Dr. Dodge: Passion for Health

Many people think that our country needs some kind of health care reform, and the United States Congress is engaged in an intense effort to pass health care legislation this year. It is a difficult issue to resolve and the national debate about it has been impassioned. Against this background, a letter I received recently from 76-year old “Uncle Joe” is revealing about problems regarding health care in America today. (“Uncle Joe” is a fictitious name, but his medical situation is real.)

Uncle Joe writes: “I have had one total knee replacement, two open-heart surgeries, and two other major surgeries, plus cataract surgery, diabetes since 1974, and several other medical problems. I must use a cane to walk. I don’t read much health advice for seniors because it is so unrealistic.” 

Uncle Joe has had major medical and surgical treatment from some of America’s finest physicians. He is on multiple medications for his chronic ailments, and he follows his doctors’ recommendations faithfully. He is overweight, but is considered a good patient overall. He doesn’t put much stock in advice that asks him to do anything about his lifestyle because it is “unrealistic.” He has faith in his doctors, but little faith in his own power to influence his health. 

Uncle Joe is a delightful person who has enjoyed many enriching experiences in his lifetime. His lifestyle is not terrible, but a few changes earlier in his life would have served him well. Eating more healthfully and exercising more regularly over the last thirty years would have helped him prevent major health problems that are largely due to his rich Western diet and sedentary habits. 

His medical history is instructive about America’s health care. His doctors have taken excellent care of him, but such high-tech care is hugely expensive. If you multiply his history by millions of others in similar situations, it is easy to understand why our national health care is so costly. 

Unfortunately, the children and grandchildren of Uncle Joe’s generation have already started down an unsound path. Even if health care reform succeeds in cutting most of the waste out of the system, overall health care costs will continue to escalate over the next few decades because ever more unhealthy people keep entering a technologically expanding health care pipeline.

America is not a healthy country. It ranks lower in health indices than many other nations. Our major killer diseases today continue to be heart disease, cancer, stroke, chronic lung disease, and diabetes. Our national obesity epidemic aggravates many other diseases and afflicts people of all ages. How can we help people avoid so much illness? Most doctors want to help people be healthy, but practically speaking, most of their work involves diagnosing and treating disease. 

In fact, doctors cannot dispense good health. They can advise preventive measures, help control chronic diseases, and do their best to rescue patients from the ravages of disease or disability, but responsibility for our health rests mainly within each one of us. Wholesome living is the best way to attain long-term good health. This is not something that our doctors can do for us. It is up to us. 

Does lifestyle really have that much impact on health? A recent editorial in the Journal of the American Medical Association (September 16^th, 2009) summarized its importance: "Disease prevention initiatives aimed at improving nutrition, physical activity, tobacco use, and related lifestyle behaviors are likely to have the greatest effect in slowing the annual increase in health care costs. This is because they have the largest influence on reducing the future burden of disease, particularly in regard to obesity and the sequelae of diabetes, heart disease, and cancer." 

Think about this: Disease prevention initiatives aimed at improving lifestyle behaviors have the largest influence on reducing the future burden of disease! We each have more power to shape our own health than most of us realize – more power than doctors or any other influence! 

Why don’t Americans adopt healthier lifestyles? The millions of “Uncle Joes” who suffer mediocre health in spite of being “good patients” do not realize how much they could improve their own health simply by making a few lifestyle changes. The favorable impact such changes can have on our national health picture is even less well understood by the average person. 

Most people do not understand how changing their habits can help prevent chronic diseases like stroke, heart disease, diabetes, and cancer. To put it bluntly, they don’t believe a simple change in habits can have such great effects. Yet, study after study over the past few years has made it clear that a sound lifestyle is the most powerful health force on earth. 

Changing long-standing behavior is a challenge. It’s not hard to decide to make changes in one’s life, but following through with lasting change is another story. New Year’s resolutions are a classic example. They are easy to make, but even easier to break. It’s not easy to change habitual behavior. Yet, if enough people make such change, we can build a healthier nation. Some may dismiss this as an “unrealistic” or utopian idea, but I believe America has the capacity to change. 

We can build a healthier America, one person at a time. This is a vision that young people and seniors alike can embrace. Most of us can learn to adopt and enjoy healthier lifestyles. It may not happen overnight, but if we make the commitment to do so, we can become a much healthier nation in the coming decade. Let’s each carry out our part to help build a healthy America!