Culture, Mortality and Disease

Culture and Mortality, Part 4: The Epidemic Disease Burden

This is the fourth of four articles about Culture and Mortality

Despite the fact that we have more scientific research, health related research, pharmaceutical products, self-care products, and more sophisticated medical interventions than ever before in history, we continued to have a remarkable disease epidemic. This includes a significant increase in suicides, and a persistence in cancer, heart disease, autoimmune disease, type II diabetes, gastrointestinal disorders, Alzheimer’s disease and other dementias.

Here are some 2017 United States statistics: Number of deaths for leading causes of death:

• Heart disease: 647,457
• Cancer: 599,108
• Accidents (unintentional injuries): 169,936
• Chronic lower respiratory diseases: 160,201
• Stroke (cerebrovascular diseases): 146,383
• Alzheimer’s disease: 121,404
• Diabetes: 83,564
• Influenza and Pneumonia: 55,672
• Nephritis, nephrotic syndrome and nephrosis: 50,633
• Intentional self-harm (suicide): 47,173

Addiction

·       Drug overdose deaths continue to increase in the United States.

• From 1999 to 2017, more than 700,000 people have died from a drug overdose.
• Around 68% of the more than 70,200 drug overdose deaths in 2017 involved an opioid drug.
• In 2017, the number of overdose deaths involving opioids (including prescription opioids and illegal opioids like heroin and illicitly manufactured fentanyl) was 6 times higher than in 1999.
• On average, 130 Americans die every day from an opioid overdose.
• Cigarette smoking remains a persistent source of chronic disease, including cancer, with about 7% of the population smoking.
• Vaping has developed into a profitable industry that is now killing people; people need to be breathing good clean air not tobacco smoke or vaping liquids

·         What about cannabis? Well, cannabis is a gateway drug for many people. It is a mood-altering drug with habituation and addictive potential.  There are certain curative characteristics with cannabis use and we believe that medical personnel should be making decisions about therapeutic use of cannabis.  In an accident culpability analysis, persons testing positive for THC and particularly those with higher blood levels, were 3 to 7 times as likely to be responsible for a motor-vehicle accident as persons who had not used drugs or alcohol before driving. In comparison, the overall risk of a vehicular accident increases by a factor of almost 5 for drivers with a blood alcohol level above 0.08%, the legal limit in most countries, and increases by a factor of 27 for persons younger than 21 years of age. Not surprisingly, the risk associated with the use of alcohol in combination with marijuana appears to be greater than that associated with the use of either drug alone.

• Food addiction is real for millions of people who continue to consume highly processed foods that are loaded with high levels of fat, sugar, and salt that create hyper-palatability and addiction. These foods are directly linked to type II diabetes, obesity, dementia and other conditions.
• We need to operate from a good dose of common sense when it comes to normalizing the use of mood-altering substances. It is not mentally or emotionally healthy to be reliant on the brain-altering compounds contained in addictive drugs.
• Millions of people are in trouble with alcohol, and in my view, one of the worst things we could do would be to add additional mood- altering substances to the mix.

Healthcare costs continue to climb, and this system is quickly becoming unstable and unsustainable. In this context is important to understand that’s only about 3% of our population maintains healthy levels of all four of these health behaviors: non-smoking; healthy weight and BMI, body mass index; consuming five fruits and vegetables daily; regular physical activity. Given this, we can readily see that most of this disease burden is a lifestyle related and is under the control of the patient.

Some believe that psychosocial risk factors need to be given a much higher priority as we negotiate the impact of disease economically, and in terms of mortality and morbidity. This includes such issues as stress, mental illness, isolation, and the addictions. We will elaborate on the issue of addiction in a separate article.

A significant part of the disease burden involves taking medications and all of the huge number of side effects from these medications. The European Commission estimates that adverse reactions from prescription drugs cause 200,000 deaths; so together, about 328,000 patients in the U.S. and Europe die from prescription drugs each year. This makes prescription drugs a major health risk, ranking 4th with stroke as a leading cause of death. 

Dr. Beth Frates, a leader in Lifestyle Medicine, has some very important comments about this disease epidemic. She expresses great concern about our country being absorbed in a health care crisis. There is a clear increase in the incidence of morbidity , in the number of Americans who are coping with chronic disease. One of the repercussions of this is the incredible burden of healthcare costs that have become out of control and unsustainable. It is time for action; actually, we are way into the process of an entrenched pattern of more and more of our GDP being targeted at healthcare costs. We need to adopt a new cultural understanding of how critically important it is for folks to adopt a new lifestyle that is healthy and prevents the onset of chronic diseases. We know how to do that and we need to get on with the business of public policy change, positive change within the healthcare industry, and a reorientation of peoples understanding about disease prevention. Without shifts in how people live their lives and how they view their health, we are setting up an unnecessary toxic and lethal endpoint.

The main point we want to make here is that perhaps 70% or more of all chronic disease is related to lifestyle factors that we have control over; lifestyle Medicine initiatives target needed changes in our daily activities in order to prevent and reverse the epidemics of cancer, diabetes, heart disease, dementia and all the rest.

 References

·        Cannizzaro, Joseph: ‘Answers for the 4A epidemic, healing for kids with autism, ADHD, asthma, and allergies,’Siloam Publishing, 2012.

·        Centers for Disease Control and Prevention, National Center for Health statistics, CDC.gov, 2017.

·        Davis, Brenda: ‘Kick diabetes essentials: the diet and lifestyle guide,’ Book publishing Company, 2019

·        Frates, Beth et al.: lifestyle medicine handbook, an introduction to the power of healthy habits, Healthy Learning, 2019.

·        Greger, Michael and Stone, Gene: ‘ How Not to Die,’ Flatiron Books, 2015.

·        Hughes, K. et al., ‘The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis, The Lancet Public Health, 2017.

·        Monnat, S.M. and Chandler, R.F.: ‘The long-term physical health consequences of adverse childhood experiences.’ The Sociological Quarterly, 2015.

·        Scholl L, Seth P, Kariisa M, Wilson N, Baldwin G. Drug and Opioid-Involved Overdose Deaths – United States, 2013-2017. WR Morb Mortal Wkly Rep. ePub: 21 December 2018.

·        Zahler, William A: ‘Health, inertia, and information: why are we sick?’ Create Space and KDP, paperback and Kindle editions, March 2018.

·        Zahler, William A: ‘Synergy and the Dynamics of Lifestyle Change’, Create Space and KDP, published January 2019.

William Zahler, MSW, DipACLM

November 2019