In 1965 Epidemiologist Lester Breslow and his colleagues from the human population laboratory of the California state department of public health began a survey of a sample of households in Alameda County, California. Researchers sent detailed questionnaires to each resident 20 years or older. Nearly 7000 people returned surveys. Among other questions participants answered questions about seven basic health practices
19)getting 7 or 8 hours of sleep daily, (2) eating breakfast almost every day, (3) rarely eating between meals, (4) drinking alcohol in moderation or not at all, (5) not smoking cigarettes (6) exercising regularly, and (7) maintaining weight near the prescribed ideal.
Before the study only smoking had been implicated as a health risk, evidence that any of the other 6 practices predicted health were quite weak.
A follow up 5 and 1/2 years later revealed that Alameda County residents who
practiced six or seven of the basic health-related behaviors were far less likely to have died than those who practiced zero to three. This was independent of their 1965 health status, thus suggesting that healthy behaviors lead to lower rates of death.
9 years later another follow up found that cigarette smoking, lack of physical activity, and alcohol consumption were strongly correlated to mortality, whereas obesity and too much or too little sleep were only weakly associated with
increased death rates. As it turned out, skipping breakfast and snacking between meals did not predict mortality.
People with few social contacts were 2 and 1/2 times more likely to have died than those with many such contacts.
In 1994 representatives from all the major tobacco companies came before the Congress subcommittee on health to argue that cigarettes do not cause heart disease and lung cancer, no scientific study has ever proven that cigarette
smoking causes heart disease oar lung cancer in humans. This is technically true because only experimental studies can absolutely demonstrate causation and no such experimental study has ever been (or ever will be) conducted on humans.
Still, scientists can infer a causal link if certain conditions are met.
The first criterion is that a dose-response relationship must exist between a possible cause and changes in the prevalence or incidence of a disease. This is a direct consistent
association between an independent variable, such as a behavior and a dependent variable, such as disease. There is such a relationship between the number of cigarettes smoked per day and the number of year on had smoked and the subsequent incidence of heart disease, lung cancer, and stroke.
Second: the prevalence or incidence of a disease should decline with the removal of the possible cause. This is true for smoking as well, quitting lowers one's risk of cdv and lung cancer.
Third: the
cause must precede the disease.
Cigarette smoking almost always precedes incidence of disease.
Fourth, a cause-and-effect relationship between the condition and disease must be plausible; that is, it must be consistent with other data, and make sense from a biological viewpoint. The underlying connection between a behavior do not need to be known but it must be a reasonable possibility.
Fifth, research findings must be consistent.
Sixth, the strength of the association between the
condition and the disease must be relatively high.
Finally there must be well-designed studies. Well designed observational studies can yield the results equivalent to experimental studies and a large number of these observational studies consistently reveal a close association between cigarette smoking and cdv and lung cancer.
1. Healthy habits that are practiced throughout their lives are more effective than medicine to remedy chronic illnesses that could've been preventable.
2. One online group called Type One Teens as a place for other kids with diabetes to connect both online and through face-to-face social activities
Grace Emerson Terrell, the CEO of Cornerstone Health Care, reported that her company "blew up the physician-centered model" and the brief primary care visit, redesigning patient care and financial incentives. "We'll give compliant diabetics free medications if they work with wellness coaches"
Ebekozien's team recruited local women who themselves had type 2 diabetes and trained them as "health ambassadors" to reach out to their neighbors by telling their own stories. The Health Ambassadors sometimes helped their neighbors learn to shop and cook nutritious food. Sometimes they accompany them to doctor's appointments. Efforts like these can have special importance in areas where residents of color may feel downright wary of medical professionals, several speakers said. "Trusted voices make the most effective messengers," said Anne Filipic, president of Enroll America, a nonprofit created to help Americans sign up for insurance through the new exchanges.
To make and maintain new behaviors, people with diabetes or pre-diabetes often need lots of outside reinforcement. Some people find this at bricks-and-mortar setting like the YMCA, which is now deeply involved in diabetes prevention. With funding from the CDC and the UnitedHealth Group, the YMCA has rolled out a yearlong, evidence-based diabetes prevention program to 24 states. The program costs less than $300 per person, according to John Anderson. At the YMCAs, participants join in 16 weekly classes that teach behavior change strategies around food and exercise, followed by monthly classes. The YMCA receives additional payments if participants reach the goals of a 5-7 percent weight reduction, the level that research has shown can keep a prediabetic person from becoming diabetic.
Women tend to gravitate towards in-person classes, several speakers said, while men tend to find them less appealing. For men and for others not able to or inclined to attend classes, an online community and digital tools may work better. Of course, many people will access both types of support.
CollaboRhythm from the MIT Media Lab, has the goal of equipping patients to lead in disease management with help from doctors, health coaches, relatives and friends. Patients have easy access to all relevant data on their own devices and to frequent, detailed advice from coaches. They start out as "apprentices" learning how to manage their own diabetes and advance to become "masters" who can coach other patients.
Project Not Me, which involved having participants watch an entertaining, educational reality TV show. The reality program, available to study participants on demand, had 16 episodes that paralleled the experiences of people in the YMCA's program. The show featured six appealing prediabetic people of different ages, genders and ethnicities, working with a friendly health coach.