Wednesday, January 08, 2014

Checking Your Blood Pressure Does More for Your Health than a Blueberry Smoothie

When I was a very small boy I saw my grandmother have a heart attack. I remember her children, my mom and her brothers, frantically rushing to get her in a car to drive her to the hospital. That was the last memory I have of her. Needless to say, it made a lasting impression on me and our entire family.
The CDC estimates that 68 million people have high blood pressure in the United States. For some perspective Heart disease kills almost 19 times more people annually than guns, and that includes all gun deaths, even suicides and accidents.
I read and write something about about health everyday and there is much more hype around super foods and high-intensity exercise than simply getting your blood pressure checked.
Research Trip India, 2009
I cannot stress how important it is to check your blood pressure. Not checking your blood pressure is extremely risky. One way to think about your blood pressure is that it measures the health of your heart and arteries, which are the highways that transport food and oxygen to every part of your body. Your heart is the engine that makes that happen. Said another way, in the dark ages, when king a wanted to attack an enemy’s castle they would block the routes in and out of the castle so no food or supplies can enter. The people inside would starve or surrender. If your organs and other vital parts of your body are blocked from getting food and oxygen they would die. If your blood pressure is high that could mean there is a disruption somewhere along the highway. 

This dysfunction can be the result of too much fat and inflammation in the arteries or problems with the heart muscle itself. This indicator of a problem can lead not only to a heart attack, it can also cause permanent scarring of your kidneys, loss of eye sight and limbs, as well as other problems. So waiting on checking your BP or not treating high blood pressure with lifestyle change and/or medication is doing long-term damage to your vital organs and they call them vital for good reason. 
To repeat, my main argument here is that keeping up with your health indicators through a spreadsheet is far more beneficial than eating blueberry smoothies. I think many people forego checking because they are afraid that they will have to make drastic changes to their diet and lifestyle. I love food, tasty food, and I can say that small changes to your diet and a little exercise go a long way. The bonus is that if you make those small changes early, inspired by the knowledge of your BP, then you can still eat many of the foods you want. If you wait and you will have to make drastic changes in a short period of time.  
Sometimes I think what my life would have been like if my grandmother were alive. Her death left a weak spot in our whole family, in fact much of our family became estranged after her death. So help keep your family together by staying healthy and checking your blood pressure often. 

Tuesday, December 31, 2013

A Win-Win with Purple Sweet Potatoes

Recently, I was in a local fruit and vegetable market, informally known as Liz and Frank's, where I usually purchase ingredients for our family meals. Since, I cook most of the meals in our home, and try to make as much as I can from scratch, I’m always looking for new ingredients. I embrace the challenge of turning mundane weeknight meals into an adventure. As a health researcher I am always thinking of ways to increase health in not only my family’s life but also the state that I live in and love, Mississippi. 

As I was rummaging through the market bins, I stumbled across an oddly colored sweet potato. I didn’t have to think twice; I grabbed 4 or 5 and put them in my bag. My first thought was to roast them. I ran into a friend and fellow cook there, and we spoke about this new ingredient. He said he had used them in a sweet potato gratin and that they have a lot more starch than a regular sweet potato. He also suggested that I may have to cook it longer than an orange- colored sweet potato. 

My first attempt to was just to roast them and explore their flavor. Then I would base my next dish on the taste and texture. My first impression after roasting was that they are way less sweet than regular sweet potatoes. I would say more like a cross between yucca and an orange sweet potato. They paired really well with the garlic mayo I mixed up for a dipping sauce. So this is a healthy food that tastes really good—my kids wolfed them down. 

The next recipe I made was a bit more work than simple roasting. I searched the internet and found 3 recipes that I combined: Emeril’s stewed pork and purple sweet potato recipe, Rick Bayless’ pork tinge and another from Food and Wine mag. I love stews and find them perfect for a family of four, especially in the winter time. It was absolutely delicious, and again, my kids devoured it.

I hope that next Thanksgiving my wife will let me substitute typical orange sweet potatoes with these purple ones for her very sweet, traditional Southern sweet potato casserole.

I also researched the health benefits of the purple sweet potato. They contain anthocyanins, like blueberries and other blue/purple fruits. Anthocyanins are powerful anti-oxidants and have been associated with a healthy diet. Purple sweet potatoes are a starch healthier than most, and they retain the anthocyanins after the cooking process more than their blue and purple fruit cousins. This has led many health researchers to believe that they are a “super-food.” They’ve been included in all sorts of foods, from drinks, candy, and desserts in many  parts of Asia.

In my local area, there’s a need for economic opportunities and for more healthy foods. Vardaman, Mississippi, is known as the “Sweet Potato Capital,” and at this time of year, you can hardly drive through many parts of the state without seeing pickup trucks overflowing with sweet potatoes that farmers are selling on the roadside. Purple sweet potatoes could be a big benefit to both local farmers and the people in Mississippi, which suffers from the highest rates of diabetes and obesity in the US. If my kids inhaled them before other tempting items on the table, then maybe people with diabetes or other children who need to eat healthier might find them a tasty, affordable food.

Thursday, November 14, 2013

So You Hate The ACA, Now What?

One of the major “arguments” against the Affordable Care Act (ACA) that is repeated ad nauseum is that it is an economic disaster. The unarguable fact is that health care costs have been rising at an alarming rate for many decades. As far back as 1963, Kenneth Arrow, a pro-capitalist, Nobel prize-winning economist, wrote an important paper explaining why health care costs were rising, and they’ve increased exponentially since.

The first row in the table below shows total US government expenditures on health care from 1960 to 2011, during which time it increased almost 100 times. Total individual spending on personal health also increased just over 100 times in that period. Going further, if we look at how much people have spent per person, we see costs have increased roughly 70 times. Hospital expenditures increased about 90 times in that period. The US population only increased by 156 million people—less than double. And here’s the kicker—the average median income only increased by $8000 in that 50-year period.

Total National health expenditures: 
$27.4 Billion
$2700.7 Billion
National expenditures on personal health
$23.4 Billion
$2279.3 Billion
Per person expenditures 
Hospital care aggregate expenditures
$9 Billion
$850.6 Billion
US population
186 million
311 Million
Average Annual Income*

In almost half a century, the cost of health care severely outpaced household income. This situation is unsustainable, and there's no sign of it rectifying itself anytime soon. Hating something is not good enough; you have to come up with a solution. 

Wednesday, September 18, 2013

An unedited impromptu interview with a community health worker in India

I shot this video when I was taken on a tour of community health centers in North India with a team of doctors from North Korea, in 2009. I am sorry for the unpolished nature of the video. It was my only opportunity to do this on very short notice. . The role of the community health worker is an important linkage to larger medical establishments. Unfortunately, here in the US we can use a good deal of them. 

Wednesday, July 10, 2013

One Year of Personal Health Indicators!

I just completed a year of data collection on my own health indicators. Above is one graph I made comparing my systolic blood pressure against my physical activity recorded in minutes over the course of one year. One thing that caught my eye was the points when my BP was the highest my PA decreases. This is a known negative relationship, none-the-less, interesting to see my own body following the evidence.

Thursday, May 02, 2013

A Belated Eulogy for Eleanor

I was one of the few students at school who loved studying statistics. All the knowledge that you learn about people is amazing. But like many people, the parts of my life that are the most exciting to me are those that don’t fit well into statistical description.

One such extraordinary part of my life was my friendship with Eleanor. When I met her, she was 85 years old and very sharp. A part-scientist/part-painter with a PhD in English, Eleanor often went for walks and spent a lot of time outdoors sitting on her walker observing nature. It was during her daily jaunts that I began to spend time with her. We immediately hit it off as we discovered that we both had a poetic appreciation of nature, and we both loved art and science.

I met her on my own circuitous journey, which landed me a job as an activity assistant in an assisted-living facility in Mississippi. My wife, a native Mississippian, and I moved there from Seattle after we jumped off of society’s escalator of pre-planned milestones to follow our own personal goals. Within weeks of landing in small-town Mississippi, I was teaching a seated version of Tai Chi to residents of the assisted-living home.

Those classes were well attended, particularly by two residents, Franny, whom I wrote about earlier, and Eleanor. There were many moments that the three of us sat in Eleanor’s room when I felt like I was in a Samuel Beckett play. It was during these occasions that I came to know that Eleanor did not think she “understood” life but sought to understand it, like many of Beckett’s characters. This pursuit of trying to understand life that we shared was probably brought on because of traumas we had each carried like a heavy backpack on a long journey. But they pushed us to explore life and compelled us to share notes about our own unique journeys.

Often this sharing took place in her room where we would sit for hours discussing philosophy, psychology, the arts, and anything that helped us understand the trauma we had experienced. One of the things I loved about Eleanor was that she engaged many people to share whatever they knew about life, and a number of people visited her because of her openness to their experiences. Often others would join in and we would have rich and unexpected conversations.

Some of those discussions included deeply religious people who would tell us their take on the meaning of life, which usually involved heavy dogma. This often disappointed Eleanor and annoyed me, as some people went so far as to claim that my role in her life was to help her find Jesus. Independently, Eleanor and I had come to the conclusion that there is no knowing, only seeking.

Eleanor and I couldn’t relate to those who claim to “know” what life is about, like many religious people and statisticians. I believe as people who had to walk with trauma, she and I didn’t have that feeling of certainty about much in life. We lived in uncertainty and were caught in between statistics and religion.

Five years after Eleanor’s death, I haven’t met anyone quite like her, but I am still carrying my backpack and proudly upholding the values that we shared. I looked up the origin of her name, and of its many possible meanings, the one I think is most suitable to describe her is from the Latin root of the verb lenire, “to soothe or to heal.”

If anyone chooses to write about me after I die, I hope they have as difficult a time as I had in conveying a glimpse of Eleanor.

Saturday, March 10, 2012

The Libertarian Endgame

On September 12, 2011, during CNN’s GOP Tea Party express debates, Wolf Blitzer posed a hypothetical question to Republican candidate Ron Paul, asking who should foot the bill for a healthy 30-year-old man who chooses not to buy health insurance and then suddenly ends up in a coma with expensive medical bills? Paul responded that freedom is about taking risks and personal responsibility, and it is not about the government taking care of everybody. Paul is a libertarian and, as such, believes that government should be as small as absolutely possible and only interfere in people’s lives for basic protection from hostile enemies and criminals.

Blitzer then asked, should we just let him die? Some in the audience cheered, “Yes, let him die!”  Many left leaning groups and individuals used this as a glaring example of the hypocrisy of the right. Republicans are a party that claims higher moral ground, conservative family values, and pro-life agendas, and yet at a party debate some verbalized support for a person dying because he couldn’t cover medical bills.

Paul himself said that we shouldn’t let him die, but he offered only altruistic church groups and charities as the solution. In 2012, medical expenses account for 60% of American bankruptcies.  So, leaving this incredible financial burden for church groups and charities to shoulder means that, in reality, many people would die.

The day after the debate, news broke that Paul’s close friend and 2008 campaign manager, Kent Snyder, died of pneumonia at age 49 after accruing more than $400,000 in medical bills. Paul and his staff raised $50,000 towards the bills, but the hospital bill was never paid off. Apparently, libertarians think it is acceptable for the hospital to eat that bill. So they overlook an important point about our medical system: we pay these bills by a back-door financial policy. Hospitals make up for this kind of unpaid bill by the raising the cost of everyone else’s medical care.

This issue is a defining moment for the US because one could easily blame the high costs of healthcare on the Emergency Medical and Treatment and Active Labor Act (EMTALA), which says hospitals that receive taxpayer money cannot refuse care to people. Would libertarians propose getting rid of the EMTALA? Is this the kind of society we want to live in?

One other reason why healthcare costs are high is that the US political system allows corporations to get so powerful that they can steer government policy towards their own interests. Using their monetary influence, they can break down regulation and fix the game in their favor. If, as libertarians believe, government should be small and only used in defense and the like, who will be there to regulate these big corporations when they are in total control? Their default answer is the invisible hand of the market. But even Adam Smith, the great hero of capitalism, extolled the benefits of the invisible hand only when there is a general well being among all citizens. 

I agree that when it comes to government intrusion on lives of its citizens, I think we should look at policies with a libertarian eye and not make a policy without a good reason. However, there is very good reason to provide health care, both for moral reasons, like those above, but also economic ones. The libertarian stance claims that when government gets involved, costs go up. Ron Paul frequently makes this argument in his speeches. I am not sure where their evidence comes from. Data shows instead that healthcare costs are lower in single-payer health systems.

When the ethical and practical reasons for a libertarian position on healthcare crumble, why continue to cling to the hard line?