Public Health--15 Irrefutable Certainties (Part 1 of 3)

In spite of the fact that we collectively know more about health issues than at any other time in history, it can also be said that most people today are more confused about what constitutes definitive/conclusive health knowledge than at other times in history. To put it more bluntly, the huge number of discoveries, epiphanies and accomplishments of modern times, far from necessarily making people more knowledgeable, have often made them more skeptical, unsure and confused. 

To some extent, this phenomenon can be blamed on the relative increase/expansion of health knowledge; more importantly, however, it's a matter of constantly getting contending/alternative views and opinions on most things. Ultimately, it becomes a question of who's right and who's wrong. 

To make matters worse, however, both sides may be partly right or each side may be equally right, depending on the usually-changing circumstances.

Having said this, there are some things about health that we can say with almost absolute certainty--for, indeed, contrary to what some people think, we don't always have to have 100% certainty. In fact, the following assertions rest on fairly-solid ground and can help us all make intelligent decisions in the future about our health:

1.  We all need on-going competent, high-quality & comprehensive medical care. Whether you believe in universal health insurance or not, no developed country can aspire to establish stable over-all prosperity unless it makes sure that all its citizens have access to this, including the destitute, the homeless, the institutionalized and the otherwise marginalized. Failure to provide this results in ever-present communicable diseases, skyrocketing costs (because emergency/impromptu treatment is always more expensive than prevention or regular/one-on-one care), and "putting-out-fires" medicine (as opposed to "preventing fires" medicine). 

We also need care from the right personnel and under circumstances most beneficial to us at the clinical level.  Regarding the use of nurse anesthetists (NA) in place of anesthesiologists, for example, we need to keep important things in mind, such as the fact that doing things for the sake of saving money may not always be in our best interest. Nurse anesthetists, while they may be very capable, are not on the same level as anesthesiologists; the former is a highly-trained nurse--the latter, though, is a physician. 

Originally slated to work only under the supervision of anesthesiologists (like Physicians Assistants or PAs), there's been a push (mostly for fiscal savings) to give nurse anesthetists leading roles--i.e., literally take the place of anesthesiologists in some cases. Some experts are asking if this is a wise decision. The same questions are being asked when PAs are administratively (i.e., only on paper) working under a physician but, in reality, play the role of physicians (especially at private emergency care facilities). 

2.  We need access to fresh, clean water on a regular basis. This may sound overly obvious to some people but, especially in the US, it really isn't. In the US (as in other developed countries), too many people have replaced water with dangerously unsuitable substitutes--most notably, carbonated drinks, energy/sports beverages, alcoholic beverages, unnecessarily chemically polluted water (e.g., fluoride & chlorine), etc. Too many young people, especially, think that drinking carbonated drinks is perfectly fine but their rotted, imperfect teeth (because of phosphoric and other acids therein) say otherwise, as does the associated bone problems (e.g., osteoporosis) they may develop later in life. 

What health conditions are people developing because of the fluoride (a known poison once used against rats) in their tap water? But if flouride were the only questionably-safe chemical in our drinking water we might adapt--this, however, is often not the case. More and more, we are finding that our water sources are becoming contaminated with herbicides, pesticides and the many pollutants (including medicines being dumped with our garbage) all around us. Ironically, the pathogen-polluted waters of third world countries and what was found in most communities of the past (before the 1900s) may not have negatively affected as many people as the discarded chemicals-infected waterways of developed countries today.

Sadly, the lessons that John Snow imparted to us from the 1800s have not completely sunk in, it seems. He's the physician/epidemiologist who helped to identify a microorganism (Vibrio Cholerae) as the culprit behind several cholera epidemics in England. A lack of clean water, amazingly, to this day is responsible for many of the diseases in the world, especially in poor countries. Every decision we make both as individuals and as a human society needs to take into account how ridiculously important clean/unpolluted water is to our overall health!

3.  "Your health is what you eat" should replace "you are what you eat." Although the latter is familiar to most (if not all) persons on this planet, how many people actually take it seriously. Then again, this isn't scientifically accurate. We, in fact, don't become what we eat--mainly because our digestive juices and enzymes break down foods into individual, molecularly different by-products than what we took in. 

Having said that, what we eat does greatly affect our health. Eat the wrong things, in fact, and you will not only not feel well but you may develop disease. One of the best examples of this can be seen when men started sailing the seas, by necessity only eating what they could safely and conveniently carry on-board. Not knowing better, they failed to pack fruits (probably because these were hard to keep fresh in long voyages). The results were cases of scurvy, a nasty protein synthesis ailment that was not only painful and debilitating but, ultimately, lethal (if left untreated). The problem was finally abated/managed, when sailors were given ascorbic acid-containing fruits while on the high seas.

Unfortunately, many people today still haven't learned these valuable lessons. They develop serious medical problems like diabetes mellitus, cardiovascular disease, or cancer, all the while not realizing that their diets were mainly to blame. Even the medical establishment, we must sadly report, hasn't exactly gleaned all the wisdom that the scurvy story imparts. 

When was the last time, for example, that your doctor lectured you about your diet? The medical paradigm, in fact, is to treat symptoms and deal with problems after they arise--instead of concentrating on origins, putting the emphasis on prevention and acknowledging that proper nutrition is the foundation of good health.

4.  We need access to fresh, nutritionally-rich fruits and vegetables. One of the many shameful things the US government is guilty of is providing subsidies to farming enterprises that did not support this principle. Tobacco, corn and sugar crops, for example, while they have provided important monetary benefits, have not been as important as the fruits and vegetables that should have received the same assistance. To this day, partly because of these misguided policies, fruits and vegetables remain outside the financial means of many poor people.

It's not a matter of feeding the masses but making sure that they have access to those foods that most affect (in a positive way) their health. How many medical problems might we mitigate or better manage simply by making sure that children, pregnant women and working men (on whose shoulders our economy depends) ate the recommended amounts of fruits and vegetables?

For the record, there are no substitutes for the nutrients derived from fruits and vegetables. Some people assert that we can just take pills and manufactured supplements but we just cannot be sure at this time that such tools work as well (or if at all--since some experts think that vitamins and minerals taken in pills may simply pass through out intestines without being absorbed or absorbed only in limited quantities). 

In fact, the same experts remind us that ascorbic acid is not the same as Vitamin C, since what we call "Vitamin C" is a process that takes place in the digestive system that involves a combination/reaction of several substances, including special enzymes, not just ascorbic acid. 

Finally, because many of the fruits and vegetables these days are being grown on nutrionially-deficient soil, the products thereof are not as nutritionally-worthy as those grown properly. Also, if we subject fruits and vegetables to unsavory processes (irradiation, chemically-toxic pesticides/herbicides, genetic modification, etc.), we may be undoing the good that these foods can provide when grown organically (i.e., within the proper, healthy parameters and conditions). 

5.  None of the key vitamins and minerals thus far identified as "essential" can be overlooked or left out of our diets--if  we are truly committed to proper nutrition. Some people, for example, act as if the so-called "trace minerals" can be ignored since, after all, we need such miniscule amounts thereof. The fact of the matter, though, is that some of these vitamins and minerals are necessary for normal development and physiological integrity.

Take potassium, for example: we may not need huge amounts of it, but, without the miniscule amounts (relatively speaking) needed, the heart may not function properly. Without iron (and other key nutrients), your blood cells would go into unscheduled or harmful apoptosis (cell death); without adequate amounts of calcium and Vitamin D, your teeth would fall out and you'd be breaking bones every time you bumped into something hard; without zinc, men (especially) might confront sterility, immune disorders, prostate and other sexual/reproductive problems; without vitamin K, you would face serious blood clotting, bone and heart problem issues; without Vitamin A, you can eventually go blind; etc.

Conclusion To Part 1

In spite of all the misunderstandings, disagreements, and constantly-changing health information in our midst, there are principles and facts that provide stability, dependability and useful guidance.  By knowing these facts, we can make intelligent decisions with potentially life-saving/ameliorating repercussions. We may also use these as weapons against those who, because "everything is bad for us" arguments, fail to protect themselves properly.

For the record, not everything is bad for us, but, because we are constantly identifying things with detrimental effects (often previously thought to be harmless or even beneficial), some people use this as an excuse to become or remain ignorant, apathetic or devil's advocate-oriented. Yes, once in a while, the dangers attributed to something is unnecessarily sensationalized or exaggerated; in most cases, however, there is at least some truth in what is promulgated. 

Ultimately, the idea is to become a well-informed, cautious consumer--not necessarily a paranoid, gullible or easily manipulated (in either direction) skeptic/cynic. 

Copyright, 2015.  Fred Fletcher.  All rights reserved.