It's Your Job to Stay Healthy

When adults go to the doctor and lab work is ordered – blood test, urinalysis, mammogram, and x-ray – the adults has the test done. Days may be weeks go by, but the doctor’s office never calls back with the results.  As an adult, it’s your responsibility to call the doctor’s office for your results.  Some doctor’s office is very efficient and almost 100% of the patients are notified of test results, either positive or negative outcomes. But there are many more offices, that are not so organized, and patients are not informed of abnormal results. Is that the doctor’s fault or yours?

 If you have the benefit of health care you should be thankful. Millions of Americans don’t have access to health care. If you have the ‘luxury’ of access to health care, then you should take responsibility for your health.  When tests are ordered, you should do the follow-up. If you need to take corrected action to improve your health because of diabetes, cancer, hypertension or sexually transmitted disease – take it! Don’t wait for someone else to improve YOU. If you are a cigarette smoking, fast food eating obese couch potato, whose responsibility is that – the devil made you do it?

Improve your quality of life with as little as 10 minutes a day of you time. You can exercise in front of the TV. Watch Sit and Be Fit, a televised exercise program aimed at seniors, but good for anyone who can’t get off the couch. The series is available on YouTube and video.  The Pennington Research Center reported that the body will respond to even a small amount of exercise, like walking the dog on a leash, taking the stairs and/or parking farther from the door. The people who were doing the least exercise will benefit the most from the exercise.

People should still be aiming at not smoking, doing about 150 minutes of exercise a week or 10,000 steps per day.  Wearing a pedometer is an easy way to track your steps each day. Put it on when you get up in the morning and wear it until bed time. The all or nothing attitude is a pitfall to fitness. Anything you do is better than nothing.

For more than 400 years, Preventive Medicine in the United States had a history since about 1607. The significant experiments in America in preventive medicine, and Beall and Shryock have proclaimed it as "The Advent of Preventive Medicine: Boston, 1721." It was pertinent to the theme of this article to evaluate a few of the episodes, and some of the theories, ideas, and observations of those times which were visionary of the scientific preventive medicine of the 19th century. Particularly significant were the little-known views of Cotton Mather. Cotton Mather was a member of the Royal Society since 1713. Cotton Mather was aware of the published letters of Timoni and Pylarini, and was awed by them. The two men definite a belief in favor of inoculation which Mather formed prior to 1716 on the basis of stories told him by his African servant (Onesimus), and by other African slaves. The Africans reported about the practice of inoculation in Africa. Mather, quoting these resources, brought out the African evidence continually in letters and pamphlets and most appealingly in the manuscript of his never-published volume "The Angel of Bethesda."

In "The Angel of Bethesda," Cotton Mather stated extensively his theory that smallpox was caused by “animalcule,” stating an ancient germ-theory of disease which he derived largely from Benjamin Marten and from his knowledge of the works of Athanasius Kircher Leeuwenhoek among others. He conjectured upon the suggestion of the vermicular, or animalcular, hypothesis of smallpox for immunology, and chemotherapy, with much older terminology of the time.

Presently, the core curriculum in preventive medicine in most American medical schools move from an emphasis on infectious disease to the problems of an aging population, mortality and morbidity from chronic diseases, and social and health policy issues. Preventive Medicine developed as a division of medicine apart from Public Health. By classification, preventive medicine is applied to ‘healthy’ people, normally by actions affecting huge numbers or populations. Its prime aim is prevention of disease and promotion of health. It got a solid base only after the detection of causative agents of diseases and the institution of the germ theory of disease.

Preventive care is a foundation of family medicine. Regular visits for patients of all ages are planned to promote wellness and disease prevention. These appointments can include additional services, such as vaccinations, screening laboratory services, counseling and even management of chronic medical problems. The history linked with preventive medicine services is not problem-oriented, and does not entail a primary complaint or history of current illness. It purposes is a comprehensive analysis of systems, a comprehensive or interval past, family and social history, and a comprehensive evaluation/history of relevant risk factors. The preventive medicine examination is multisystem, but the specific content and extent of the exam is based on the patient's age, sexual category and recognized risk factors. Irrelevant issues may be tackled as part of a preventive visit. For instance, a patient seen in the spring or fall might ask for a prescription renewal for allergy medications.

Age-appropriate counseling and discussion of topics universal to the group are also included in the preventive medicine services. Case in point, issues related to birth control is discussed with women of child-bearing age, and preventative assistance is given to parents of pediatric patients. Appraisal of safety issues, the requirement for screening tests and planning about the condition of previously diagnosed stable diseases are also considered part of the comprehensive preventive medicine service.

Social Medicine has changeable connotation attached to it. By origin, it is the study of man as a social being in his total environment. It may be recognized with care of patients, prevention of disease, administration of medical services; undeniably with roughly any subject in the wide-ranging field of health and welfare. Social medicine is not a new division of medicine but somewhat a new direction of medicine to the changing needs of man and society.

Community Medicine has been defined as that area of expertise which deals with population, and consist of those medical personnel who try to calculate the requirements of the population, both sick and well, who sketch and oversee services to meet those needs, and those who are occupied in research and teaching in the field. Nowadays health is not simply a lack of disease; it is associated with quality of life in its place. Health is measured as a means of productivity. The comprehension of the conditions of both public health and preventive medicine is crucial for clarification and understanding.

There has been much said about health reform for a century. The state of Alabama provides free health insurance to state employees. According Parade magazine, the state employees have until the end of November to get screened for chronic diseases to retain the free insurance. If the employees failed to get screened, they’ll have to pay $25.00 per month. There are millions of people who would be willing to pay a low fee of 25.00 per month for health insurance.  That co-pay is less than what is require for federal government employees to pay monthly.  The federal government pays approximately 75% of the premiums while the employee pays the remainder 25% to belong to the Federal Employee Health Benefits Program (FEHBP).

Employee Wellness Programs are not a new concept.  Many companies including the departments in the federal government and military had wellness programs for more than 30 years.  President Obama and other supporters of healthy Americans encourage employee wellness programs.  We should be looking at the quality of life at all stages – from birth to death. The absence of illness/disease is a cost savings to patients and employers.  To patients the cost savings is seen in dollars saved on medications, doctor visits and loss of time at work. Not all employers pay for sick leave. To employers the cost savings is seen in dollars saved on loss productivity, replacement of sick employee and paid leave.

Elements of a Comprehensive Worksite Wellness Program were defined by Healthy People 2010 as:

• Health Education
• Seminars
• a. diabetic management
• b. hypertension management
• Education Sessions
• Classes –
• a. tobacco cessation
• b. Nutrition
• Lectures –
• a. women’s health
• b. men’s health
• Newsletters
• Health education or health promotion literature
• a. pamphlets
• b. videos
• c. and/or leaflets
• Website or links to web-based information or resources and interactive based education
• Personal safety information and training programs (Personal & Work Related)
• Work and job related safety information and training programs such fire safety
• Supportive Social and Physical Environments
• Health Fairs
• Immunization campaigns or availability
• a. seasonal influenza
• b. other adult immunizations
• Walking Groups/ Running Groups
• Exercise or fitness classes or groups
• Incentive Use –
• a. shirts
• b. caps
• c. promotional items
• Shower facilities offered
• Locker Rooms
• Bike racks or storage
• On-Site Fitness Facilities
• Commercial Fitness Membership
• Group discount arranged
• Subsidy provided
• Full Memberships provided
• Integration of Worksite Wellness Program into Organizational Structure
• a. Tobacco – free building
• b. Support for Healthy Food Choices includes:
• i. Cafeterias
• ii. More fruits, vegetables, less fried food
• c. Vending Machine
• i. Snacks with lower Trans fats, sugar and salt
• d. Available Microwaves and Refrigerators
• Screening Programs
• a. Blood Pressure checks
• b. Diabetes Screening
• c. Substance Abuse Screening
• d. Mammography
• e. Stress Screening
• f. Cholesterol Screening
• g. Health Risk Appraisal
  
  

Healthy People 2010 goals for worksite wellness programs are identified as:  75% of worksites offer a comprehensive worksite wellness program, and; 75% of employees participate in the program.

The Leading Health Indicators for Healthy People 2020 will be used to gauge the health of America over the next 10 years. Each of the 10 Leading Health Indicators has one or more objectives from Healthy People 2010 related to it. Why is that? Because since Healthy People was initiated, all of the objectives were not met. As a group, the Leading Health Indicators reveal the most important health concerns in the United States at the beginning of the 21st century. Health concerns remain about the same. The Leading Health Indicators were chosen on the basis of their capacity to inspire action, the accessibility of data to measure advancement, and their significance as public health issues.

The Leading Health Indicators are—

• Physical Activity
• Overweight and Obesity
• Tobacco Use
• Substance Abuse
• Responsible Sexual Behavior
• Mental Health
• Injury and Violence
• Environmental Quality
• Immunization
• Access to Health Care

Blake, John B.: Public Health in the Town of Boston, 1630-1822. Cambridge: Harvard University Press, 1959, preface, p. ix

1. See reference 5, chap. IV, pp. 52-75, "The Inoculation Controversy, 1721-1722," in the cited volume.

Fitz, Reginald H.: Zabdiel Boylston, Inoculator, and the Epidemic of Smallpox in Boston in 1721. Bull. Johns Hopkins Hosp. 22: 315-327, 1911.

Beall, Otho T., Jr., and Shryock, Richard H.: Cotton Mather: First Significant Figure in American Medicine. Baltimore: The Johns Hopkins Press, 1954. See esp. chap. VII, pp. 93-123, "The

Advent of Preventive Medicine: Boston, 1721," and chap. VIII, pp. 123-126, "Conclusions: Mather's Place in Medicine."

1. Mather, Cotton: The Angel of Bethesda. An Essay Upon the Common Maladies of Mankind. Manuscript written in the period 1720-1724. The original manuscript is in the possession of the American Antiquarian Society, at Worcester, Mass. A transcription of it, typed, made by Worthington C. Ford about 1911, is also in the library of that Society. In addition to numerous distributed quotations, a considerable portion of the text, taken from this transcription, is reproduced in chap. VIII, pp. 127-234, "Selected Sections From 'The Angel,'" in Cotton Mather, by Beall and Shryock. See reference 23. A lively and interesting account of Mather and this work will be found in the following reference.

2. Thayer, W. S.: Cotton Mather's Rules of Health. Bull. Johns Hopkins Hosp. 16 (174): 293-300, September 1905.

Marten, Benjamin: A New Theory of Consumptions: More Especially of a PHTHISIS, or Consumption of the Lungs. London: R. Knaplock, 1720, esp. p. 51.

Mather, Cotton: An Account of the Method and Success of Inoculating the Small-Pox, in Boston in New-England. London: J. Peele, 1722. This pamphlet, "a letter from a gentleman there, to his friend in London," though unsigned has proved to be Mather's. It is dated at the end "Boston, in New England, Sept. 7, 1721."