Tag Archives: Public Health

Straight, No Chaser: The Health Risks of Urban vs. Rural Living

August 29, 2016General Health and Wellness, Public Health844-SMA-TALK, Behind the Curtain, Public Health, Rural health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Urban healthJeffrey Sterling, MD

What’s your flavor, city vs country living? Regardless as to wear you live your life, each decision comes with defined risks to your health, and yes, these effects go beyond the risks of different forms of trauma in each location. To extend the scenario globally, it is an amazing fact that for the first time in human history, it is estimated that more people worldwide live in urban areas than in rural ones. In today’s Straight, No Chaser, we evaluate a few health facts that speak to the relative value of city vs. country living.
It is important to understand that some considerations are more reflective of socioeconomic status than urban vs. rural dwelling. Notably, poverty is a cause of poor health and limits access to health prevention and medical care, regardless of the location of one’s home. There are strong correlations between lower income and higher death rates (mortality) across the board. Poverty, not urban living per se, increases the likelihood of encountering violence, increases the likelihood of experiencing violence and child abuse.

More specific to inner-city urban living, in 1997 the American College of Physicians identified specific health problems most commonly associated with US inner cities, labeling this disadvantage as an “urban health penalty.” They included the following:

Drug abuse
HIV infection
Teenage pregnancy
Violence

Simply put, addressing this set of issues requires addressing the root causes of poverty. It is also of note that access to care presents as significant problems in both urban and rural communities, but for different reasons. Rural communities are likely to have access considerations due to geographic and physician shortages, and urban communities are more likely to have barriers prevent accessing available resources.

There are defined differences in health and health risks, based on living in the city vs. a rural location. For example, those that live in cities:

Actually have less of a risk of becoming obese;
Are less likely to die of an accident;
Are more likely to be lactose tolerant.
Are more likely to develop asthma, have allergies and suffer from dry eyes;
Are more likely to have better TB resistance;
Have a much lower risk of suicide;
Have troubled circadian rhythms and disturbed sleep; and
Report a more pleasant and healthy old age.

Finally it is worth noting that inner city environments produce specific public health threats. These include the following:

Homelessness,
Increased availability of illicit drugs,
Increased spread of HIV infection and treatment-resistant tuberculosis
Presence of higher concentration of certain types of pollutants, such as carbon monoxide and molds.

At the end of the day, these risks may or may not result in health problems for you individually. It is important for you to be aware of the risks in order to limit your exposure. Be empowered, not crippled, by this information, and enjoy the rest of this wonderful time of the year, regardless of your environment.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Straight Outta Health – The Health Risks of Urban vs. Rural Living

August 18, 2015Public Health, General Health and Wellness844-SMA-TALK, Behind the Curtain, Public Health, Rural health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Straight Outta Compton, Urban healthJeffrey Sterling, MD

The amazing success of the movie Straight Outta Compton has focused attention on the consequences of living in inner city America. Among these consequences are adverse effects on one’s health, and yes, these effects go beyond the risks of trauma. To extend the scenario globally, it is an amazing fact that for the first time in human history, it is estimated that more people worldwide live in urban areas than in rural ones. In today’s Straight, No Chaser, we evaluate a few health facts that speak to the relative value of city vs. country living.
It is important to understand that some considerations are more reflective of socioeconomic status than urban vs. rural dwelling. Notably, poverty is a cause of poor health and limits access to health prevention and medical care, regardless of the location of one’s home. There are strong correlations between lower income and higher death rates (mortality) across the board. Poverty, not urban living per se, increases the likelihood of encountering violence, increases the likelihood of experiencing violence and child abuse.

Drug abuse
HIV infection
Teenage pregnancy
Violence

There are defined differences in health and health risks, based on living in the city vs. a rural location. For example, those that live in cities:

Actually have less of a risk of becoming obese;
Are less likely to die of an accident;
Are more likely to be lactose tolerant.
Are more likely to develop asthma, have allergies and suffer from dry eyes;
Are more likely to have better TB resistance;
Have a much lower risk of suicide;
Have troubled circadian rhythms and disturbed sleep; and
Report a more pleasant and healthy old age.

Finally it is worth noting that inner city environments produce specific public health threats. These include the following:

Homelessness,
Increased availability of illicit drugs,
Increased spread of HIV infection and treatment-resistant tuberculosis
Presence of higher concentration of certain types of pollutants, such as carbon monoxide and molds.

At the end of the day, these risks may or may not result in health problems for you individually. It is important for you to be aware of the risks in order to limit your exposure. Be empowered, not crippled, by this information. Hopefully that will keep you straight outta an emergency room.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Contrasting Healthcare Reform In the U.S. and Halfway Around the World

February 16, 2015General Health and Wellness, Public Health, Health PreventionAffordable Care Act, 844-SMA-TALK, healthcare reform, I844-SMA-TALK, Indonesia, legalization of marijuana, marijuana, Public Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Thoughts from a crowded Starbucks in Jakarta, Indonesia

Over my career, I’ve been fortunate to have studied and assisted healthcare systems all over the world. This past week, Sterling Medical Advice had the pleasure, privilege and outright honor of being invited to spend a week in Indonesia with the U.S. Department of Commerce on a healthcare mission in what will be a recurring role. By way of introduction (in case you weren’t aware), Indonesia is the fourth most populous country in the world (right after the U.S.) with a population of approximately 252 million people. It is approximately the same size as the United States, and it is a democracy and a member of the G-20 (with the 17^th largest world economy).

More relevantly, Indonesia is in the midst of becoming the largest country in the world to implement a system of universal healthcare for its citizens. That’s right: by 2019, Indonesia will have enrolled their entire population in a universal healthcare system that is not owned or run by the government. This is a living rebuttal to those who insist that universal healthcare is necessarily socialist medicine.
There are some interesting observations to be made and contrasts between the system design and our own healthcare system. The U.S. currently spends over $8000 per person on healthcare per year; in Indonesia the average spend will be $60/person. This translates into Indonesia spending approximately $15 billion annually on health care after implementation of its new system, compared with over $2 trillion spent in the U.S., inclusive of Indonesia’s goal of doubling its current contributions toward its citizens’ health as part of its healthcare reform.

Dr. Sterling with Dr. Hasbullah Thabrany, professor of health policy at the University of Indonesia in Jakarta and architect of the world’s largest healthcare system

Access will be the foremost priority in the new system of Indonesia, whereas in the U.S., choice is the core component. Still, reform efforts of both systems are prioritizing access; unfortunately in the U.S., access still usually means utilization of the emergency room as a last resort as opposed to having everyone connected to a primary care physician.
Both systems suffer from dramatic physician shortages. In the U.S. this shortage has been addressed by the expansion of numbers and responsibilities for physician assistants and nurse practitioners. Indonesia has yet to permit non-physicians to obtaining status as independently licensed practitioners. In Indonesia, medical schools are opening in an attempt to address the shortage over the long-term; this is not a policy priority in the U.S.
These comments aren’t meant to suggest one country’s approach is better or worse. Such opinions are best addressed by review of objective data. Prior to the implementation of the Affordable Care Act in the U.S. and the current effort in Indonesia, both countries were performing less that either would have wanted. The World Health Organization’s (in)famous rankings of various countries’ systems (based largely on access and outcomes) placed the U.S. system #38 despite being the most expensive and Indonesia’s #92 while being #154 in costs. On the other hand, the U.S.’ ongoing spending of $2 trillion annually on healthcare does wonders for our economy.

As much as anything, the successful implementation of a universal healthcare system in a country the size of Indonesia should encourage those in the U.S. who have long advocated for such here, meaning if the political will ever existed, it could be accomplished. Unfortunately, the ingrained financial interests here continue to outweigh the desires of the public health community.
In the meantime, appreciate that the basics of a country’s ideal healthcare system should be the tools you utilize as your personal healthcare system. Embrace prevention through diet, exercise, screenings, immunizations and healthy life choices. Obtain information and advice to help guide your health decisions. Find a primary care physician. Get prompt treatment when you need it. The benefits of good health are worth the effort at every level.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Powerful Living

March 31, 2014General Health and WellnessGeneral Health and Wellness, Health Prevention, Hematology & Oncology/Blood Disorders/Cancer, Obstetrics and Gynecology, Public HealthJeffrey Sterling, MD

At “Straight, No Chaser,” our posts aim to inform and encourage you to manage your health. However, sometimes we experience lapses in health that are beyond our control. Today, in honor of National Women’s Month, we welcome Dr. Sheri Prentiss to the blog. As a breast cancer survivor and Susan G. Komen 3-Day Spokesperson, she shares a message of hope and empowerment in the face of just one such health challenge.

power
When you think of the most powerful women you know, who comes to mind? Some of us think of political figures like Hilary Clinton. Perhaps you think of Oprah or Beyonce or other entertainers.
It’s easy to recognize “power” in celebrity or status in the newsworthy, but true power is something much more subtle and sublime. Webster’s Dictionary defines powerful as “having power, authority, influence.” According to this definition, being powerful has nothing to do with being a public figure, a multi-millionaire or a politician.
While the world certainly needs revolutionaries, entertainers and politicians, what it needs MORE are everyday women, not using their power to position themselves over others, to re-write history or to be rich and famous, but who are creating awesome lives for themselves and others, just like the women I meet on every 3-Day event!

The world is in desperate need of women who channel their power into touching hearts with their authenticity, stirring emotions with their self-expression, and impacting their worlds with their “regular” lives. In doing these things, we DO change the world, we WILL re-write history, we will be remembered as women who knew and exercised their power.
power woman
What are the secrets of power-full living? How can you invite more power into your life? It’s easier than you think:
1. A powerful woman exercises her authority. This doesn’t this mean you go around bossing people around, but it does mean you stand up for your values, refuse to be a door-mat, take full responsibility for your life, reject the victim role, refuse to settle for less than you deserve in life and love and use your power to speak your mind.
2. A powerful woman spots her leaks and patches them right away. We all have an incredible capacity for power. Think of this capacity as a gas tank, power being the fuel that moves you. When you have a leak—even the tiniest pin-hole—you lose your power. Where in your life do you lose power? What people, activities, obligations or thought processes drain you of your power? When you find them, “patch” them by making whatever changes are necessary.

3. A powerful woman surrounds herself with other powerful women. Truth is, you won’t always feel strong and in control. Troubles, fears, and real-life problems have a way of draining our power. Women who are connected to other women can share their power. When one friend is low on power, another can siphon some of hers to share. When you’re driving on E and putter out on the side of life’s highway, a caring friend can pick you up and bring you to the nearest re-fueling station.

4. A powerful woman re-fuels regularly. Like fuel, power gets spent the more you move. The more you exercise your power, the more necessary it is to re-fuel. A powerful woman does this by connecting with inspiration on a regular basis, by expressing her creativity, by reading good books, by praying, meditating or exercising. There are a million different ways you can re-power. Pick what appeals to your heart and do it.
5. A powerful woman shares her power. It seems to go against what we think of as powerful, doesn’t it? The good news is, sharing your power doesn’t diminish yours. You can share your power perhaps by mentoring a teenage girl or by raising your kids to be strong and independent or by putting your arm around someone who’s sad and empty. There are countless ways you can share your power, and, unlike those dreadful fuel-leak energy-drains, this one actually works in reverse. When you share your power, the world becomes a little brighter, a little more beautiful, and YOU become even more power-filled. power wings
So my questions to you today are these: “Where is your point of power? What energizes you? Where do you lose power? How do you re-fill your tank? How can you share your power?”
Today, consider your amazing capacity for a power-full life … and start living it. Today, share my motto with me: L.I.V.E Everyday!^TM—Love myself and others…Inspire those around me…Voice my dreams and ambitions…Enjoy life.
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Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress