Wednesday, January 25, 2012

Statistics of Word Use

The New York Times published a table entitled "Choice Words" (January 25) which compares the frequency with which President Obama used certain words in his State of the Union addresses (now I note sometimes abbreviated as SOTU - why must we abbreviate everything?) compared with how often they were spoken by the present Republican presidential hopefuls.

Again - beware of text out of context!

Word - "job" - Could be used as in "My job as president......"
Word - "business" - Could be used as in "The economy is the people's business."
Word - "war" - Could be used as in "the war on ignorance......"
Word - "freedom" - Could be used as in "We all have the freedom to decide for ourselves...."
Word - "government" - Could be used as in "The government of Iran......"

Admittedly, these words were more often than not used in the contexts in which they were assumed to be used.  But this form of information, again, brings to mind the potential "misinformation" that could be generated in the absence of the entire circumstance of the variable being measured.

Saturday, January 21, 2012

New Statistics of Heart Disease in the United States

Something new and different!

Facts that may interest you from the American Heart Association "Executive Summary:  Heart Disease and Stroke Statistics - 2012 Update."  (After all, I am a pediatric cardiologist!)

1.  Based on 2008 data, more than 2200 Americans die of cardiovascular disease every day - an average of 1 death every 39 seconds.  Although cardiovascular disease accounts for 1 out of every 3 deaths in the U.S., the actual rate of death decreased by 31% from 1998 to 2008.

2.  There are about 76,400,000 individuals in the U.S. with hypertension.

3.  Cigarette use (despite 40 years of attempts to eliminate):
          a.  21% of men 18 or older continue to smoke.
          b.  18% of women 18 or older continue to smoke.
          c.   19.5% of students in grades 9-12 report "cigarette use."

4.  33,600,000 American adults over 20 years of age have a total serum cholesterol of 240 mg/dl or greater.

5.  The prevalence of overweight and obesity in the U.S. in adults 20 years old or greater is 67%.

6.  Among American children ages 2-19, the prevalence of overweight and obesity is 49%.

7.  The proportion of youth (18 years and younger) who report engaging in no regular physical activity is high and the proportion increases with age.  Among children in grades 9-12, 30% of girls and 17% of boys reported no significant physical activity in the previous 7 days.

8.  33% of adults report engaging in no aerobic leisure-time physical activity.

9.  Total direct and indirect cost of cardiovascular disease (including stroke) in the U.S. was $298 billion (2008).    By comparison, the cost of all cancer (malignant and benign) treatment in 2008 was $228 billion.

Tuesday, January 17, 2012

Preventive Medicine - Your Job, Not Your Physician's

How often have we read of the need to improve preventive measures in order to improve health as well as to decrease the cost of health care.  Unquestionably true, in my opinion.  But emphasizing preventive care does not demand an increase in physician-visits.  Maintenance of good preventive measures does not require expensive programs.  It does not require physician visits every few months; it does not require unnecessary mammograms, unnecessary CT scans, unnecessary ultrasounds, unnecessary blood tests, etc.   Society (government) has to agree on which measures are statistically preventive, and which are not.  If, hypothetically, a CT scan can detect a treatable disease or disorder in its early stages 100% of the time, but the disease or disorder  has a known occurrence of only 1 in 10,000 population,  should society support the cost of 9,999 normal CT scans to find the 1 with the disease?  In our rush to promote our health we cannot ignore statistical data.  We should not expect insurance companies or government programs to support preventive programs that search for "needles in haystacks."  As wonderful as it may be to be able to preventively treat the above-discussed disease in the 1 patient who may have it, the cost to society of finding him may easily be $5,000,000 (10,000 CT scans at $500 each)!

For the vast majority of us preventive care comes at little or no cost.   All it takes is a common sense diet, a common sense exercise routine (no gym required, believe me), a common sense avoidance of proven potentially dangerous habits, and little more.  These are the essentials of "prevention" - they are effective - they are without any major costs.  You do not need a physician to live a healthy life.  A physician's job should not be to keep you healthy - you can easily do that on your own.  A physician's job is to treat disease and to monitor the treatment of disease. Preventive measures to maintain good health is your job, not his.  

Thursday, January 5, 2012

The Rights of Humans and Other Living Things

A recent article in the New York Times, "Animal Studies Cross Campus to Lecture Hall," raises the oft-considered issue of animal rights.  The philosopher Peter Singer has been a leader in the "animal rights" world and has argued that those animals who are sentient beings have a right not to be eaten, or killed for their skin or fur, nor used in experimentation.  The article points to Singer's questioning "how humans could exclude animals from moral consideration, how they could justify causing animals pain."  We have become increasingly aware of animals as thinking, emotional, sensitive creatures, many of whom seem to exhibit caring and moral behavior towards members of their herd, flock, pack, etc.

Does the fact that a living thing exhibits a form of moral behavior automatically grant that creature an unquestioned right to life?  Does the fact that a living thing exhibits sentient behavior automatically grant that creature an unquestioned right to life?  Should rights be granted to living things even if those things have no understanding of these rights nor any obligations to extend such rights to other things?  Do trees have a right not to be cut down?  Do flowers have a right not to be picked?   Are all living things to be given "unalienable rights?"

Or should we determine that living things that are human beings are ex parte and deserving of special rights because of their species - rights that are not to be conferred on other living things.  Would it be fair to argue that an animal that has a right not to be killed should also have a moral obligation to refrain from killing?  If an animal attacks and kills another animal does that animal have a right to a fair trial?  Does a sentient, caring, loving service dog have a greater right to life than a non-sentient newborn with major abnormalities that would forever limit his abilities to sustain a  sentient or normal existence?

I would argue that we humans are ex parte.  Not a religious argument, but an evolutionary one.  We are unique in the world.  Morality, which humans understand to a degree infinitesimally greater than any other living thing could understand, confers on humans a special niche.  Even the most severely limited human, who is non-sentient, whether newly born or in the depths of old-age related severe dementia, has a greater right to life than the kindest and most caring of any other living thing.  Human beings are very special living things and have "unalienable" rights that do not devolve to other living things.  Other living things have only the rights we humans grant them, for they are unable to understand rights and obligations at any meaningful level of development.

Sure, we absolutely should be kind and attentive to other living things.  But the argument that they have rights in any way equivalent to those of the most non-sentient, most damaged human animal is not a consideration.