The news was shocking. In April, the Centers for Disease Control and Prevention announced that life expectancy in this country is now the shortest it's been in nearly two decades. Even more troubling was the news that younger Americans are now dying at higher rates than their counterparts in other high-income countries. We are now also listed as among the highest maternal and infant mortality rates among upper-income countries. Many experts believe that much of the problem stems from the way the U.S. health care system is structured.
So, what has been done over the last six months to start to address what should be viewed as a medical emergency?
According to a July report by Forbes contributor Anuradha Varanasi, for one thing, it has led researchers to further investigate what they believed to be "data inconsistencies related to the link between BMI (body mass index) and all-cause mortality in the general population."
The National Health Interview Survey is described by Wikipedia as "an annual, cross-sectional survey intended to provide nationally representative estimates on a wide range of health status and utilization measures among the nonmilitary, noninstitutionalized population of the United States."
"During the 20th century, researchers claimed that people with a higher body mass index are at a far higher risk of suffering from lifestyle diseases like diabetes, stroke, and cardiovascular disease — to name a few. And that, in turn, shortens their life expectancy," reports Varanasi. "But as it turns out, that is not true after all. A new PLOS One study states that a high BMI range (over 30) by itself does not increase an individual's mortality risk."
"Epidemiologic evidence regarding the association between BMI and mortality has been inconsistent, especially with regards to overweight and obese individuals, with some analyses demonstrating similar or lower risk of all-cause mortality," writes the authors of the study, Aayush Visaria and Soko Setoguchi from Rutgers University. They go on to say that there could be various reasons why people with a high BMI could have a mortality risk similar to those with a "normal" BMI. Forbes also notes that the study has its limitations. First, the participants in the NHIS data had self-reported their BMI, which could have caused misclassification.
This concept that obesity should not necessarily be considered a factor in increased mortality risks, if taken on face value, seems so contrary to what we are consistently told.
One recent reminder comes in the form of a Medical News Today report that says that "cardiovascular disease, type 2 diabetes, and obesity have long been linked through research, disease prevention, and treatment protocols."
The statement was made in connection with an announcement by the American Heart Association of a newly defined cardiovascular-kidney-metabolic disorder that adds kidney disease to the connection between cardiovascular disease, Type 2 diabetes, and obesity. Known as CKM syndrome, experts say defining CKM as a disorder and adding it as part of this collection of chronic health conditions "could help improve prevention, intervention, and treatment through more integrated care," reports Medical News Today's Bob Curley.
The CDC estimates that 41.9% of adults and 19.7% of children in the U.S. are obese, and more than 37 million adults have diabetes.
Reports NBC News' Linda Carroll, in an accompanying statement to the American Heart Association announcement, Dr. Chiadi E. Ndumele, the director of obesity and cardiometabolic research in the division of cardiology at Johns Hopkins University, states that "more than 90% of adults fall on the CKM spectrum, driven mainly by record levels of obesity and Type 2 diabetes in adults and children ... we're seeing the health consequences of all these conditions interacting and leading to earlier presentations with heart disease."
"More Americans are being diagnosed with multiple chronic health problems at younger ages, for the first time, the American Heart Association is identifying a new medical condition that reflects the strong links among obesity, diabetes and heart and kidney disease," reports Carroll.
Says Dr. Howard Weintraub, the clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Heart in New York, "We need to keep America's youth a healthy weight and not let their arteries turn into lead pipes by the time they are in their 30s."
Another pivotal question about America's failing health is found in a recent USA Today five-part health report. "With so much known about the prevention of diabetes, why do rates across the United States continue to rise?" the headline reads. "Type 2 diabetes rates continue to climb in the United States, despite well-known treatments and prevention approaches," reports Karen Weintraub. In search of some answers, Weintraub and reporter Adrianna Rodriguez crisscrossed the country talking to researchers, clinicians and patients.
According to the USA Today report, "more than 1 in 10 Americans have the disease (though many don't know) and another nearly 4 in 10 are at risk for it. In total, half of all adults and a quarter of teenagers have diabetes or pre-diabetes." In addition, "the country spends more than $300 billion a year to address diabetes, accounting for $1 out of every $4 spent on health care."
Weintraub and Rodriguez found the personal impact of diabetes devastating, leading to "heart attacks, amputations, blindness, kidney disease, double the risk of premature death." They found people with diabetes often must fend for themselves against systemic barriers and a difficult disease.
"We have made tremendous gains in understanding diabetes," said Dr. Donald Berwick, a pediatrician and former administrator of the Centers for Medicare & Medicaid Services. "The best diabetes care can make a very big difference. You can't say we don't know what to do." Poor diet, including too much meat and refined grains, has been shown to drive Type 2 diabetes. Providing nutritious meals to those with health problems and movement limitations could save more than $13 billion in the first year alone, says Weintraub and Rodriguez.
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