|
Is There a Science of Health?
Connie White
Delaney, Dean of the University of Minnesota School of Nursing, recently
stated that Iceland practiced a national philosophy that could be
summarized in four points:
1.
The healthy help those who are ill;
2.
The employed help those who are unemployed;
3.
The young help the old; and
4.
The rich help the poor.
I recognized
these principles from my home country of Norway. I also believe them to
apply to all Scandinavian countries, so let us add Denmark, Finland and
Sweden to this list. We may disagree on the best way to apply these
principles, but I don’t think we disagree on their importance or
desirability.
These five
countries are among the richest — and healthiest — countries in the
world. They all are capitalist economies.
In the United
States, insurance companies used to practice a similar philosophy: The
healthy paid for those who were ill and accident-free drivers paid for
those who had accidents. But as experience with claims accumulated,
actuaries identified those who were likely to become ill; those who
would be most likely to lose their homes in floods, or hurricanes or
fire; and those who were accident-prone drivers. The higher the risk of
adverse events for an insured person, the higher the premiums, until
many of those who truly needed the financial protection could no longer
afford it.
The extraordinary
annual increases in health insurance premiums have fostered a new focus
on health in the U.S., both among employers and in the general
population.
The World Health
Organization defines health in a rather complex way: “ . . . health is
a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.” In more recent years, this
statement has been modified to include the ability to lead a “socially
and economically productive life.” I like a simpler, more flexible
definition that has been proposed by Dr. Kenneth R. Pelletier of the
University of California School of Medicine in San Francisco. It is a
definition that embraces both decathlon athlete Bruce Jenner and
physicist Stephen Hawking: Man in harmony with his environment.
What does such a
harmony imply?
I think it implies
acceptance, friends, meaningful work, having enough income to meet one’s
basic needs, being satisfied with one’s life, and enjoying access to
good health care and good education.
Statistically, there are dozens of known variables that
correlate with health. Living in a small town is healthier
than living in a big city. Living high above sea level is
healthier than living at sea level. Being in control of
one’s life is better than not being in control of it. Less
negative stress is healthier than constant negative stress.
If we equate
health with longevity, there are studies that show that having pets may
make you live longer compared to not having pets. Historians and
librarians tend to live the longest; people who had warm and nurturing
parents lived longer than people who had cold and indifferent parents.
Colder climates seem to favor longevity; so does loving what you
do.
By knowing — and avoiding —
the precursors of disease and mishaps, we can live longer. We do so by
not smoking, by not drinking immoderately, by using seat belts, and by
avoiding accidents. We also help ourselves by controlling our blood
pressure, cholesterol levels, and height/weight ratio. |
|
When
Lewis Thomas wrote about medicine in his book, The
Youngest Science, he dated the science of medicine
to have emerged around 1910 with the publication of the
Flexner Report. A science of health would be
more complicated than the science of medicine, and has yet
to earn the designation “science.”
The 20th
century saw the conquest of infectious disease and the
management of chronic disease. The 21st century
will usher in the Drive for Health (as predicted by Lester
Breslov in a recent appearance at the School of Public
Health at the University of Minnesota).
Eight
thousand years ago, mankind could expect to live about
thirty years. Global life expectancy is now sixty-seven
years and increasing. It is possible that we shall see
centenarians becoming the largest demographic group.
A
science of health will reveal startling new truths at par
with those uncovered by the pioneers of medicine who
discovered bacteria, viruses and prions. A science of
health will point out the way to create healthy cities,
healthy homes, non-toxic environments, healthy
relationships, meaningful and challenging work, lifelong and
relevant education, and, perhaps, the means to pursue our
dreams. The human genome will teach us to prevent diseases
far beyond our abilities today, maybe to the point of making
us “disease proof.”
Good
science emerges from good questions. In the end, there is
only one science — the search for truth in any discipline.
The distinction between natural and social sciences may
vanish. By today’s standards, I think that both the science
of medicine and the embryonic science of health are largely
social sciences. By that, I mean that both the number of
variables and our inability to experiment with those
variables (holding all other variables constant and
examining the relationship between two or more variables)
will await more advanced methods and analytical capabilities
to rival the natural sciences.
Were
the health sector to cease being a “disease sector,” and
truly focus on health, everything will change!
Doctors, nurses, dentist, social workers, psychiatric
workers and psychologists, nutritionists, speech and hearing
therapists, occupational therapists, physical therapists,
and other health care professionals, will all add new roles
to their work. Completely new professions will emerge. The
character of existing professions would be altered:
Architects and city planners will emerge to build and plan
for healthy lives; businesses will find new profit
opportunities in a healthier world; and governments will
regulate what free and fair competition cannot achieve in
bringing good health to everyone.
Oral
traditions and herbal remedies practiced today in China have
origins that go back in time thousands of years. From them,
we learn that to be healthy is to be in harmony with oneself
and one’s environment.
It is
curious, isn’t it, that the future of health has been
foreseen all along in insights from the distant past? It is
about how we best should live, and how we could leave this
world a better place.
That’s
why there will be a science of health one day, inspired by a
few great, eternal questions:
What
makes us ill and how can we prevent illness?
What makes us healthy and
how do we stay healthy?
How do we put those insights
to work in making this world a better place?
|
