Tuesday, August 21, 2012

Health Care Crisis (Part 1)

America’s rapidly declining health and the simultaneous increasing cost of health care has been a wave steadily approaching the shores of our national well-being for over a decade.  Most of us knew the wave was out there somewhere, yet the majority behaved as if it really wasn’t a concern, at least not enough to make important changes in diet and exercise.  Maybe we were lulled into thinking that “insurance will cover it” in the last 20 years since 60% of the population began receiving health care coverage through their employers.  Well, the wave has hit the shore, like a tsunami, and change we must.  We are now in the midst of a “health care crisis” and now it’s sink or swim:

• The CDC reports that in 2005 more than 133 million Americans–almost 1 of every 2 adults–suffered with chronic illness.

• Nearly 26 million Americans have diabetes and an estimated 79 million Americans have “pre-diabetes”). Type 2 “adult-onset” diabetes is increasing in the adult population and has made a surprise appearance in children.

• In May 2009 the CDC published the results of a study in its National Health Statistics Report which found that 1 in 3 American adults in the U.S. meet the criteria for metabolic syndrome, a common but silent combination of metabolic symptoms including cholesterol, triglycerides, glucose, insulin, blood pressure and obesity that leads to heart attacks and diabetes (more on all of these in future blogs).  Hypoglycemia, a related disorder, plagues the lives of countless millions more.

• Cardiovascular diseases accounted for 1 in every 3 deaths in the United States in 2009, a year in which the direct and indirect cost of cardiovascular disease in the U.S. was an estimated $312.6 billion (American Heart Association’s “Heart Disease and Stroke Statistics--2013,” Circulation: Journal of the American Heart Association).  And lest we think these statistics are only of concern for retirees, the Framingham Heart Study revealed that 45% of all heart attacks occur in people under age 65.

• And of course we have all heard (or seen) by now that 67% percent of Americans--a whopping two-thirds of us--are either overweight or obese.

The facts are sobering, we are clearly in trouble.  But it really didn’t sneak up on us unawares--the ripples of the big wave have been hitting us for well over 2 decades.  While billions of dollars have been allotted to battling the trend, the overall health of America continued to decline.  As a nation the motivation to change just was not there.  Now, however, the exploding health care crisis is arguably the greatest threat to the well-being of individuals, families, businesses, and the American economy itself.  The escalating cost of insurance premiums and health care, coupled with sinking wages, and combined with escalating numbers of uninsured Americans, has become a recipe for disaster.  Recent health care reform law (the Affordable Care Act) is an attempt to avert that disaster, but the outcomes of such a late-entry strategy are yet to be seen, and unsure at best.  The need for individuals and companies of all sizes to take action to prevent disease has never been more important.

Signing up for a free RSS feed or daily e-mail update of the Seed to your inbox daily can support you in that effort.  The Seed is a short daily tip, education or encouragement to keep the vision of good health in the forefront of your mind.  The Seed will encourage you about just how doable a healthy lifestyle really is and help keep you motivated (anyone who has ever been on a diet or behavior change program realizes that being motivated to start is not difficult, it is staying motivated that is the more difficult key to real lifestyle change).  The Seed is like having a free Registered Dietitian to support you.

It is generally recognized that there are 6 “Stages of Change” (first clarified by James Prochaska, PhD).  No matter which stage you find yourself in (or straddling), a daily delivery of the Seed to your inbox or RSS feed can help support you whether you currently enjoy a healthy lifestyle or you need help to move through the stages of behavior change:

Prochaska’s “6 Stages of Change”:

Precontemplation: Precontemplators have no current intention of changing.  We have all been precontemplators at one point or another.  You may have no current intention of changing, but the Seed can get you thinking, and that’s where it starts.

Contemplation: Contemplators accept or realize that they have a problem and begin to think seriously about changing it.  It is easy to get stuck in the contemplation stage for years!  Sound familiar? Contemplators need more consciousness-raising which allows them to focus on the negatives of their current behavior and to imagine the consequences down the line if they do not do things differently.  A daily Seed can assist contemplators (even stuck ones) to move on to the next stage of change.

Preparation: Most people in this stage are planning to take action within a month.  Preparers develop a firm, detailed scheme for action.  Many motivate themselves by making their intended change public.  A daily Seed provides tools for you to prepare for action and can help increase your motivation.  The Seed blog can also serve as a forum for you to make your intended change “go public”.

Action: Clearly and evidently modifying behavior, action is the busiest stage of change.  Helping relationships with people who support your goals and applaud your efforts provide more motivation.  The daily Seed can be a consistent visible reminder of support for your efforts.  You might even find an applause or two on the blog if you decide to share about your efforts.

Maintenance: Often far more difficult to achieve than action.  Prochaska says that maintenance can last 6 months to a lifetime, but I find that people who follow the methodology and philosophy of the N.E.W. LIFE program ("put in" missing exchanges instead of "cut out" desirable foods) experience a change of desire in a surprisingly short amount of time, without any "all-or-nothing" dietary restrictions and find "maintenance" to be an enjoyable new lifestyle instead of the arduous task many have experienced after a diet.  People in maintenance should apply the same strategies as those in the action stage, including helping relationships. Because it is free, receiving the Seed in your inbox or RSS feed reader can serve as an ongoing means of support during maintenance where the “rubber meets the road” in the months and years ahead.  The Seed can help you to stay committed to improving and maintaining a healthy lifestyle.

Termination: The problem no longer presents any temptation!  The cycle of change is exited.  But you just may find that you enjoy receiving the Seed and staying updated with the latest health and nutrition information from your “inbox Registered Dietitian”.

Notice that there are 3 stages even before a person gets to the action stage.  The Seed can support you at any stage of the game because in all behavior change there is a “brooding period” to start.  If that is where you find yourself let the Seed help you to “brood” on the right things.

We all know that change takes time, but the dismal health statistics above reveal there really is no more time left.  Wherever we are at in the stages of change, we need to begin, now.  We need to strengthen our collective mindset, and our individual resolves, and make the necessary lifestyle changes to keep this boat afloat, even though the wave did just hit the shore.  Our government has made its best attempt to stop the tsunami, but government help is always inadequate at best.  Real change, which is what we need, always comes down to individual action.  Your efforts do matter, so aim for any improvement in health for yourself, your family, your business, and your country, even if that means just “brooding” about it for awhile.  Better yet, go grab an apple or a carrot, right now.  Prevention is key, and daily support from a Registered Dietitian can help you and your family to be better equipped to survive the “health care crisis”.

The Seed is written by a Registered Dietitian (yours truly).  Registered Dietitians are uniquely trained to provide the highest quality nutrition education available in the United States and also administer specific “medical nutrition therapy” (the recent term adopted since Medicare coverage for Registered Dietitians) necessary for disease management.  While the Seed cannot deliver individualized medical nutrition therapy to your inbox or feed (I'm not allowed), you can be sure that it will deliver the highest quality nutrition education available in these United States!

So sign up with the subscribe to e-mail updates button at the top of this page.

Best of health to you!

Diane Preves, M.S., R.D


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