Taboo #8 – Ill Health.
You may think that Covid-19 is done and dusted but for many it’s the ‘gift’ that keeps giving and we are seeing a tsunami of Long-Covid cases that months and even years later people are affected by. Post-Viral syndromes are nothing new and the more we ‘find out’ about Long-Covid the more symptoms we find that seem to be correlated to a history of previous Covid-19 infection but rather than helping define the condition this just seems to muddy the waters such that there are possibly many different conditions as yet to be defined. Unfortunately there is no test to identify an entity that can diagnose or as yet even suggest a possible cause or mechanism to explain why some people are affected once their immune systems have cleared the infection. It’s also true that once we have had Covid-19 we don’t get great immunity and there are numerous cases where patients report 2, 3 or more infections with Covid-19. Fortunately most (but not all) are relatively mild in part because there is some immunity but also some of the newer Covid-19 variants seem to be less virulent. The advice does seem to be to continue with vaccinations and stay away from those infected or even those unknown:unknown cases for example crowds, public transport etc. To wear a mask or not? Evidence isn’t clear but it will likely do no harm and since what evidence there is suggests it is the mask wearer who is protecting others from inhaling their virus, it may help keep some distance from others worried they’ll catch your Covid-19 whether you have it or not!! Now onto more general rather than specific stuff!
Ill Health – How do we avoid it? How do we deal with it when it does affect us?
We can look at the top ten causes of death in men and women and focus on the preventable, however there is more to life than death so not only should we focus on quantity of life and what kills us but on what affects our quality of life whilst we are alive! Mortality AND Morbidity. I hear so often people say, “..well I have to die of something!” and a quick painless death may well be the best way to go especially if you have chosen your deity wisely and have paradise to look forward to for eternity. However death and dying are seldom that considerate so good luck with that as there’s that rather awkward in-between stage that most of us will have to face up to and cope with which will include illness, infirmity, disability, decrepitude etc. Much of this we have little choice about but which we can modulate by pursuing a healthier lifestyle, modifying risk factors, taking up screening and keeping fit and active. Whilst we’re above ground we might as well have more fun TOYLing than the TOILing with doctor’s appointments, disability and feeling worse than we need to(?!)
In our high-income countries we have made great strides and reduced much of the morbidity and mortality seen in the third world. Most has been with the help of engineers rather than doctors – we live in a safer world with fewer deaths on the roads and at work. We have clean water so fewer communicable diseases, we’ve cleaned up the air we breathe and smoke less and so have fewer respiratory diseases. Agricultural advances and favourable climates have allowed us to eat well albeit ‘too well’ for some, science has increased yield and nutritional value and processing despite some disadvantages has given us ‘fortified’ foods with beneficial additives such as vitamins as well as alternatives to more harmful foodstuffs containing cholesterol etc. Hunger and famine are huge killers not just by way of starvation but by weakening the body and making illness more likely and more difficult to fight off. Much of communicable disease prevention has been secondary to advances in those things we take for granted such as clean water, sewer systems, heat and light at home and work etc. However, medicine has played its part too. We have fewer maternal and neonatal deaths with vaccination programs eradicating or nearly eradicating many killer diseases. Those we still have to contend with such as scarlet fever are now less virulent than in the past and easily treated with antibiotics. (Despite a growing problem with bacterial resistance due to their overuse.) Some vaccines may not protect us completely by giving us full immunity, but should we contract the illness it is likely going to be less serious to our health than if we are not vaccinated. By being vaccinated we will also help protect the ‘heard’ especially those few who for medical reasons cannot be vaccinated. If we are ill most of us have affordable healthcare which we can access early in the disease process and thus have a greater chance of a better outcome. Advances in medicine can make us better and keep us living longer, however these can’t be relied upon alone. Prevention is still better than cure. Obesity and its assassins heart disease, stroke, diabetes and cancer is an ever-increasing problem with statistics suggesting that our children may end up with lifespans shorter than ours and die before many of us. Food is BIG business and governments worldwide seem incapable, or more likely unwilling of making the necessary changes that would encourage healthier eating or at least lessen the appeal of unhealthy diets and are thus somewhat complicit in making the health of the nation worse than it might otherwise be, whilst at the same time ‘encouraging’ healthier lifestyles. Pretty much every western government has proposed major interventions that could make a REAL difference, however ‘Big Food’ either lobbies against this ‘nanny state’ or gets involved (‘free money – I think not!) and waters down the proposals to a level that their business is not harmed whist we continue to be so!
Smoking too is a HUGE health issue with increased morbidity and mortality despite government ‘intervention’ (..or is it that the tax gained is so much that the economies can’t do without it?!) There is good news however, we know the problem and the solution isn’t going to need billions to sort out.
3 SIMPLE rules.
- STOP Smoking.
- Eat Less.
- Exercise more.
YES – It’s probably that simple whoever you are!
There is a ‘truism’ (excuse??) that after WW2 food was expensive but exercise cheap – many worked in manual jobs and walked to and from work. Now with the ‘advance’ of food science and agriculture we find ourselves with cheap food aplenty, have sedentary desk jobs and drive everywhere including the expensive gym! Maybe walking to the gym, turning around and walking back home is the way forward! Vegetables are less expensive than meat and do us and the environment less harm. It’s not rocket science, is it?
More baby boys are born every year than girls however any numerical lead vanishes very early on. From birth to old age the female of the species are simply healthier and do better in terms of health and staying alive! (From death by accident to suicide and from cancer to cardiovascular disease men are dying younger than women.) Out of the 15 leading causes of death, men lead women in all of them except Alzheimer’s disease and this is possibly because men don’t live long enough to get diagnosed or are too sick with other conditions for it to be a priority to diagnose. Although the gender gap is closing, men still die five years earlier than their wives, on average. This gap may be due to biology with genetic and or environmental factors also playing a large part. (There is some evidence that women who work in traditional male careers with the same stress and long hours behave just like their male counterparts when it comes to sickness and dying.) However, men it seems are their own worst enemy with their health seeking behaviour, or rather lack of it meaning their approach to health plays a massive role too. Men go to the doctor less than women and are more likely to have a serious condition when they do go. Women often have the ‘calling card’ of a child they take to the doctor as well as ‘women’s health’ issues from Contraception to Breast and Cervical Cytology screening for which they are prompted to attend for. “…………whilst I’m here doctor…….” Is a very common ‘entre’ at the family practice.)
Worldwide, the average life expectancy at birth was 71.5 years (68 years and 4 months for males and 72 years and 8 months for females) over the period 2010–2015 according to United Nations World Population Prospects 2015 Revision,
Life expectancy for a man has increased dramatically in the past 50 years somewhat closing the gender death gap. Quantity is important but possibly more so is Quality of life and how we can live what life we have to its fullest potential.
Like any machine we need to maintain and service our bodies whilst using the correct fuel. Looking for potential problems using screening tests may also catch a problem early and save breakdowns later.
Unforeseen accidents will happen and cosmetic appearance may decline, but it is the “guts” of a machine that will determine whether its fit and reliable or if we’re heading for the mechanic or scrapyard!
Although it’s difficult to separate out all the risk factors some are ‘independent’ – That is not related to other risk factors directly. For example regarding cardiovascular health, smoking independent of cholesterol level will increase your risk of heart disease. Stopping smoking won’t affect your cholesterol level, cutting down on animal fat in your diet will do that, but will reduce your overall risk of having a heart attack or stroke. Some risk factors are modifiable, for example Blood Pressure, Obesity, Cholesterol, Fitness and heavy drinking, others aren’t – Sex, Family and Ethnicity for example – Some might include Socio-Economic Status, where you live and your occupation too.
My message to you is that your overall risk IS modifiable by YOU.
I’ve written or am thinking of writing something along the lines of:-
Above the neck – e.g. Mental Health see Taboo #4 Mental Health , Dementia etc. DEMENTIA – losing more than memories.
Chest – Cardiovascular Disease – Lung Disease – Breast etc.
Abdomen – Liver – Gut (Stomach, Colon Cancer, Piles) etc.
Below the waist – Sex (See Taboo #6)
Men– Urinary – BPH, Ca Prostate, ED etc.
Women – Breast, Menopause etc.
Happy to be directed in terms of priorities – the above will take some considerable time however open to ideas!
What would you add to this?