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Center for the Advancement of Health: Essays on GoodBehavior

CENTER FOR THE ADVANCEMENT OF HEALTH
FEBRUARY 2009

Finding a New World Order

My 401K account and pension have lost 40 percent of their value in the past six months – yours too, probably. 

Don't you hate it when that happens?

Most of us are not particularly sophisticated about investing, but we know how to ask for advice, to check in regularly with different experts and to act on their recommendations by judiciously diversifying our portfolios. 

Jessie Gruman
President
Center for the
Advancement of Health

So the sting of this loss feels especially sharp.  If we had ignored the rules, someone could say "I told you so," and we would agree.  We would have an explanation for our misfortune.  But we followed the rules, and the sense of loss is magnified by our bewilderment about what we can do to prevent further loss.

These are familiar feelings to me.  I generally follow the science-based recommendations about health: diet, exercise, screening tests.  So each of the three times I have been diagnosed with cancer, I have felt like a healthy person who has been drop-kicked into a foreign country.  I don't understand the language. I don't have a map. And I am desperate to find my way home.

Alas, much of life is random.  Despite our best efforts, disasters occur and chance misfortune only illuminates the insignificance of our efforts to control them.  Bad luck is particularly infuriating -- and disorienting -- to those whose prudent rule-following is not rewarded.

So how do we meet the new reality, whether with regard to our health or our investments?

We’ve been urged to pick ourselves up, dust ourselves off and get to work.  But what does that mean when the road ahead feels so uncertain due to a new diagnosis or changes in financial status?  For most of us, it means modifying old habits.  Whether new diets, new disease treatments or new budgets are in order, it is unlikely that we can make informed decisions or develop new patterns of behavior without some combination of introspection, personal responsibility and expert guidance

Despite glitzy promises, you can’t simply go to a Web site and grab a quick, personalized reliable answer about the physician, procedure or prescription that can best respond to your recurring chest pains.  Rather, what is needed is an understanding that health care varies in quality -- just as all investments are not alike -- and that it requires the same sort of due diligence employed by savvy investors to find the doctor, treatment or hospital that are right for you.

Unfortunately, the Web-based tools to smooth the search are still crude and it isn’t easy to separate the good from the mediocre or the science from commercial chaff. Every hospital – like every mutual fund – can find ways to claim to be above average.  It's up to us to determine what really counts.  Picking a hospital because it serves good meals is akin to selecting a mutual fund because it brags of an award-winning Web site.

A crisis doesn't signal the end of order.  You can't suspend your due diligence.  You still have to ask questions, look for good answers and apply your best judgment.  You still have to break a sweat and pass on that cupcake.  Those old rules are here to stay.

FROM THE HEALTH BEHAVIOR NEWS SERVICE

The Health Behavior News Service regularly distributes stories summarizing new research on health behavior issues. These stories can be found online at http://www.cfah.org/hbns/news/index.cfm.

Here are some stories released in January:

'Positive' Studies More Likely to Make It Into Medical Journals
Confirming suspicions that studies with low-key results often get neglected, a new Cochrane review finds that research is more likely to end up in print if it has a certain 'wow' factor.

Vision Tests for Older Drivers Not Proven to Prevent Crashes
Serious automobile accidents have prompted questions about the eyesight of elderly drivers, but reviewers say a lack of strong evidence leaves them unable to determine whether vision tests lead to fewer fatal crashes

Radiation Lowers Relapse Risk in Noninvasive Breast Cancer
A new review confirms that the addition of radiation therapy to lumpectomy in the treatment of DCIS, a noninvasive early form of breast cancer, substantially lowers the risk of recurrence of either DCIS or invasive breast cancer.

Help Possible for People Obsessed With Imaginary Physical Flaws
Worrying about a bad hair day or idly wishing for a more-perfect profile: we've all been there. However, people suffering from body dysmorphic disorder go far beyond that, obsessing over exaggerated or even imaginary physical defects, to the point where it affects their ability to work, attend school or have ordinary social contacts. Now, a new review finds that drug therapy and psychotherapy can effectively treat the condition.

Ankle Splints Improve Mobility After Stroke
After a stroke causes weakness on one side of the body, ankle splints help restore mobility while wrist splints don't make that much difference, according to a new review of studies.

Fatigued Cancer Patients Might Benefit From Specialized Counseling
Addressing the psychological, social and behavioral aspects of fatigue during active cancer treatment is "a promising type of intervention," according to a new systematic review.