Reforming Health and Healthcare

There is a lot of talk about disease prevention in the discussions on healthcare reform. However, not all the necessary players are participating if we are going to achieve this. Prevention is more than annual visits to your primary care doctor annually. It is the social change that is necessary to eradicate poverty, reform education and increase literacy. It must provide safer housing, cleaner drinking water, safer food, and cleaner air, while continuing to perform the best medical research in the world.

About 90 million Americans  are basically illiterate and unable to perform basic reading and numerical tasks for functioning in the healthcare environment and acting on healthcare information and has negative effects on the health of the population with adverse health outcomes. Among the groups tied to poor literacy are those with fewer years of education which occurs most often in the poor. Impoverished  neighborhoods have notoriously awful schools that do not provide students with the basics they need to read and write.  This is not irreversible as shown in the magnet schools in the Bronx, N.Y., when good teachers teach in these neighborhoods, there are excellent results.

Numerous  studies have evaluated the relationship between literacy and poor choices in regards to health. The largest study (n= 3,019) found a significant relationship between poor literacy and various measures of smoking among adolescent boys and girls. Smoking has the most deleterious effects on our health. It accounts for over 400,000 premature deaths and over $100 billion a year in healthcare costs. Raising literacy would lower smoking rates and significantly improve our health. And folks, it’s not just smoking, high poverty, and low literacy rates also means less screening for cancer and sexually transmitted diseases.

There is also more obesity in poor neighborhoods. Most of this is related to the paucity of grocery stores that carry fresh fruits and vegetables and the easy accessibility to fast food restaurants. Obesity is another modifiable behavior that results in 400,000 premature deaths a year.

If we really want to reform healthcare and increase America’s health while reducing healthcare costs, we must address poverty and education. Therefore, the following departments should be at the healthcare reform table: interior, agriculture, education, the Food and Drug Administration, the Centers for Disease Control, and the Department of Health and Human Services. Let’s get together and pull our resources together to make America the healthiest nation.


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