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A jarring vision of a medical utopia--drawing on the last half-century of medical advancement during which genetic intervention has taken a greater role in the prevention of disease.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
Results from the National Research Council's (NRC) landmark study Diet and health are readily accessible to nonscientists in this friendly, easy-to-read guide. Readers will find the heart of the book in the first chapter: the Food and Nutrition Board's nine-point dietary plan to reduce the risk of diet-related chronic illness. The nine points are presented as sensible guidelines that are easy to follow on a daily basis, without complicated measuring or calculatingâ€"and without sacrificing favorite foods. Eat for Life gives practical recommendations on foods to eat and in a "how-to" section provides tips on shopping (how to read food labels), cooking (how to turn a high-fat dish into a low-fat one), and eating out (how to read a menu with nutrition in mind). The volume explains what protein, fiber, cholesterol, and fats are and what foods contain them, and tells readers how to reduce their risk of chronic disease by modifying the types of food they eat. Each chronic disease is clearly defined, with information provided on its prevalence in the United States. Written for everyone concerned about how they can influence their health by what they eat, Eat for Life offers potentially lifesaving information in an understandable and persuasive way. Alternative Selection, Quality Paperback Book Club
In 1950 men and women in the United States had a combined life expectancy of 68.9 years, the 12th highest life expectancy at birth in the world. Today, life expectancy is up to 79.2 years, yet the country is now 28th on the list, behind the United Kingdom, Korea, Canada, and France, among others. The United States does have higher rates of infant mortality and violent deaths than in other developed countries, but these factors do not fully account for the country's relatively poor ranking in life expectancy. International Differences in Mortality at Older Ages: Dimensions and Sources examines patterns in international differences in life expectancy above age 50 and assesses the evidence and arguments that have been advanced to explain the poor position of the United States relative to other countries. The papers in this deeply researched volume identify gaps in measurement, data, theory, and research design and pinpoint areas for future high-priority research in this area. In addition to examining the differences in mortality around the world, the papers in International Differences in Mortality at Older Ages look at health factors and life-style choices commonly believed to contribute to the observed international differences in life expectancy. They also identify strategic opportunities for health-related interventions. This book offers a wide variety of disciplinary and scholarly perspectives to the study of mortality, and it offers in-depth analyses that can serve health professionals, policy makers, statisticians, and researchers.
This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
The chaotic state of today's health care is the result of an explosion of effective medical technologies. Rising costs will continue to trouble U.S. health care in the coming decades, but new molecular strategies may eventually contain costs. As life expectancy is dramatically extended by molecular medicine, a growing population of the aged will bring new problems. In the next fifty years genetic intervention will shift the focus of medicine in the United States from repairing the ravages of disease to preventing the onset of disease. Understanding the role of genes in human health, says Dr. William B. Schwartz, is the driving force that will change the direction of medical care, and the age-old dream of life without disease may come close to realization by the middle of the next century. Medical care in 2050 will be vastly more effective, Schwartz maintains, and it may also be less expensive than the resource-intensive procedures such as coronary bypass surgery that medicine relies on today. Schwartz's alluring prospect of a medical utopia raises urgent questions, however. What are the scientific and public policy obstacles that must be overcome if such a goal is to become a reality? Restrictions on access imposed by managed care plans, the corporatization of charitable health care institutions, the increasing numbers of citizens without health insurance, the problems with malpractice insurance, and the threatened Medicare bankruptcy—all are the legacy of medicine's great progress in mastering the human body and society's inability to assimilate that mastery into existing economic, ethical, and legal structures. And if the average American life span is 130 years, a genuine possibility by 2050, what social and economic problems will result? Schwartz examines the forces that have brought us to the current health care state and shows how those same forces will exert themselves in the decades ahead. Focusing on the inextricable link between scientific progress and health policy, he encourages a careful examination of these two forces in order to determine the kind of medical utopia that awaits us. The decisions we make will affect not only our own care, but also the system of care we bequeath to our children. This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1998.
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
From the physician behind the wildly popular NutritionFacts website, How Not to Die reveals the groundbreaking scientific evidence behind the only diet that can prevent and reverse many of the causes of disease-related death. The vast majority of premature deaths can be prevented through simple changes in diet and lifestyle. In How Not to Die, Dr. Michael Greger, the internationally-renowned nutrition expert, physician, and founder of NutritionFacts.org, examines the fifteen top causes of premature death in America-heart disease, various cancers, diabetes, Parkinson's, high blood pressure, and more-and explains how nutritional and lifestyle interventions can sometimes trump prescription pills and other pharmaceutical and surgical approaches, freeing us to live healthier lives. The simple truth is that most doctors are good at treating acute illnesses but bad at preventing chronic disease. The fifteen leading causes of death claim the lives of 1.6 million Americans annually. This doesn't have to be the case. By following Dr. Greger's advice, all of it backed up by strong scientific evidence, you will learn which foods to eat and which lifestyle changes to make to live longer. History of prostate cancer in your family? Put down that glass of milk and add flaxseed to your diet whenever you can. Have high blood pressure? Hibiscus tea can work better than a leading hypertensive drug-and without the side effects. Fighting off liver disease? Drinking coffee can reduce liver inflammation. Battling breast cancer? Consuming soy is associated with prolonged survival. Worried about heart disease (the number 1 killer in the United States)? Switch to a whole-food, plant-based diet, which has been repeatedly shown not just to prevent the disease but often stop it in its tracks. In addition to showing what to eat to help treat the top fifteen causes of death, How Not to Die includes Dr. Greger's Daily Dozen -a checklist of the twelve foods we should consume every day.Full of practical, actionable advice and surprising, cutting edge nutritional science, these doctor's orders are just what we need to live longer, healthier lives.
In Twenty Years of Life, Suzanne Bohan exposes the ugly truth that health is largely determined by zip code. Life expectancies in wealthy versus poor neighborhoods can vary by as much as twenty years. Bohan chronicles a bold experiment to challenge that inequity. The California Endowment, one of the nation's largest health foundations, is upending the old-school, top-down charity model and investing $1 billion over ten years to help distressed communities advocate for their own interests. With compassion and insight, Bohan shares stories of students and parents, former street shooters, urban farmers, and a Native American tribe who are tapping into their latent political power to make their neighborhoods healthier. Their stories will fundamentally change how we think about the root causes of disease and the prospects for healing.