Good material. I am wondering if your comprehensive system for managing chronic disease includes the social environment within which the patient works and lives. I imagine you are familiar with the Whitehall studies of Michael Marmot. Those studies, as I read them, indicated that the status of the individual within an occupational hierarchy had a strong influence on the development of heart disease. It seems to me that if American healthcare practitioners are going to have a positive impact on morbidity and mortality, they are going to have to come to terms with social conditions.
You are absolutely correct. If your income and health literacy is low, you are much more likely to have chronic illness earlier and severe complications. If you are poor and black, you are four times as likely to end up on dialysis. Most of this is policy based. It determines who gets sick and how much care they need. Much of it is beyond the control of medicine. Your study was British, but these factors are amplified here. In other developed countries they eat more real, whoke food that is locally sourced. Everyone has access to primary care. At a minimum, we should outlaw ads that target children with fast and processed food commercials.
The Critical Paragraph From Crossing the Quality Chasm
Here is the critical paragraph from Crossing the Quality Chasm that outlines what must be done to Make America Healthy Again
To facilitate this process, the Agency for Healthcare Research and Quality should identify a limited number of priority conditions that affect many people and account for a sizable portion of the national health burden and associated expenditures. In identifying these priority conditions, the agency should consider using the list of conditions identified through the Medical Expenditure Panel Survey (2000). According to the most recent survey data, the top 15 priority conditions are cancer, diabetes, emphysema, high cholesterol, HIV/AIDS, hypertension, ischemic heart disease, stroke, arthritis, asthma, gall bladder disease, stomach ulcers, back problems, Alzheimer's disease and other dementias, and depression and anxiety disorders. Health care organizations, clinicians, purchasers, and other stakeholders should then work together to (1) organize evidence-based care processes consistent with best practices, (2) organize major prevention programs to target key health risk behaviors associated with the onset or progression of these conditions, (3) develop the information infrastructure needed to support the provision of care and the ongoing measurement of care processes and patient outcomes, and (4) align the incentives inherent in payment and accountability processes with the goal of quality improvement.
Yes, agree. REQUIRE every institution whose mission is improving public health to have a prioritized budget to prove it is using public funds on the most disabling, costly diseases. That would include HHS, NIH, CDC $1.75 trillion/yr budget. REQUIRE every publicly funded institution would include medical schools, nursing schools, public health departments which should also prioritize their education to the most disabling, costly diseases. REQUIRE licensure agencies focus on the most disabling, costly diseases.
A top priority needs to be the root causes of brain disorders clinical trials. NO root causes of brain disorders clinical trials found at NIH. They have no DEMENTIA focused team. NO f/u of proven research such as Miklossy's 2011 "Alz is a neurospirochetosis...meets Hill's and Koch's postulates" or Sapi's 15 yrs of Lyme causing cancer. NIH is not funding diagnostics therapeutics which could have helped millions, 2019 his "Lyme in the Era of Precision Medicine" describes how. Itzhaki showed similar brain dementia and chronic illnesses from HSV. Shemesh confirmed HSV triggers tau tangles. Tanzi and others show amyloid is an immune response. Breitschwerdt found Bartonella in 11 of 17 schizophrenic pts, 43% of psychotic pts and it causes many other mental illnesses. Epstein Barr virus (EBV) was found in 800 of 801 MS patients per BJornevic's 20-yr military study.
What did NIH do with any of these as they have a $48 BILLION budget this year? NOTHING. Why not test all schizophrenic pts in a clinic? Why not f/u on any of this including "Can an 80 yr old drug cure Alz?" after Dr Herbert Allen suggested antibiotics because he had confirmed that Lyme triggers dementia plaques. Monkey brain research did too in 1995, 1997, 2012. Try a cheap trial that top researchers suggested to NIA leaders: give angcyclovir/fucoidan/penicillin 2 weeks a year for all early dementia patients to treat persistent infections.
NIH does NO clinical trials. Only individual researchers who then get a patent for a pill/vaccine. Cheap drugs and cures are not profitable for companies to do a clinical trial. So NIH needs to chage. Private funding at consortiums are doing it on a shoestring what NIH needs to fund: Neuroimmune.org, Alzheimer's Pathobiome (AlzPi.org) are again proving that dementia and mental illnesses are often triggered by infections. IDSA at "The Science of Alz & Infections" researchers said EVERY known brain disorder can be triggered by infections including amyloid, protein misfolding, epigenetic and genetic expression. Toxins, brain nutrients (MTHFR, leucovorin effects on B12, folate to help autistic children, depression, etc ) yet most clinicians do not know any of this except functional psychiatrists like Dr Ken Bock and Dr Greenblatt who have helped thousands of children get well by "test don't guess" root causes.
Instead private funds are being used to do this such as at the Neuroimmune.org consortium on mental illnesses
Good material. I am wondering if your comprehensive system for managing chronic disease includes the social environment within which the patient works and lives. I imagine you are familiar with the Whitehall studies of Michael Marmot. Those studies, as I read them, indicated that the status of the individual within an occupational hierarchy had a strong influence on the development of heart disease. It seems to me that if American healthcare practitioners are going to have a positive impact on morbidity and mortality, they are going to have to come to terms with social conditions.
You are absolutely correct. If your income and health literacy is low, you are much more likely to have chronic illness earlier and severe complications. If you are poor and black, you are four times as likely to end up on dialysis. Most of this is policy based. It determines who gets sick and how much care they need. Much of it is beyond the control of medicine. Your study was British, but these factors are amplified here. In other developed countries they eat more real, whoke food that is locally sourced. Everyone has access to primary care. At a minimum, we should outlaw ads that target children with fast and processed food commercials.
The Critical Paragraph From Crossing the Quality Chasm
Here is the critical paragraph from Crossing the Quality Chasm that outlines what must be done to Make America Healthy Again
To facilitate this process, the Agency for Healthcare Research and Quality should identify a limited number of priority conditions that affect many people and account for a sizable portion of the national health burden and associated expenditures. In identifying these priority conditions, the agency should consider using the list of conditions identified through the Medical Expenditure Panel Survey (2000). According to the most recent survey data, the top 15 priority conditions are cancer, diabetes, emphysema, high cholesterol, HIV/AIDS, hypertension, ischemic heart disease, stroke, arthritis, asthma, gall bladder disease, stomach ulcers, back problems, Alzheimer's disease and other dementias, and depression and anxiety disorders. Health care organizations, clinicians, purchasers, and other stakeholders should then work together to (1) organize evidence-based care processes consistent with best practices, (2) organize major prevention programs to target key health risk behaviors associated with the onset or progression of these conditions, (3) develop the information infrastructure needed to support the provision of care and the ongoing measurement of care processes and patient outcomes, and (4) align the incentives inherent in payment and accountability processes with the goal of quality improvement.
Yes, agree. REQUIRE every institution whose mission is improving public health to have a prioritized budget to prove it is using public funds on the most disabling, costly diseases. That would include HHS, NIH, CDC $1.75 trillion/yr budget. REQUIRE every publicly funded institution would include medical schools, nursing schools, public health departments which should also prioritize their education to the most disabling, costly diseases. REQUIRE licensure agencies focus on the most disabling, costly diseases.
A top priority needs to be the root causes of brain disorders clinical trials. NO root causes of brain disorders clinical trials found at NIH. They have no DEMENTIA focused team. NO f/u of proven research such as Miklossy's 2011 "Alz is a neurospirochetosis...meets Hill's and Koch's postulates" or Sapi's 15 yrs of Lyme causing cancer. NIH is not funding diagnostics therapeutics which could have helped millions, 2019 his "Lyme in the Era of Precision Medicine" describes how. Itzhaki showed similar brain dementia and chronic illnesses from HSV. Shemesh confirmed HSV triggers tau tangles. Tanzi and others show amyloid is an immune response. Breitschwerdt found Bartonella in 11 of 17 schizophrenic pts, 43% of psychotic pts and it causes many other mental illnesses. Epstein Barr virus (EBV) was found in 800 of 801 MS patients per BJornevic's 20-yr military study.
What did NIH do with any of these as they have a $48 BILLION budget this year? NOTHING. Why not test all schizophrenic pts in a clinic? Why not f/u on any of this including "Can an 80 yr old drug cure Alz?" after Dr Herbert Allen suggested antibiotics because he had confirmed that Lyme triggers dementia plaques. Monkey brain research did too in 1995, 1997, 2012. Try a cheap trial that top researchers suggested to NIA leaders: give angcyclovir/fucoidan/penicillin 2 weeks a year for all early dementia patients to treat persistent infections.
NIH does NO clinical trials. Only individual researchers who then get a patent for a pill/vaccine. Cheap drugs and cures are not profitable for companies to do a clinical trial. So NIH needs to chage. Private funding at consortiums are doing it on a shoestring what NIH needs to fund: Neuroimmune.org, Alzheimer's Pathobiome (AlzPi.org) are again proving that dementia and mental illnesses are often triggered by infections. IDSA at "The Science of Alz & Infections" researchers said EVERY known brain disorder can be triggered by infections including amyloid, protein misfolding, epigenetic and genetic expression. Toxins, brain nutrients (MTHFR, leucovorin effects on B12, folate to help autistic children, depression, etc ) yet most clinicians do not know any of this except functional psychiatrists like Dr Ken Bock and Dr Greenblatt who have helped thousands of children get well by "test don't guess" root causes.
Instead private funds are being used to do this such as at the Neuroimmune.org consortium on mental illnesses