A Commentary on American Health

ByAnalysis<br> By Dr. Mehmet Oz

Feb. 1, 2002 -- Editor's note: A member of the World Economic Forum takes a closer look at the state of American health.

I am a heart surgeon. Every day I take someone's heart and stop it completely. Sometimes I fix it. Sometimes I replace it with another heart. Sometimes I replace it with a machine.

The miracle of modern medicine allows physicians to grasp people on the precipice of death and pull them to health. At least that's what I thought in the isolated, temperature controlled world of the OR.

But my patients demanded more. They showed me that alleviating symptoms is not necessarily curing disease and that surviving is not synonymous with being well.

I learned to treat the whole patient, rather than just her arteries or his valves and this stimulated the creation of a complementary medicine center.

My patients today are offered customized alternative treatments including yoga, massage, and guided imagery in conjunction with their high technology medical devices.This holistic approach created empowered patients who were well equipped to face the challenges of illness and life.

Yet, doctors influence the world one patient at a time and the tools we use to create health awareness do not touch the millions who have abdicated responsibility for their own well being and the overarching needs of society. There had to be a way for communities to become actively involved in creating a healthy environment and encouraging citizen participation in wellness.

While searching for a mythical operating theatre for society, I was invited to visit a group of influential decision makers at the World Economic Forum. Over the past several years as demonstrators petitioned outside the guarded entrances to the meeting halls, many participants had the epiphany that countries cannot sustain creation of wealth without also building health.

'The Possible Human' Manual

Into this fertile soil was planted the seeds for a health manual for society, The Possible Human, slated for release at this year's annual meeting. First, we need an accurate diagnosis of our current condition.

For example, living in the United States can be dangerous to your health. Obesity is present in over a third of Americans and has become a more important predictor of chronic ailments and worker quality of life than any other public scourge.

The illnesses caused by obesity also lead to the most number of lost workdays of any single ailment and increase pharmaceutical and hospital expenditure.

Second, like many illnesses, throwing money (like medicines) at the problem is not the solution. When measured across the country, expenditures on health and achievement of wellness are not correlated.

Individual states are ranked for healthy days/year, medical care expenditures and overall health score. The Possible American report argues that health is an economic resource that should be nurtured.

Health Equals Productivity

Healthy people not only make fewer demands upon the health and social care systems, they are also more productive. In fact, 75 percent of illness costs to business is lost productivity rather than direct expenditures for health care costs.

Third, as in medicine, complex challenges require innovative solutions. We need a new understanding of "wellness" based on wider influences on health, including how long the commute to work takes and how often a sick child prevents the parents from functioning fully at work.

This definition has to be customized to individual communities since we all have different pain points. The challenge will be to ensure that the opportunity to reach one's potential becomes the birthright of all.

This battle has already been engaged by some. After Philadelphia was voted the "fattest city" in America, the city government announced initiatives to help its citizens lose 76 tons in 2001.

The effort included appointing a city health "czar" and launching school education programs. Philadelphia also partnered with the private sector to add bike lanes and racks, sponsor monthly walk-to-work days, and increase access to gyms and sporting-good stores.

These initiatives spurred additional private public partnerships and enabled the city to rise dramatically from the bottom on the obesity charts.

Fourth, we need to create a holistic plan to prevent the patient from relapsing. This should include awareness that individuals (and society in aggregate) have responsibilities for their wellness. After all, are we proud that our five top sources of calories are whole milk, cola, margarine, white bread, and rolls?

Health care is delivered locally and must be governed at this level, so the final product can be customized to the individual and his community.

Wellness awareness should be our mantra. Many prominent world leaders meeting at the World Economic Forum today in New York share this belief.

As a healer who has become part of this group, I am acutely aware that influential organizations such as this need to generate concrete ways for local governments, businesses, schools, and families to invest in wellness. Americans cannot abdicate our responsibility to our own wellness.

Dr. Mehmet Oz is a heart surgeon at New York's Columbia-Presbyterian Medical Center

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