CHAUTAUQUA - Medicine will be both more precise and effective in the next 10 to 15 years, but wellness in the 21st Century will require everyone to change their behavior a little or, for many, a lot. That was the clear message from a trio of featured speakers who opened the "Health Care: Reform and Innovation" themed week nine at Chautauqua Institution Monday.
The United States is now among the least healthy in the developed world; rife with obesity, circulatory disease, cancer and premature disablement, according to Drs. Harvey Fineberg, Timothy Johnson and Micheal Roizen.
All of the physicians' well-attended presentations made use of up-to-date medical, biological and sociological findings that point to the current paradox of medico/biological scientific achievements accompanied by declining markers of good health at earlier ages than a half-century ago. An example of this, provided by Dr. Roizen of Cleveland Clinic, is the amount of heart and circulatory disease found in people under 25 years old. Autopsies following accidental death showed such disease in about 10 percent of victims in the 1950's compared with 90 percent now.
Dr. Fineberg, president of the Institute of Medicine, spoke mid-morning in the amphitheater about "precision medicine" which includes more accurate diagnosis as well as very specific drug and surgical interventions.
Dr. Johnson, the 2 p.m. Hall of Philosophy lecturer, addressed efforts to reform health care in the U.S. He referenced the advances outlined in the morning lecture and their implications for health care policy.
Dr. Roizen followed Johnson with numerous examples of how one nationally-known health center, Cleveland Clinic, has accomplished better outcomes while markedly reducing costs.
It was Roizen who again and again showed evidence that most of the illness and disablement in the U.S. is self inflicted. As for genetic predisposition to poor health, Roizen said, "Up to age 25 your genes take you where they want to go: above the age of 25 it's your choice." That, he said, is because roughly 80 percent of genes are what he termed "switching mechanisms."
About 98 percent of us can control these switchs and thus make sure the correct "on" and "off" decisions are made. A simultaneous video presentation showed prostate cancer tumors becoming noticeably smaller by behavior changes designed to positively affect the patient's DNA.
All of the speakers noted that a large number of American adults make the very bad decisions to use tobacco, over eat, consume bad forms of fat, consume sugar and sweet syrups, not exercise and not keep stress in check. Statistics compiled and studies made over long periods of time show these decisions cause great increases in serious illness, disability and premature death.
Dr. Roizen in particular noted that the very good news is that changing bad habits to good ones will improve a person's health in as little as a month.
Quit tobacco, lose weight, increase exercise and decrease stress, he stated, and you will quickly and steadily improve your wellness, no matter your age.
Tobacco, including second-hand smoke, is the single greatest cause of sickness and death in this country, Roizen maintained. Cleveland Clinic will no longer hire anyone who uses tobacco as a matter of both economics and ethics, he said. Smokers keep health insurance premiums higher than if only nonsmokers are insured and this extra cost is unfair to nonsmokers who also, he said, are harmed by second-hand smoke.
If you quit using tobacco however, "You get a do over," according to statistics.
Walking 10,000 steps every day should be a goal, Roizen said, even if it's two steps at a time 5,000 times a day. He wasn't kidding. Wheelchair patients at the Clinic often have to begin this way, but soon are ambulatory again, he said.
Sugar and most fast-food must be eliminated too, according to all three doctors. Doing so reduces obesity, adult-onset diabetes and circulatory ailments. Dr. Roizen suggested eating a few nuts about a half -hour before eating. The "good" fat in nuts helps reduce food cravings, he maintained.
Costs of sickness and disability in the U.S. are higher than anywhere else, all of the speakers emphasized. Curbing the increase and reducing the bite they take out of the Gross Domestic Product can be accomplished, all agreed, with a big if: If people take much better care of themselves on average than they are now.