Health, health care, trauma and health insurance in America

        According to the Army's Chief Surgeon, trauma is the third-leading cause of death in the U.S., taking 160,000 lives in 2004.  This is more than any cause other than heart disease or cancer.  Further, traumatic deaths are disproportionately inflicted on the young.  The Surgeon--Dr. John Holcomb--is determined that some good come out of the Iraq debacle by developing useful trauma data that can be applied to provide better care for military casualties and civilian trauma victims.  He has guided investigation in the area of blood clotting, burns, amputation and transporting patients directly to locations other than "the nearest level one facility".

        With respect to the other two leading causes of death, cancer and heart disease, recent research has confirmed that the primary method of effectively addressing these causes to reduce the resulting death rate, is to assure the availability of primary health care to all citizens.  In insured groups, the successful early diagnosis and treatment of these problems results in an improved survival rate.  The Chief Executive of the American Cancer Society reduced it to this simplicity: "A woman without health insurance who gets a breast cancer diagnosis is at  least 40 percent more likely to die."

          As for heart health, the primary culprits remain smoking and obesity, and obesity may also be implicated in cancer etiology.  The New York Times reports that two recently published books point out how complicated it can be to address modern health issues.  Just a few examples include the decision in the 1950s to attach a more effective filter to Kent cigarettes:  great idea, except that they used pure asbestos as the filtering mechanism.  Another example was the use of Estrogen supplements to combat menopausal symptoms; it turned out to enhance the growth of cancers in some patients.  Everyone knows about the prescribing of morning-sickness medication that lead to birth defects in children, and we all know that radiation can diagnose a tumor, treat it, or cause it--all depending on the circumstances and requiring a careful balancing of factors. 

        Along the same vein, NPR's recent Science Friday examined the question of a "healthy diet" and pointed out that in less than twenty years, medical science has made several 180 degree turns in its diet recommendations.  The "four food groups" and the food pyramid no longer stand scrutiny, and more recently Dean Ornish's focus on eliminating animal fats has come into question.   Current research suggests that the healthiest diet must limit the intake of carbohydrates and particularly complex carbohydrates, in order to limit the production of LDL or "bad" cholesterol.