who smoke and are still attending parties or working!! This erroneously tricks us into a false sense of security. Our brain comes to conclusion that smoking may not be that harmful or that it selectively harms and I am not one of them.
Science/research can help/aid us to see things clearly.
Smoking affects both men and women. The data for females has matured late. A paper published in lancet documents the ill effects well. Without going into the statistics or much into the data, let me give only the conclusion here..

Among UK women, two-thirds of all deaths of smokers in their 50s, 60s, and 70s are caused by smoking; smokers lose at least 10 years of lifespan. Although the hazards of smoking until age 40 years and then stopping are substantial, the hazards of continuing are ten times greater. Stopping before age 40 years (and preferably well before age 40 years) avoids more than 90% of the excess mortality caused by continuing smoking; stopping before age 30 years avoids more than 97% of it.

Wish everyone healthy living!