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D4PC Member Dispels Healthcare Myths Propagated By the Mainstream Media, by Jodi Carroll, RN
Sunday, May 30, 2010
I wanted to share this Letter to the Editor that I wrote in response to an article that was in the Chicago Tribune on Sunday reporting the high infant mortality rates in the U.S., and blaming our health care system.
Hello,
I am writing to comment on a recent article that I read in the Chicago Tribune about infant mortality rates in the United States. As a critical care nurse and MPH student (Master's in Public Health), I would like to challenge many of the assumptions you made in this article.
First, asserting that a health care system is largely responsible for infant mortality (or overall citizen health and longevity) lacks detail of important facts and is highly misleading. Two studies presented in one of my Master's program textbooks, "Delivering Health Care in America: A Systems Approach", reports that determinants of an individuals health status are as follows:
(Starfield 1973): Lifestyle and behavior 50%, Genetic makeup 20%, Social and environmental 20%, Medical care 10%
(Blum 1981): Environment, lifestyle, heredity, and medical care
The determinant with the least amount of impact on a person's health (and therefore longevity) is the health care system.
You compared the U.S. with Australia, yet you failed to discuss very important population differences such as obesity rates, tobacco, alcohol and cocaine use. In aWorld Health Organization report from 2008, the U.S. had the highest rates of tobacco, alcohol, and cocaine use, all of which impact the health and viability of a fetus, not to mention the mother - and any individual for that matter (link below). Last reported, the U.S. also posted the highest rates of obesity (link below). Obesity can cause unnecessary risks and complications to a fetus, reducing its survivability upon birth.
Similarly, I wonder if you realize that Australia was ranked number 32 by the World Health Organization study of health care systems? If you believe that the WHO study reflects how well a system is performing (and I argue that it does not, having read the report), the question should be asked, how could their poorly performing health care system be the reason for their low infant mortality rates, rather than their population behaviors?
You further fail to discuss the rates of infertility treatments between the nations mentioned in your article. I myself am a consumer of several years of infertility treatments and was very fortunate to ultimately have healthy triplets. However, multiple gestation pregnancies bring with them much higher risk of mortality of one, two, or three of the infants - not to mention the mother. Therefore, you should be comparing how many multiple gestation pregnancies other health care systems are faced with, where 4 infants are born and only 3 survive? Certainly you can agree these are important parts of an infant mortality equation?
You also fail to discuss the rates of teen pregnancy between the nations. The U.S. has the highest rate of teen pregnancy, and teens are often unprepared for the required changes in lifestyle and frequent monitoring conducive to delivering a healthy and viable infant, and our obesity rates only make that problem worse.
Cuba has a lower infant mortality rate than the United States, but would you suggest we start modeling their health care system? They do not even try to push the ball forward with medical advancement. Perhaps their higher rates of abortion per capita can highlight why their infant mortality rates are lower? It is less challenging for a health care system to terminate higher risk pregnancies than it is to learn how to bring them to term and move that ball forward in helping them live longer and longer.
The concept of blame is large and growing ever larger in this country, and this article highlights that fact. Too many people believe that if they are not healthy, certainly the blame for that lies elsewhere. Our health care system faces challenges that no other health care system faces, yet we still have higher survival rates for cancer than most other countries. Our nations struggle with pneumonia and diabetes are less a reflection of a health care system, and much more a reflection of a society's priorities, to smoke and over-consume food. A health care system facing that kind of population is forced into a position of symptom management, unless of course you believe that doctors and nurses should be physically forcing people to follow the recommended diet, quit smoking, start exercising, show up for appointments, etc.
There are a lot of reasons why a society is unhealthy and faces challenges with longevity, the least of which is the health care system. The next time you are comparing health related statistics between the U.S. and other countries, it would be prudent to include important factors to health and longevity such as lifestyle, violence, accident rates, etc. How will we ever truly solve our nations health and longevity problems when people are so intent on blaming the very thing that has the least amount of impact on that problem to begin with?
Below are links to help make the points I am making above.
obesity rates http://www.nationmaster.com/graph/hea_obe-health-obesity
teen pregnancy rates http://www.nationmaster.com/graph/hea_tee_pre_percap-health-teenage-pregnancy-per-capita
child maltreatment http://www.nationmaster.com/graph/hea_chi_mal_dea-health-child-maltreatment-deaths
gun violence http://www.nationmaster.com/graph/cri_gun_vio_hom_ove_hom_rat_per_100_pop-rate-per-100-000-pop
rapes http://www.nationmaster.com/graph/cri_rap-crime-rapes
total crimes http://www.nationmaster.com/graph/cri_tot_cri-crime-total-crimes
murder rates http://www.nationmaster.com/graph/cri_mur-crime-murders
auto accident rates http://www.nationmaster.com/graph/hea_mot_veh_dea-health-motor-vehicle-deaths
plastic surgery consumption http://www.nationmaster.com/graph/hea_pla_sur_pro-health-plastic-surgery-procedures
Much regards,
Jodi Carroll, RN
I wanted to share this Letter to the Editor that I wrote in response to an article that was in the Chicago Tribune on Sunday reporting the high infant mortality rates in the U.S., and blaming our health care system.
Hello,
I am writing to comment on a recent article that I read in the Chicago Tribune about infant mortality rates in the United States. As a critical care nurse and MPH student (Master's in Public Health), I would like to challenge many of the assumptions you made in this article.
First, asserting that a health care system is largely responsible for infant mortality (or overall citizen health and longevity) lacks detail of important facts and is highly misleading. Two studies presented in one of my Master's program textbooks, "Delivering Health Care in America: A Systems Approach", reports that determinants of an individuals health status are as follows:
(Starfield 1973): Lifestyle and behavior 50%, Genetic makeup 20%, Social and environmental 20%, Medical care 10%
(Blum 1981): Environment, lifestyle, heredity, and medical care
The determinant with the least amount of impact on a person's health (and therefore longevity) is the health care system.
You compared the U.S. with Australia, yet you failed to discuss very important population differences such as obesity rates, tobacco, alcohol and cocaine use. In aWorld Health Organization report from 2008, the U.S. had the highest rates of tobacco, alcohol, and cocaine use, all of which impact the health and viability of a fetus, not to mention the mother - and any individual for that matter (link below). Last reported, the U.S. also posted the highest rates of obesity (link below). Obesity can cause unnecessary risks and complications to a fetus, reducing its survivability upon birth.
Similarly, I wonder if you realize that Australia was ranked number 32 by the World Health Organization study of health care systems? If you believe that the WHO study reflects how well a system is performing (and I argue that it does not, having read the report), the question should be asked, how could their poorly performing health care system be the reason for their low infant mortality rates, rather than their population behaviors?
You further fail to discuss the rates of infertility treatments between the nations mentioned in your article. I myself am a consumer of several years of infertility treatments and was very fortunate to ultimately have healthy triplets. However, multiple gestation pregnancies bring with them much higher risk of mortality of one, two, or three of the infants - not to mention the mother. Therefore, you should be comparing how many multiple gestation pregnancies other health care systems are faced with, where 4 infants are born and only 3 survive? Certainly you can agree these are important parts of an infant mortality equation?
You also fail to discuss the rates of teen pregnancy between the nations. The U.S. has the highest rate of teen pregnancy, and teens are often unprepared for the required changes in lifestyle and frequent monitoring conducive to delivering a healthy and viable infant, and our obesity rates only make that problem worse.
Cuba has a lower infant mortality rate than the United States, but would you suggest we start modeling their health care system? They do not even try to push the ball forward with medical advancement. Perhaps their higher rates of abortion per capita can highlight why their infant mortality rates are lower? It is less challenging for a health care system to terminate higher risk pregnancies than it is to learn how to bring them to term and move that ball forward in helping them live longer and longer.
The concept of blame is large and growing ever larger in this country, and this article highlights that fact. Too many people believe that if they are not healthy, certainly the blame for that lies elsewhere. Our health care system faces challenges that no other health care system faces, yet we still have higher survival rates for cancer than most other countries. Our nations struggle with pneumonia and diabetes are less a reflection of a health care system, and much more a reflection of a society's priorities, to smoke and over-consume food. A health care system facing that kind of population is forced into a position of symptom management, unless of course you believe that doctors and nurses should be physically forcing people to follow the recommended diet, quit smoking, start exercising, show up for appointments, etc.
There are a lot of reasons why a society is unhealthy and faces challenges with longevity, the least of which is the health care system. The next time you are comparing health related statistics between the U.S. and other countries, it would be prudent to include important factors to health and longevity such as lifestyle, violence, accident rates, etc. How will we ever truly solve our nations health and longevity problems when people are so intent on blaming the very thing that has the least amount of impact on that problem to begin with?
Below are links to help make the points I am making above.
Alcohol, tobacco, cocaine: http://www.cbsnews.com/stories/2008/07/01/health/webmd/main4222322.shtml
obesity rates http://www.nationmaster.com/graph/hea_obe-health-obesity
teen pregnancy rates http://www.nationmaster.com/graph/hea_tee_pre_percap-health-teenage-pregnancy-per-capita
child maltreatment http://www.nationmaster.com/graph/hea_chi_mal_dea-health-child-maltreatment-deaths
gun violence http://www.nationmaster.com/graph/cri_gun_vio_hom_ove_hom_rat_per_100_pop-rate-per-100-000-pop
rapes http://www.nationmaster.com/graph/cri_rap-crime-rapes
total crimes http://www.nationmaster.com/graph/cri_tot_cri-crime-total-crimes
murder rates http://www.nationmaster.com/graph/cri_mur-crime-murders
auto accident rates http://www.nationmaster.com/graph/hea_mot_veh_dea-health-motor-vehicle-deaths
plastic surgery consumption http://www.nationmaster.com/graph/hea_pla_sur_pro-health-plastic-surgery-procedures
Much regards,
Jodi Carroll, RN
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