Demystifying Medicine One Month at a Time

Category: mental health (Page 2 of 2)

Column Laurel

Good news dept:

2016-Column-Contest-560x469Dear loyal GlassHospital readers–

GlassHospital was recently recognized by the National Society of Newspaper Columnists as a finalist for columnist of the year in the Online, Blog, and Multimedia Category with >100,000 readers. This is for work published on the world’s best health care site, NPR’s Shots blog [to which I attribute such high readership — you loyalists on this site are in much more select company].

I was awarded third place, behind a Reuters columnist who works to bring broader understanding of Islam to a large general readership, and a columnist from The Street who writes frequently to expose scams and complicated investment schemes that over-promise and under-deliver. Given all that’s going on in the news cycles of late, I think this makes perfect cosmic sense.

I do my best to share NPR work on this site to attract you over there, but if you’re interested in the columns for which I won the award, links to them are below.

  1. From August 2015 — Suicide: not a natural cause of death
  2. From April 2015 — How should we educate 21st century doctors?
  3. From September 2015 — For older folks, pruning back prescriptions can bring better health

Thanks for reading!

‘100% Meat and Meat Byproducts’

This week I was reminded of ALPO dog food commercials of my youth, in which cowboy-turned-space captain Lorne Greene assured us the product was “100% meat and meat by-products.”


Two concurrent news stories brought that haunting phrase back to me:

  1. The revelation that two escaped convicts had tools (hacksaw blades) smuggled to them inside packages of meat.
  2. The story about Chinese authorities cracking down on a meat smuggling ring involving tons of 40 year-old meat that had been frozen, thawed, and re-frozen dozens of times.

Really ew.

rainbow white houseSupreme-Court-Saved-Obama-Care-Once-Again-6I agree with the correspondent who wrote: “…countless people [will be] forced to ponder the benefits of vegetarianism…”

Oh: And if you’re not that ‘into’ current events, just know that this week the arc of the moral universe of the United States of America bent sharply towards justice.

What Really Makes People Sick

Medical science has evolved rapidly. With the newest computing and laboratory technologies, the pace of knowledge generation only increases. Our biggest challenge today is in processing data, and finding the patterns within that can unlock more secrets of life and health.

sep2011_AWSI_03 bigPublic health improvements in the 20th century like sewer systems and a clean water supply, coupled with childhood vaccinations and the advent of antibiotics radically increased the human life span to its all time high–roughly 80 years for men and women in the ‘industrialized’ western world.

Some in the scientific community think an achievable human life span is closer to 120 years; that if we can alter some of the problems caused by senescence and aging, more of us will live past 100. It’s at about 120 years that current science guesses that cellular and tissue breakdown is genetically programmed to occur to such an extent that further life as we know it is near impossible.

As the list of causes of death in the U.S. has changed dramatically over the 20th century, you can now see that much of what kills us is chronic disease. Interestingly, our ability to make inroads on this list has not been as successful as it was in fighting the original infectious causes of death. We manage chronic conditions like diabetes, heart disease and cancer; very rarely do we cure them. This despite a nearly half century “war on cancer” and billions of dollars spent on research and development in heart disease.

What we’ve come to understand in the medical world, by listening to our social science colleagues, is that social factors have a profound impact on our health — such that the World Health Organization estimates that medical care (over which we spend $3 trillion annually in the U.S.) only impacts about 10% of our health. It’s the social (non-medical) factors that play an outsize role in our health as individuals and communities.

NPR Health ran a short series of radio stories and web posts called “What Shapes Health” that looked at these phenomena. They’re well worth indulging in if you didn’t catch them when they aired. Among the highlights:

  • What is an adverse childhood experience (“ACE”) and how does it impact your future health? Take a short quiz and get your own ACE score.
  • Survey research showing that people with lower incomes perceive that they pay a price with poorer health. Not surprising news, but important knowledge of the effects of inequality.
  • Housing impacts health…in a big way. If you don’t have housing, can’t afford it, or live in housing that is unsafe or substandard, in all likelihood you will die younger than others in your age cohort.

Each of these social factors (and another HUGE one: education) lead to that amorphous concept we call “stress.” It has real impact, and quite frankly we’re only in our infancy of being able to quantify what it does to us. Stay tuned.

When Health Care Workers Strike

In a relatively unusual development, mental health professionals who work for Kaiser Permanente in California went on strike.

kaiser strikeAt issue is the demand for mental health services, and the perception by the employees that they are understaffed, overworked, and not meeting their ethical obligation to see Kaiser patients in a timely fashion.

Job actions in the health care world are pretty uncommon, because of the direct impact they can have on day-to-day patient care. It’s a fine line between taking a negotiating position and potentially harming the people that we’ve signed on to help.

In health care, perhaps the most prominent unionized workers are the nurses and/or service employees (food service workers, custodial employees, etc.), who generally belong to local chapters of national unions like National Nurses United (NNU), the National Federation of Nurses, and the Service Employees International Union (SEIU) — just to name a few.

KQED radio health reporter April Dembosky covered the Kaiser story, and was featured on NPR’s All Things Considered. She pointed out a couple of interesting reasons for the appointment backlog:

  1. The Affordable Care Act has provided coverage to more than a million Californians who were previously uninsured — so demand has risen.
  2. A state initiative has worked to reduce stigma associated with mental illness — which has also driven up demand, especially in the University of California system — site of another backlog.

I was lucky enough to interview Dembosky for Studio Tulsa on Health, our local public radio show, in which we explored this issue in more depth. If you’re interested, you can hear it here.

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