Tag Archives: health

The negative effect of loneliness on health

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Loneliness is not just a social or emotional condition; it affects physical health.

The scourge of loneliness has been with us since time immemorial, but only in recent years has its toll on human health gained appreciation. New research shows that feeling lonely or socially isolated bumps up a person’s average risk for coronary heart disease and stroke — two of the developed world’s most prolific killers — by 50%.

As a risk factor for heart attack, clogged arteries or stroke, those statistics put loneliness on a par with light smoking, anxiety and occupational stress. And they make social isolation a more powerful predictor of such vascular diseases than are either high blood pressure or obesity…

The new research, published Tuesday in the British Medical Journal’s publication, Heart, aggregated the findings of 23 separate studies that asked people to characterize their level of social engagement. Each of those studies then tracked participants for periods ranging from 3 to 21 years and noted whether they had a first stroke or were newly diagnosed with, or died from, coronary heart disease…

As a result, it’s hard to know whether loneliness is a contributor to, the result of, or just another symptom of poor health. And for the same reason, it’s hard to know whether programs aimed at getting the socially isolated to re-engage will improve their health, and how.

Social relationships matter, not just for using weak ties to get a job but also to improve your health.

The article hints at interventions at the end, primarily suggesting that doctors can ask about social networks and relationships. However, how possible is it for doctors to incorporate more social factors into their analysis, whether that involves asking people about social behaviors or recommending treatment? Doesn’t a finding like this suggest we need a more holistic approach to health that would incorporate physical conditions as well as emotional and social conditions? Perhaps we need more of the biopsychosocial approach. Maybe this requires having multiple professionals – doctors, social workers, psychologists – working together as units to address conditions.

More than ten year gap in life span among rich and poor

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New data shows that the difference in life spans between richer and poorer Americans continues to grow:

The poor are losing ground not only in income, but also in years of life, the most basic measure of well-being. In the early 1970s, a 60-year-old man in the top half of the earnings ladder could expect to live 1.2 years longer than a man of the same age in the bottom half, according to an analysis by the Social Security Administration. Fast-forward to 2001, and he could expect to live 5.8 years longer than his poorer counterpart.

New research released on Friday contains even more jarring numbers. Looking at the extreme ends of the income spectrum, economists at the Brookings Institution found that for men born in 1920, there was a six-year difference in life expectancy between the top 10 percent of earners and the bottom 10 percent. For men born in 1950, that difference had more than doubled, to 14 years.

For women, the gap grew to 13 years, from 4.7 years…

It is hard to point to one overriding cause, but public health researchers have a few answers. In recent decades, smoking, the single biggest cause of preventable death, has helped drive the disparity, said Andrew Fenelon, a researcher at the Centers for Disease Control and Prevention. As the rich and educated began to drop the habit, its deadly effects fell increasingly on poorer, uneducated people. Mr. Fenelon has calculated that smoking accounted for a third to a fifth of the gap in life expectancy between men with college degrees and men with only high school degrees. For women it was as much as a quarter.

In the set of the right to life, liberty, and pursuit of happiness, you can’t have as much of the second and third if the first is not the same. While we often discuss inequality of opportunities or outcomes, we spend less time focusing on the body though commentators like Ta-Nehisi Coates have recently drawn more attention to the role of bodies in racial differences.

The article does suggest that evidence shows access to healthcare is not a big driver of this gap.

Wearable fitness devices might not be very reliable

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The FDA uses different criteria for consumer fitness devices compared to medical devices:

Sehgal should know: he and his colleagues at the Center for Digital Health Innovation have compared the data reported by consumer wearable devices to relevant clinical gold standards in multiple studies over the past two years. They’ve found that very few devices currently on the market perform with the reliability one would expect from a medical-grade device.

And in fact wearable devices such as the Fitbit haven’t been clinically validated to perform at the same standards for reliability that the U.S. Food and Drug Administration uses for medical devices, such as the traditional blood-pressure cuff in a doctor’s office. Consumer wearables are marketed under the FDA’s less rigorous “wellness-focused” rubric.

Trister says that rather than tracking general activity, the most promising wearables target a specific thing. He cites startup Empatica’s Embrace wristband, which measures skin conductance—a signal that tends to rise as you get stressed—to detect an oncoming seizure (see “A Sleek Wristband That Can Track Seizures”). And Sehgal also points to devices being used in research labs that similarly measure the conductivity of the skin to help determine the severity of post-traumatic stress disorder among soldiers returning from war.

The end of this article suggests we’ll need time to see whether these devices can actually be used to help treat certain conditions. In the meantime, it would be interesting to know two things.

  1. What would it take to upgrade wearable devices for the masses: is it an issue of cost (all the testing an0d regulations would drive up the average price too much) or technology (these devices can’t yet be always reliable)?
  2. How would the average user know whether their particular device is unreliable? And if they could figure it out, do they have grounds for financial recourse?

Two questions regarding the “Zen commute”

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I’ve seen numerous stories in recent months about creating more calm, Zen commutes. Here is a recent example:

“We can say, ‘OK, I’m going to be in the car for an hour,'” said actor Jeff Kober, who teaches meditation in Los Angeles. “‘Now, what can I do to improve my quality of life during that hour?'”

Resist the urge to relinquish that hour to an inner monologue of traffic complaints, work worries and side-eye looks at coughing riders. Instead, treat it as a time when you can incorporate more contentment, either by getting more meditative or taking measures to create your own oasis.

“Because we’re essentially captive, why not make it into something really productive?” said Maria Gonzalez, who teaches the benefits of mindfulness in business as founder of Argonauta Strategic Alliances Consulting in Toronto…

Experts say, however, that it is possible to change how you embark on, endure and exit your commute.

Even as these practices might limit the negative health consequences of commuting, there are two unanswered questions that came to my mind:

  1. Are mindful drivers safer drivers? There have been major campaigns in recent years to limit the distractions of drivers. If drivers are mindful or being Zen about things other than driving, isn’t this a problem? We still want drivers to focus on the driving, whether stressed while doing it or not.
  2. The bigger issue, of course, is why so many people have long commutes where they are so stressed and harmed. The average American commute is around 26 minutes (and supercommuters are limited) due to a variety of factors: Americans like cars, residences are spread out, our government promoted highways over mass transit, and so on. If we really wanted to deal with the problems of commuting, the Zen part seems like a band-aid on an issue of having people relatively far from their workplaces. Or, maybe this provides more reasons to promote telecommuting and working from home.

Our lack of knowledge about the indoor biome

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Science may be going to the natural frontiers on Earth but what about the indoor biome?

If you add up the area of the indoor biome in Manhattan — including its walk-ups and high-rise apartments — it’s three times bigger than the area of the island of Manhattan itself…

And yet the indoor biome remains at science’s frontier. “We know virtually nothing about it,” said Laura J. Martin, an ecologist at Cornell University.

In the journal Trends in Ecology and Evolution, Ms. Martin and 24 fellow scientists have issued a manifesto urging serious scientific investigation of the indoor biome. We need to find out not only what is living in our homes and workplaces, the scientists say, but how they got there…

Dr. Dunn and his colleagues argue that, ecologically speaking, our houses have a lot in common with caves. In both habitats, temperature and humidity are much steadier than outside, making for stable environments. But both lack the dense vegetation that most other biomes have, so there’s less food to be had…

But our houses also have otherworldly ecological niches, like shower heads and freezers, that can support more biological diversity than you’d find in a cave.

This may be a bigger issue than ever for three reasons:

1. People have become more sedentary than in the past for a variety of reasons, which often means they are inside more.

2. The indoors has made it possible to adapt to more inhospitable habitats. (Think heating and air conditioning.) Yet, this also provides more potential for mixing organisms.

3. And the reason that might funnel the necessary money to study the great indoors: health. When is the indoor biome healthy for humans and when is it not? We know about some features of this – think exhaust and particulates in garages or from fireplaces or bacteria in the kitchen or bathroom – but do we know the whole complex story? What if the indoors was making us less healthy?

Building attractive staircases to encourage better health

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Staircases are necessary in many buildings but a new report suggests constructing them in attractive ways would help boost health:

And as ULI’s report argues, there’s more at stake than just aesthetics. A raft of research suggests that more appealing stairways may actually beckon more people to climb, in turn helping to reduce stroke risk, improving cardiovascular health and fighting obesity.

First, the obvious: More exercise, like the kind you get from taking the stairs instead of the elevator, is good for you. A 40-year study of nearly 17,000 (male) Harvard alumni, published in 1986, found that those who walked, took the stairs and played sports were likely to live longer than their more sedentary classmates. The researchers found that by age 80, one to two additional years of life were attributable to exercise. Take the stairs, enjoy a longer life.

And it appears designers and architects really can bait people into doing what’s good for them. A 2004 study saw a 9 percent increase in foot traffic when researchers added motivational signs, artwork, carpeting, new paint and music to a CDC building’s stairwells. A similar 2001 study published in the American Journal of Public Health tested two interventions in the University of Minnesota’s public health building and found that while shaming signs—“Take the stairs for your health”—didn’t motivate stair travel, adding artwork and music to them via a compact disc player (aww, 2001) increased stair traffic by nearly 5 percent. “Buildings should be designed with attractive stairwells that are accessible to the general population,” the researchers concluded.

There are more dramatic intervention options, too. ULI, guided by principles from the Center for Active Design, argues that developers should be thinking seriously about stairways even before the construction crew moves in. The groups recommend placing stairs closer to building entrances than elevators and making them more visible. (A 2007 analysis found stairways’ accessibility and visibility explained 53 percent of their use in 10 university buildings.) Using glass panels as walls instead of concrete and cinderblock also gently guides people toward stairways.

Stairs can be an exciting architectural feature as well as a health boon. In contrast, elevators in large buildings don’t present many benefits for health or architecture. The typical lobby of a modern high-rise includes a spacious room with ill-defined sections with banks of elevators somewhere to the side or back. Stairs, if done well, can present an interesting focal point and help define the space. However, I wonder if these findings primarily apply to low-rise buildings where the stairs could be used as the primary means of traveling between floors.

Mass transit as repository of microscopic organisms

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A new study found all sorts of organic material in the New York City subway:

To get a clearer picture of what that ecosystem is made of, Mason and his team set out to map the vastness of the urban microbiome. Using nylon swabs and mobile phones, the group identified 15,152 different organisms lurking on railings, trash cans, seats, and kiosks in 466 New York City subway stations. Their findings were published this week in the journal Cell Systems.

The team also found that, on a microscopic level, the subway is littered with leftovers—evidence of what New Yorkers like to eat. Cucumber particles were the most commonly found food item, along with traces of kimchi, sauerkraut, and chickpeas. Bacteria associated with mozzarella cheese coated 151 stations. And other traces of pizza ingredients such as sausages and Italian cheese were everywhere. (The Wall Street Journal transformed much of that data into a clickable map that lets you explore the findings by subway line.)

And although Mason and his team also found particles of harmful bacteria related to the bubonic plague and anthrax, the levels were so low that they pose little danger to humans. “The important fact is that the majority of the bacteria that we found are harmless,” Mason said. Much more common were the protective bacteria that eliminate toxins and make the subway cleaner. “They represent a phalanx of friends that surround us,” he said…

Of the more than 10 billion DNA fragments that the team sequenced, about 5 billion were unaccounted for. That’s not to say that these DNA fragments belong to never-before-seen organisms. Rather, it shows that the library of sequenced genomes still has many empty shelves. Where beetles and flies were most prevalent in this sampling, evidence of cockroaches was absent—not because New York isn’t crawling with them (it is), but because scientists haven’t fully sequenced the cockroach genome yet. Once that information becomes available, cockroaches will become better represented in the sampling, according to Mason.

While I’m sure plenty of people will be grossed out by such knowledge, it highlights the level of microscopic complexity going on all around us and suggests there is a lot of scientific work in this area still be done. We know the bottoms of the oceans might be the last large frontier on Earth but it sounds like the NYC subway offers plenty of opportunities itself.

Now that we have such information about what is in the subway system, I want to know how the organic material interacts with humans on a regular basis. Where is this material? How many people are made sick and, conversely, does such a collection provide benefits for users?

Being a better neighbor linked to better heart health

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Be nice to your neighbors because it may just help keep your heart healthier:

For the latest research, the University of Michigan team used data from 5,276 people over 50 with no history of heart problems, who were participants in an ongoing Health and Retirement Study in the United States…

At the start of the project, the respondents were asked to award points out of seven to reflect the extent to which they felt part of their neighbourhood, could rely on their neighbours in a pinch, could trust their neighbours, and found their neighbours to be friendly.

When they crunched the numbers at the end of the study, the team found that for every point they had awarded out of seven, an individual had a reduced heart attack risk over the four-year study period.

People who gave a full score of seven out of seven had a 67 percent reduced heart attack risk compared to people who gave a score of one, study co-author Eric Kim told AFP, and described the difference as “significant”.

This was “approximately comparable to the reduced heart attack risk of a smoker vs a non-smoker,” he said.

“This is an observational study so no definitive conclusions can be drawn about cause and effect,” the statement underlined.

While this research doesn’t establish direct effects, it introduces additional reasons for being a better neighbor. Would conclusive findings that this would help people’s health be more convincing to Americans than civic or moral arguments? Focusing on health could have a more individualistic emphasis – “I’d like to live longer” – though health could also be viewed on a community-wide scale – fewer heart problems mean less community money spent on healthcare.

It is also interesting that this relies on self-reported accounts of neighborliness. Is this fairly accurate? This could be measured in a variety of ways: number of conversations or visits with numbers, participation in local groups, and reports from neighbors about the neighborliness of others. Of course, it could be that perceptions of being a good neighbor matter even more than actual actions. Yet, I wonder how this lines up with the typical shocked accounts suburbanites present when one of their neighbors is accused of a crime.

“The Suburbs Made [Americans] Fat”

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A new study suggests the design of streets in suburbia contributed to heavier residents and other adverse health outcomes:

In prior research, Marshall told me, they found that in the most extreme cases “older, denser, connected cities were killing three times fewer people than sparser, tree-like cities on an annual basis.” Of course, people walk and bike more in dense cities, but the research on actual ties to health outcomes is scant. So Garrick and Marshall took on and have just completed a large study of how street networks might influence our health.

They looked at the three fundamental measures of street networks—density, connectivity, and configuration—in 24 California cities, and compared them with various maladies. In the current Journal of Transport and Health, Garrick and Marshall report that cities with more compact street networks—specifically, increased intersection density—have lower levels of obesity, diabetes, high blood pressure, and heart disease. The more intersections, the healthier the humans…

Garrick and Marshall have also previously found that people who live in more sparse, tree-like communities spend about 18 percent more time driving than do people who live in dense grids. And they die more readily—despite old research that implied otherwise. Studies from the 1950s looked at safety in cul-de-sacs and found, as Marshall put it, “You’ll have fewer crashes in the cul-de-sacs. Sure, you’re safer if you never leave the cul-de-sac. If you take into account the entire city, your city might be killing more people.”…

They also found that wide streets with many lanes are associated with high rates of obesity and diabetes. That’s most likely indicative of, as Garrick and Marshall put it, “an inferior pedestrian environment.” Similarly, so-called “big box” stores in a neighborhood indicate poor walkability and are associated with 24.9 percent higher rates of diabetes and 13.7 percent higher rates of obesity.

Dense cities promote walking and biking, so the push for healthier cities fits with the vogue push for active lifestyles—as opposed to gym routines smattered across an indolent existence. Physical activity is not just concerted exercise time and deliberate recreation. It’s about ways of life. For some people, that’s best accomplished by making things inevitably more difficult on themselves in everyday life.

This seems to make some intuitive sense though there are lots of factors likely involved. I’m thinking of Putnam’s Bowling Alone which highlighted a whole range of factors that contributed to decreased civic engagement including sprawl and the rise of television.

But, if such research holds up – and even if it takes some time to confirm things and reach a consensus – such findings could lead to a new/forgotten dimension of selling places and new developments. Part of the appeal of emerging suburbs in the mid-1800s was getting away from the dirty city, a place that was increasingly seen as physically and morally corrupt. Developers sold the suburbs as getting back to cleaner settings that were closer to nature. This research would flip this idea: cities and more urban places promote more movement and better overall health. I imagine anti-sprawl advocates like the New Urbanists would want to jump all over this and add it to their lists of reasons why American sprawl should be halted.

Big differences in life expectancy across American counties due to income differences

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Here is an update on the “longevity gap,” the differences in life expectancy, by county in the United States:

Fairfax County, Va., and McDowell County, W.Va., are separated by 350 miles, about a half-day’s drive. Traveling west from Fairfax County, the gated communities and bland architecture of military contractors give way to exurbs, then to farmland and eventually to McDowell’s coal mines and the forested slopes of the Appalachians. Perhaps the greatest distance between the two counties is this: Fairfax is a place of the haves, and McDowell of the have-nots. Just outside of Washington, fat government contracts and a growing technology sector buoy the median household income in Fairfax County up to $107,000, one of the highest in the nation. McDowell, with the decline of coal, has little in the way of industry. Unemployment is high. Drug abuse is rampant. Median household income is about one-fifth that of Fairfax.

One of the starkest consequences of that divide is seen in the life expectancies of the people there. Residents of Fairfax County are among the longest-lived in the country: Men have an average life expectancy of 82 years and women, 85, about the same as in Sweden. In McDowell, the averages are 64 and 73, about the same as in Iraq…

Since the 1980s, “socioeconomic status has become an even more important indicator of life expectancy.” That was the finding of a 2008 report by the Congressional Budget Office. But dollars in a bank account have never added a day to anyone’s life, researchers stress. Instead, those dollars are at work in a thousand daily-life decisions — about jobs, medical care, housing, food and exercise — with a cumulative effect on longevity.

http://www.nytimes.com/interactive/2014/03/15/business/higher-income-longer-lives.html

This is part of a growing body of research that links demographics and social forces, including social spaces, to different health outcomes. Wealthier counties can offer a wide range of health and social services as well as have more higher class residents while poorer counties have different social structures.

While the county level data is interesting, I would assume there would also be some wide differences in life expectancy within counties. Fairfax County, Virginia is one of the wealthiest U.S. counties but income levels there are not uniform. Cook County, Illinois could include some of the poorest neighborhoods in Chicago as well as Kenilworth, Illinois, one of the wealthiest suburbs with a median household income of over $247,000. Check out these maps from VCU’s Center on Society and Health on life expectancy in metro areas. Here is what they found in Chicago:

So the contrast between a county in Virginia versus one in West Virginia might be notable but one doesn’t have to travel that far to find big differences in life expectancy.