Avoidable Chronic Diseases

Both obesity and smoking can cause multiple diseases, ranging from cancer, emphysema, arthritis, coronary artery disease, to mouth disease and hypertension, any of which can significantly decrease activities of daily living, as well as, life expectancy. Both of these disease factors are preventable. Preventive measures should include those with an individual focus as well as community-wide measures. Focusing on community education and prevention efforts will help to alleviate the health concerns arising from these issues.

Although tobacco comes in many forms, cigarettes will be our primary focus. Cigarettes contain many toxic carcinogens. Tobacco, arsenic, and ammonia are among the 7,000 substances found in cigarettes known to cause many problems within the human body (CDC, 2011). Smoking causes more than, 480,000 deaths a year in the United States (CDC, 2014), and not only to smokers themselves but also among those who have secondary and tertiary contact.

Community education programs and smoking cessation classes can help to eliminate smoking. These programs can help to teach the community how to deal with this addiction and can also help families deal with this deadly disease.

According to Masters, Reither, Powers, ClaireYang, Burger, and Link (2013), “Among health professionals there is widespread agreement that high rates of obesity present serious public health challenges in the United States.” Obesity occurs in all ethnicities, genders, and age groups. Obesity is decreasing the health of our nation by causing problems with blood pressure, cholesterol, and respiratory problems. The cost of obesity is placing a burden on our health system. 

Ward-Smith (2010) states, “Obesity  has been associated with a 36% increase in the health care spending and treating the obese patient can be medically challenging.” It is placing a burden on an already weakened health system. According to Finkelstein, Trogdon, Cohen and Dietz (2009) there was an increase of approximately $40 billion on medical spending for obese patients in 2006 and medical cost increased by $147 billion in 2007.

Community education programs offer ways to teach Americans how to control their weight through exercise and healthy eating, as well as by learning how to read food labels. Such programs can also help children and youth to develop healthy eating habits while young that will last them throughout their lives. The combined effect of these programs can help to ensure a healthy generation in the future, and can reduce the strain on the United States’ medical resources and economy.

References

Center for Disease Control and Prevention. (2011). Chemical in Tobacco Smoke. Retrieved from www.cdc.gov/tobacco/data_statistics/sgr/2010/consumer_booklet/chemicals_smoke/

Centers for Disease Control and Prevention. (2014). Health Effects of Cigarettes Smoking. Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm

Ginkelstein, E.A., Trogdon, J.G., Cohen, J.W., & Dietz, W. (2009). Annual medical spending attributable to obesity: payer-and services-specific estimates. Health Affairs, 28(5) w822-w831. Retrieved from content.healthaffairs.org/content/28/5/w822.full.pdf+html

Masters, R. K., Reither, E. N., Powers, D. A., Claire Yang, Y.Y., Burger, A.E., & Link, B.G. (2013). The impact of obesity on US mortality levels: The importance of age and cohort factors in population estimates. American Journal Of Public Health, 103(10), 1895-1901. Retrieved from http://dx.doi.org.p.atsu.edu/10.2105/AJPH.2013.301379

     Ward-Smith, P. (2010). Obesity - - America’s health crisis. Urologic Nursing, 30(4), 242-245.

Sit Too Much?

Try Three Easy Movements to Combat the Fatigue and Pain from Too Much Sitting.  

On average, adults in the U.S. spend 55% of their waking time in sedentary activities and as much as 8.5 hours a day in front of a screen.  Knowing that the body will adapt to the demands imposed upon it (in this case, extended time in the seated position) it is not surprising that the muscular dysfunctions that are most common in my training practice are tight calf muscles, and weak shoulder muscles (rear deltoid and rotator-cuff).  In the seated position, the knee is bent or flexed.  One of the calf muscles, the gastrocnemius (gastroc for short), connects just above and behind the knee, and helps flex the knee. While seated, the gastroc tends to remain in a somewhat shortened, and overactive, position because the knee is flexed.  An overactive gastroc can cause plantar fasciitis, shin splints, varying degrees of knee pain, as well as low back pain.  For the neck and shoulders, reaching for a keyboard or trying to focus in on a screen can result in rounded shoulders and a forward head posture.  Clinically termed Upper-Cross Syndrome, this forward posture can cause shoulder impingement and instability, as well as headaches and neck.  Upper Cross Syndrome is characterized by tight chest muscles and anterior deltoids, and underactive rotator cuff muscles and posterior deltoids. 

By strengthening the underactive muscles, the opposing tight muscles will lengthen and allow balance in the joint to be restored.  For an overactive gastroc, terminal knee extensions (TKE) will help stretch the calf while strengthening the end range of motion for the quadriceps.  To perform a TKE, sit on the floor with your feet out in front of you. Tighten your quadriceps so that the back of your knee touches the ground.  An example can be found in the attached video. 

To strengthen the rotator cuff muscles and the rear deltoid, “T’s and “Y”s can help.  To perform a “T”, lay face down on the ground or on a stability ball.  Bring your arms out to the side and lift. To perform a “Y”, lay face down on the floor or on a stability ball and bring your arms above your head to form a "Y" and lift. Examples can be found in the attached videos.

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A few sets of each, a few times per week will help reduce some of the pain caused by sitting for extended periods of time and help reduce the chance for the onset of chronic pain. 

Clark, M, Corn, R., Lucett, S. (2007) Corrective exercise specialist:  home study course. Movement Assessment.  Calabasas, CA: National Academy of Sports Medicine

Matthews, C. E., Chen, K. Y., Freedson, P. S., Buchowski, M. S., Beech, B. M., Pate, R. R., & Troiano, R. P. (2008). Amount of time spent in sedentary behaviors in the United States, 2003-2004. Am J Epidemiol, 167(7), 875-881. http://dx.doi.org/10.1093/aje/kwm390.

Stelter, B. (2009, March 26). 8 hours a day spent on screens, study finds. The New York Times. Retrieved from http://www.nytimes.com/2009/03/27/business/media/27adco.html?_r=0.

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Using Art to Boost Individual, Family & Community Wellness

All the world's a stage, and all the men and women merely players.

William Shakespeare (1564 - 1616)

The arts have been recognized by many as being meaningful & relevant tools to understanding life; and are now being recognized as authoritative driving forces to positive health outcomes. Ever since the beginning of time, human beings have desired relevant & meaningful activities in their daily encounters (Frankl, 1966). Do you find that you do an activity easier when you understand the meaning or relevance of it?

Art is powerful. Have you ever wondered how the many forms of the arts out there & public health efforts can come together to yield positive health outcomes in efforts to prolong an enhanced quality of life for you, your family or your community? Research shows that engaging in artistic activities, either as a plain observer of the art created by others, or as an originator of art, can boost an individual’s mood and feelings, and can actually have a significant effect on the body; manifested by superior health outcomes and improved physiological wellbeing (Stuckey & Nobel, 2010)

Where is the evidence you may ask? It is out there. I urge you to research the health benefits of being involved in the arts for you and your children. Stuckey & Nobel (2010) reviewed and compiled research studies in art and healing in an effort to understand the effect of art on the wellbeing of communities and its individuals.  In their findings, 4 primary artistic modalities developed as contributors to health and wellness: (1) music engagement, (2) visual arts therapy, (3) movement-based creative expression, and (4) expressive writing. These 4 creative processes were found to have the potential to be intentionally utilized to foster health in people.

Lets explore them one-by-one:

1.      Music Engagement: Research findings support that music tranquilities the brain, reduces anxiety, and affects the immune system responses through actions on the amygdala and hypothalamus.  Music is the most easily accessible and most researched medium of art. There are studies out there that show music being utilized to control pain in cancer patients (Aldridge, 1993) and as a stress-reduction tool in coronary care units after a heart attack (Guzetta, 1999). Can you think of ways you or your loved ones can engage in music to improve your health today? Feel free to comment and share below.

2.      Visual Arts: Art is not only pleasing to the visual senses but it can also be used by individuals to express experiences that may be too difficult to put into words. Think of how visual art can be used at the bedside to explain what is going on in a patient’s body by a physician. Isn’t that powerful to imagine? Patients as well can also use visual art to explore the meaning of their disease process to them and how it impacts their past, present, and future life.  Also, I think of the limitless power of visual art during loss and grief. Studies have shown how something as simple as molding and visualizing clay can be such a powerful mode of expression. Through the somatic level tactile involvement of molding and visualizing the art form, one can facilitate verbal communication and cathartic releases of unconscious thought processes and imageries that may fail to be expressed through any spoken word (Stuckey & Nobel, 2010).I am curious to hear your responses and comments on how have you utilized visual arts to enhance your wellbeing or the wellbeing of others. Comment below.

3.      Movement-Based Creative Expression: When I think of movement-based creative expressions, I think of the power of dance and the many forms of it! However, there are many other examples of movement-based creative expressions out there. Movement-based creative expressions are nonverbal, primarily physical forms of expression that serve as psychotherapeutic or healing tools to the human body (Stuckey & Nobel, 2010). Can you think of examples of movement-based creative expressions? Through the movement of the mind and body in a creative way, stress and anxiety can be relieved, and other health benefits can be achieved. Let me share an example; Greenspan et al. (2007) conducted a study on this phenomenon studying the effect of tai chi exercises on a selected older group of women. The findings suggested that the women who were participating in tai chi perceived their health status as much improved after a noted time period. What movement-based creative expressions would you enjoy? There are many examples out there. How many times a week do you or your loved ones participate in a movement-based creative expression?

4.      Expressive Writing: Studies show that writing about individual traumatic experiences demonstrated statistically significant improvements in various measures of physical health, reduced visits to the doctor, and resulted in better immunity (Stuckey & Nobel, 2010). Journaling and emotional writing can effect physiological health, immune status, stress hormones and blood pressure. Do you find it peaceful to write about anything or certain things? When I think of this, I can’t help but note the many ways that a social media status can serve as an outlet for expressive writing and an art form. How about creative writing? I would love to hear your thoughts on this as a healthcare provider, an individual seeking health and wellness or as a community member!

From a public health perspective, I recommend and promote engagement in the arts for all in one form or another. I perceive the arts as having a significant effect on the national burden of diseases affecting all age groups within a community setting. Think about this for example: commitment to engaging in artistic activities can have the potential to reduce stress and depression in your life. Using the arts as a healing tool and a therapy is actually quite common practice today. Evidence out there shows art is being utilized to combat depression, chronic stress (Stuckey & Nobel, 2010) and many other ailments. The Arts can serve as a vehicle for alleviating the burden of chronic disease a community.

References

Aldridge D. (1993). Music therapy research 1: a review of the medical research literature within a general context of music therapy research. Arts Psychotherapy 20(1),11–35

Frankl V. (1966) Man's Search for Meaning: An introduction to logotherapy New York, NY: Washington Square Press

Greenspan, A. I., Wolf, S.O., Kelley, M.E., & O'Grady M. (2007)  Tai chi and perceived health status in older adults who are transitionally frail: a randomized controlled trial. Physical Therapy, 87 (5),525–535

Guzzetta C. E. (1989). Effects of relaxation and music therapy on patients in a coronary care unit with presumptive acute myocardial infarction. Heart Lung, 18(6),609–616 

Stuckey, H.L. & Nobel, J. (2010). The connection between art, healing, and public health: A review of current literature. American Journal of  Public Health. 100(2): 254–263. doi:10.2105/AJPH.2008.156497PMCID: PMC2804629