Americans Lacking in Preventive Healthcare
> 1/22/2007 4:07:09 PM

Though the quality of medical treatment in our country continues to rise, a large portion of the American public could lead longer, healthier lives if they were to understand the importance of the early care options and regular screenings that have the potential to prevent or reduce the possibility of future health problems.

The 2006 National Healthcare Quality Report published by the Deparment of Health and Human Services notes that, particularly in the realms of hospital and ambulatory care, the quality of treatment in this country is only getting better. By statistical measures, the quality of hospital treatment for patients with heart attacks improved 15 percent in 2006, and the measures taken to prevent complications after surgery went up 7.3 percent. Health and Human Services attributes the improvements in care to initiatives carried out by quality improvement organizations affiliated with their own Centers for Medicare and Medicaid Services, and they deserve praise for the measurable progress they've overseen.

But improvement rates for preventive measures, with the exception of vaccines for the young and elderly, remained stagnant. Nursing homes and home health care services improved by only a negligible one percent. And other numbers are much less encouraging: Only 52 percent of American adults received their recommended screenings for colon cancer, the number two cause of cancer-related deaths in this country. 56,000 citizens died of colon cancer last year, and the very reason many of these cases ended in death is because the patients involved did not receive their diagnoses early enough. The government urges everyone over fifty to have this exam once a year; those identified as high risk should start sooner. In addition, less than fifty percent of Americans with asthma received clinical advice on how to improve the quality of their environments, and less than fifty percent of diabetes patients went through all three exams - blood sugar, eye and foot - to prevent complications arising from the disease.

In perhaps the most glaring instance of industrial shortcomings mentioned by this report, less than half of the more than sixty million American adults who are classified as obese received dietary and lifestyle counseling from a health care professional in 2006. The Department recommends regular screenings followed by intensive counseling and lifestyle interventions to detect and treat potentially problematic obesity. While short-term treatment rarely achieves desired results, clinical evidence suggests that regular, intensive personal planning and weight counseling sessions result in modest long-term loss. Even small reductions in body mass can lead to health gains for the seriously obese, and these statistics make it clear that the public is not adequately aware of the health risks posed by obesity or the available options for checkups and ongoing treatment plans. Many will choose not to seek these measures for varied reasons, but our healthcare system needs to do a better job of making them visible and reinforcing how important they can be.

Also worth noting are the significant racial and socioeconomic divides inherent in these statistics from the National Healthcare Disparities Report : Blacks received poorer quality care than whites for 73 percent of the core measures included in the disparities report. Hispanics received poorer quality of care than non-Hispanic whites for 77 percent of the measures. Poor people received lower quality of care than high-income people for 71 percent of the measures. Obese black adults were less likely than whites to be told by their doctor that they were overweight, and black and Asian adults were less likely than whites to have received colon cancer screening.

While these numbers are predictable, we cannot accept complacency in the face of such huge deficits. Americans who make up a minority of our population or who live at the lower ends of the economic scale simply do not receive as much information about relevant treatments, and they are often the people who need them the most, as conditions like obesity, diabetes and colon cancer are particularly prevalent among the poor and underserved. Many individuals choose not to seek treatment because of monetary concerns, and others do not have the information needed to make these decisions on their own. Some of the increased efforts made by our healthcare representatives will fall on deaf ears, but they are vital to improving our collective well-being, and passivity is not an option. If we want to keep the dangerous costs of healthcare in our country within reason, we should take measures, no matter how small, to ensure a healthier population before treatments even begin.

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