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Dying Younger in America

For the first time since 1993, expanding life expectancy in the United States has reversed, based on the latest report from the Centers for Disease Control, Mortality in the United States, 2015. “The last time U.S. life expectancy at birth declined was in 1993, when it dropped from 75.6 to 75.4, according to World Bank data,” as quoted in the Washington Post. Life expectancy at birth in 2015 was 78.8 years, a slight fall from 2014 at 78.9 years. The larger decline fell among men, from 76.5 to 76.3 years. For women, life expectancy at birth in 2015 was 81.2,

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1 in 3 Americans Still Self-Rations Healthcare

People in the U.S. are much more likely to go without health care they need compared with health citizens in 10 other wealthy countries, according to the Commonwealth Fund’s 2016 international survey. One-third of Americans did not seek care due to costs, including going without recommended care, failing to fill a prescription drug, and/or not seeing a doctor when sick. While this self-rationing proportion of Americans dropped from 37% in 2013, the U.S. still ranks #1 in foregoing necessary healthcare due to cost. “In comparison to adults in the other 10 countries, adult sin the U.S. are sicker and more

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Most Americans Are Trying To Lose Weight: Obesity on the Minds of Americans

60% of Americans are currently trying to lose weight. So it shouldn’t be a surprise that when asked, “what’s the most serious health problem in the United States?” Americans say it’s obesity, tied with cancer, and ahead of heart disease and diabetes. Overweight and obesity are top-of-mind for most Americans, according to research conducted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and NORC at the University of Chicago. This research has created two reports which can be accessed at the link. The survey, conducted among 1,509 consumers in August and September 2016, found that Americans’ understanding of

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A New Good Housekeeping Seal for Healthy Food

If you need more proof that mainstream consumers are seeking health through the food they buy, look no further than this announcement about the new Good Housekeeping nutrition lab and launch of the new emblem:  “nutritionist approved.” The effort is underpinned by the Good Housekeeping Food and Nutrition Brand Lab Incubator, located in the GH Institute in New York City. The goal of the program is to empower consumers to “confidently navigate crowded supermarket shelves and make healthier purchases.” Ultimately, GH hopes to inspire people to make healthier food choices, and to inform food manufacturers with healthy product development and brand

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Doctors Are Growing to Like Digital Health Tools, Says the AMA

Notwithstanding the head of the AMA recently referring to digital health technologies as “snake oil,” it appears that one-half of physicians is keen on digital health. And scale, not age, matters when it comes to doctors using digital health tools. The American Medical Association (AMA) surveyed physicians on their use of digital health tools, finding that primary care physicians (PCPs) and doctors working in larger and more complex practices tend to be more digital. In Physicians’ motivations and requirements for adopting digital clinical tools, the AMA’s digital health study, “Physicians are optimistic about digital health innovation and its game-changing potential

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Most Digital Health Consumers Say They Benefit from Connected Health

Managing stress, weight, mental health, sleep, and heart function are among the top-most desired reasons already-connected health consumers are interested in further connecting their health, according to The 2016 HealthMine Digital Health Report. The most popular tools people use to digitally manage their health deal with fitness and exercise (among 50% of connected health consumers), food and nutrition (for 46%), and weight loss (for 39%). 3 in 4 people who use digital health tools say they have improved their health by connecting to these tools. 57% of digital health users also say going health-digital has lowered their healthcare costs. The survey

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Health in America: Improving, But Disparities Need Policy Prescriptions

The bad news: mortality rates haven’t improved much and obesity rates rose in one-third of communities. The good news: public health gains can be made in resource-poor communities with the right health policies, based on research from The Commonwealth Fund, Rising to the Challenge, the Fund’s Scorecard on local health system performance for 2016. The top-line of this benchmark report is that health care in the U.S. has, overall, improved more than it’s declined. Among the big levers driving health care improvement in the past year have been the further expansion of health citizens covered with insurance through the Affordable

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Money, Stress and Health: The American Worker’s Trifecta

Financial stress impacts health, relationships, and work productivity and attendance for employees in the U.S. It’s the American worker’s trifecta, a way of life for a growing proportion of people in the U.S. PwC’s 2016 Employee Financial Wellness Survey for 2016 illustrates the reality of fiscally-challenged working women and men that’s a national epidemic. Some of the signs of the financial un-wellness malaise are that, in 2016: 40% of employees find it difficult to meet their household expenses on time each month 51% of employees consistently carry balances on their credit cards (with a large increase here among Baby Boomers

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It’s World Health Day: Stay Super, Act Local

April 7 is World Health Day, and the World Health Organization (WHO) has named #diabetes the big public health challenge for 2016. What’s striking about this year’s World Health Day is the “Stay Super” public health ad campaign that WHO has developed featuring figures of super-people. THINK: Superman and Wonderwoman meet Doctors Welby, Kildare, and McDreamy. I’ve included several of the posters in the blog today to show how engaging health messaging works well when it works. The materials can be downloaded at this link. This week also saw the publication of America’s Health Rankings, spotlighting the impact of unhealthy behaviors.

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Health Consumers’ Use of Apps Is Up, Accenture Finds

One in 3 consumers is using mobile apps for health, doubling from 16% in 2014 to 33% in 2016, according to a survey from Accenture released during HIMSS 2016 conference. The proportion of people donning a wearable device for health more than doubled, from 9% to 21% between 2014-15. Part of this response is due to more physicians asking their patients — consumers — to adopt a wearable to track a health or fitness metric. One in 5 consumers said their doctor “prescribed” the use of a wearable, and 76% of these people followed the doctor’s recommendation. Most consumers and

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Behavioral Economics in Motion: UnitedHealthcare and Qualcomm

What do you get when one of the largest health insurance companies supports the development of a medical-grade activity tracker, enables data to flow through a HIPAA-compliant cloud, and nudges consumers to use the app by baking behavioral economics into the program? You get Motion from UnitedHealthcare, working with Qualcomm Life’s 2net cloud platform, a program announced today during the 2016 HIMSS conference. What’s most salient about this announcement in the context of HIMSS — a technology convention — is that these partners recognize the critical reality that for consumers and their healthcare, it’s not about the technology. It’s about

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What Zero Kilometers Means for Food and Health

Italians get the food=health connection as a natural everyday behavior. So it’s no surprise that one of the fast-selling books in Italy’s librerias is about Slow Food – a movement that’s celebrating its 30th anniversary in that hot book by Carlo Petrini, a father of the Slow Food organization. I took the photograph this evening peering into a shop window during our post-dinner walk along the Via Gucciardini past the Giunti al Punto bookstore. [In full transparency, I’ve been a long-time member of this organization, represented by the little red snail icon.] The book has a three-word title: Buono, Pulito, Giusto. This

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For Health, Viva Italia!

La salute prima de tutto! Health is first of all!  I am on holiday with my favorite person in the world, my husband, and we are Italophiles. He comes by that bias genetically, and I through loving him and sharing so many joyful, enchanting experiences in la Bella Italia over our many years of marriage. The day before flying to Italy, Dr. Michael Painter, Senior Program Officer of the Robert Wood Johnson Foundation, posted a link on his Facebook page to this wonderful explanation of why Italy ranks as the second-healthiest country in the world, just after Singapore. The rankings

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Building Health Bridges — Health:Further Goes Beyond the Disruptive

Most people in the U.S. acknowledge that their richest country in the world has a broken healthcare system, especially when it comes to costs. A handful of think tanks and lawmakers offer fixes for American healthcare. Now there’s a new problem-solver in healthcare town, Health:Further, and they aim to move U.S. health forward by building bridges between stakeholders in the U.S. health ecosystem. My longtime colleague and friend, Andre Blackman of Pulse+Signal, has joined the organization as “Producer.” Here, we’ll learn more from my (JSK) interview with Andre (AB) about the organization, their mission, and plans to go beyond “disruption”

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It’s Good to Be Hawaiian When It Comes to Health – the 2015 States of Well-Being

Where you live in the U.S. is a risk factor for your health. Hawaii, Alaska, Montana, Colorado and Wyoming rank highest on the State of American Well-Being 2015 State Well-Being Rankings, the Gallup-Healthways Well-Being Index. Well-Being is based on an index of five components that people self-assess: purpose, social, financial, community, and physical. See the map: the darker blue the state, the healthier the population perceives itself to be. Note more light blue to the northeast and south, and dark blue in the mountain states, Alaska and Hawaii. Some states have stayed in the top-tier of wellness since 2012: Hawaii

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Retailers will morph into health destinations in 2016

Retailers in the U.S. are morphing into health destinations in 2016. Members of Target’s management team attended the 2016 Consumer Electronics Show (CES) and shared their perspectives in the company blog. Among the Target teams observations came from the Chief Marketing Officer, Jeff Jones, who observed, “A tidal wave of newness is coming to fitness technology and many companies are on the cusp of changing the game. From nutrition and sleep to how you exercise, it’s all going to be measured, linked and tracked. Wearables are here to stay and getting smarter every year.” The Senior Vice President for Hardlines,

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The Consumer Health Electronics Show – Putting People At the Center

As we concluded our panel on The Wizards of Maternal Health kicking off today’s launch of the 2016 Digital Health Summit, co-located with the 2016 CES (Consumer Electronics Show) in Las Vegas, our diverse team concurred that there’s more than enough “technology” on the convention floor. The challenge now for health is to make connections between the islands of devices, and generate meaningful data and culturally contextual information and support for consumers (patients, caregivers, people) and health providers. Here at the CES, it’s all about the supply side of the equation – for health, that means digital health tools, wearables,

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The Magic of Getting Fit Starring Penn Jillette (With Help From Withings)

Health is where we live, work, play, pray and have fun. And if you’re Penn Jillette, the magician who collaborates with Teller, it took more than sleight of hand or a magic trick to lose 100 pounds — one-third of his body weight. He did it, according to this video, with the help of hard work, and using activity tracking tools from Withings. Unlike many people who quantify themselves for wellness and fitness, Penn did so to avoid having a medical procedure (i.e., the implantation of a stomach sleeve for weight loss) and also to reduce the six meds he

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TIME Sees Lots of Health in the Best Inventions of 2015

Among TIME magazine’s 25 best inventions of 2015, most relate directly or adjacently to health and health care. Among the 25 are: The EKO Stethoscope A gluten-sniffing sensor, the 6SensorLabs Nima The Sproutling baby monitor Nike Flyease 8 shoes, that you can tie with one hand Cogni-Toys Dino, the toy that talks back A smart refrigerator that can fix you a glass of nutrient-enriched water The TZOA environmental tracker for personal pollution sensing, measuring atmosphere in a specific area (e.g., temperature, particulates such as dust, pollen, mold, and car exhaust), and UV ­exposure Doppler Labs Here Active Listening earbuds The

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The Internet of Healthy Things According to Dr. Kvedar

By 2020, according to the World Economic Forum, more than 5 billion people and 30 billion “things” will be connected to the Internet — cars, refrigerators, TVs, washing machines and coffeemakers, among those 5 bn folks’ electronic stuff. But so will medical devices, activity trackers, and a host of sensor-enabled “things” to help people and clinicians optimize health and manage illness. The Internet of Things (IoT) phenomenon, which is already penetrating households with energy management and security applications, is reaching health care. One of the pioneers in this connected health market is Dr. Joseph Kvedar, who leads the Center for

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Social Determinants Impact Health More Than Health Care

The factors of where people are born, live, work and age — social determinants — shape human health more than health care. Yet in the U.S. much more resource per capita is funneled into healthcare services than into social ones. Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity was published by The Kaiser Commission on Medicaid and the Uninsured in November 2015, calling attention to the opportunity and wisdom of baking health into all public policy. The social determinants of health (SDOH) include economic stability, the physical environment and neighborhood, education, food, community and

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U.S. Health At A Glance – Not So Healthy

People in the U.S. have lower life expectancy, a growing alcohol drinking problem, and relatively high hospital inpatient rates for chronic conditions compared with other OECD countries. And, the U.S. spends more on health care as a percent of GDP than any other country in the world. This isn’t new-news, but it confirms that U.S. health citizens aren’t getting a decent ROI on health spending compared with health citizens around the developed world. In the OECD’s latest global look at member countries’ health care performance, Health at a Glance 2015, released today, the U.S. comes out not-so-healthy in the context

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The Fast-Growing Consumer Digital Health Ecosystem – Health 2.0 Day 2

The fastest-growing category of products and services at Health 2.0 is consumer-facing digital health, and a panel of companies demonstrated various flavors of the New Retail Health. One of the most prominent companies featured in Health 2.0’s conferences from the inception has been MyFitnessPal (MFP), a long-time helpful tool I’ve used to manage my own health-life. Under Armour acquired MFP earlier this year, which I covered here in Health Populi. Under Armour’s original mission was to make all athletes better. With the company’s acquisition of MyFitnessPal, Under Armour continued its morphing from a textile and sports gear company to a

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From Pedometers to Premiums in Swiss Health Insurance

A Switzerland-based health insurance company is piloting how members’ activity tracking could play a role in setting premiums. The insurer, CSS, is one of the largest health insurance companies in the country and received a “most trusted general health insurance” brand award in 2015 from Reader’s Digest in Switzerland. The company is conducting the pilot, called the MyStep project, with volunteers from the Federal Institute of Technology in Zurich and the Unviersity of St. Gallen. According to an article on the program published in the Swiss newspaper The Local, “the pilot aims to discover to what extend insured people are

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The rise and rise of noncommunicable diseases

Noncommunicable diseases (NCDs) are the #1 cause of death in the world. NCDs are the yin to the yang of infectious diseases. Mortality from infectious disease has fallen as national economies have developed, while NCDs such as heart disease, respiratory disease, cancer, diabetes, and other NCDs are a growing burden. Health Affairs devotes its September 2015 issue to The Growing Burden of Noncommunicable Diseases, featuring research focusing both on global trends and U.S.-specific challenges. In their look into the relationships between NCDs, unhealthy lifestyles and country wealth, Thomas Bollyky et. al. note that NCDs aren’t only the “diseases of affluence,”

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Happy 1st Anniversary to CVS Going Tobacco-Free

CVS quit selling cigarettes and tobacco products in 2014, made $139 bn, and saved 65,000 lives. That’s the best kind of retail health there is. It’s been a year since CVS quit selling cigarettes, I’m reminded by a one-page ad in today’s Wall Street Journal on page B5. This is a big investment in an ad for a business strategy that’s had a huge return-on-investment. The ad reads: “One year ago, we took a deep breath and quit selling cigarettes in our pharmacies. Now we’re working to create a tobacco-free world. We just want to help everyone, everywhere, breathe easier,”

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Sports and the Internet of Things: the Scoop & Score podcast

From elite soccer and football fields to youth athletes in public school gyms, wearable technology has come to sports bringing two big benefits of gathering data at the point of exercise: to gauge performance and coach back to the athlete in real time, and to prevent injury. I discussed the advent of the Internet of Things in sports on the Scoop and Score podcast with Andrew Kahn, sports journalist and writer, and Stephen Kahn, sports enthusiast and business analyst. [In full disclosure these two Kahn’s are also my brilliant nephews.] We recorded the podcast on July 14, 2015, the day

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How digital ‘everything’ and consumer expectations are re-shaping health care

Two forces are converging to shape a new era of “living services,” Accenture posits: the digitization of “everything” and consumers’ “liquid” expectations — which are demands for personalized, engaging and adaptable experiences. Accenture’s report on this phenomenon, The Era of Living Services, spans the broad range of consumers’ daily lives where these services will impact: homes, families, transportation, shopping, leisure time, jobs, finances, education, cities, and above all for Health Populi readers, “our bodies.” Living services are physically close to us, as Accenture sees them, “wrapping themselves around the everyday things we do.” They are digital services that are aware

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Avoiding Wrinkles: A World Without Tobacco

May 31st is World No Tobacco Day, heralded by the World Health Organization, and celebrated by the advocacy group Action on Smoking and Health (with the very appropriate acronym ASH). Smoking is one of the most addictive (anti-)health behaviors around, so persuading people to quit the habit continues to challenge public health advocates. Enter ASH’s engaging campaign called “The Wrinkler,” with the introductory question, “Ever notice how some people who are 25 look 45?” The video continues to explain how we can “expedite the aging process….Ladies, wish you were half your age? Don’t wait for him to look younger; make yourself

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Health is where we live, work, and shop…at Walgreens

Alex Gourley, President of The Walgreen Company, addressed the capacity crowd at HIMSS15 in Chicago on 13th April 2015, saying his company’s goal is to “make good health easier.” Remember that HIMSS is the “Health Information and Management Systems Society” — in short, the mammoth health IT conference that this year has attracted over 41,000 health computerfolk from around the world. So what’s a nice pharmacy like you, Walgreens, doing in a Place like McCormick amidst 1,200+ health/tech vendors?  If you believe that health is a product of lifstyle behaviors at least as much as health “care” services (what our

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Learning from Mr. Spock and Leonard Nimoy about living long and prospering

“Live long and prosper,” Mr. Spock repeated, like a mantra, throughout his life. We say goodbye, on this dimension anyway, to Leonard Nimoy, who passed away today at the age of 83. Star Trek is a staple entertainment — perhaps even a relaxation therapy — in my home. So Mr. Nimoy’s departure from the Planet is indeed a sad event here. In thinking about Spock’s mantra about living well, I am reminded of an interchange between him and Captain Kirk in the Star Trek movie, The Wrath of Khan. In that film, Spock is severely irradiated while saving the ship, and

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Most people want to go digital for health – especially the un-well

2 in 3 people in the U.S. would use a mobile app to manage their health, especially for diet and nutrition, medication reminders, tracking symptoms, and recording physical activity. The fifth annual Pulse of Online Health survey from Makovsky finds that digital health is blurring into peoples’ everyday lives. We’ve covered previous Makovsky digital health surveys here on Health Populi; last year, we focused on consumers managing risk in digital health platforms, and in 2013, the state of seeking health information online. That most consumers would go beyond health information search to the more engaging pursuit of managing health over

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Health and wellness at CES 2015 – trend-weaving the big ideas

Health is where we live, work, play and pray — my and others’ mantra if we want to truly bend (down) the cost curve and improve medical outcomes. If we’re serious about achieving the Triple Aim — improving public health, lowering spending, and enhancing the patient/health consumer experience (which can drive activation and ongoing engagement) — then you see health everywhere at the 2015 Consumer Electronics Show in Las Vegas this week. With this post, I’ll share with you the major themes I’m seeing at #CES2015 related to health, wellness, and DIYing medical care at home. The meta: from health care to self-care.

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Irrational exuberance in mobile health? Live from the mHealth Summit 2014

Mobile and digital technologies will bend the health care cost curve, drive individual and population health, and solve the nagging challenge of health disparities. Mobile and digital technologies will increase costs to health providers, disrupt work flows and lower clinicians’ productivity, and hit a market bubble. Depending on your lens into mHealth, and what product categories and user segments you’re looking at, all of the above can be true. The plenary session of the 2014 mHeath Summit kicked off with Dr. Harry Leider, Chief Medical Information Officer of Walgreens, who spoke of the pharmacy’s evolving role across the entire continuum of care,

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Health care costs, access and Ebola – what’s on health care consumers’ minds

The top 3 urgent health problems facing the U.S. are closely tied for first place: affordable health care/health costs, access to health care, and the Ebola virus. While the first two issues ranked #1 and #2 one year ago, Ebola didn’t even register on the list of healthcare stresses in November 2013. Gallup polled U.S. adults on the biggest health issues facing Americans in early November 2014, and 1 in 6 people named Ebola as the nation’s top health problem, ahead of obesity, cancer, as well as health costs and insurance coverage. Gallup points out that at the time of

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Blurred lines: health, pharmacy, food and care

In the past few weeks, several events bolster the reality that health and health care are in Blurred Lines mode. Not Robin Thicke Blurred Lines, mind you, but the Venn Diagram overlapping kind. Walmart launched real primary care clinics in South Carolina and Texas. These will provide services beyond urgent care, charging $4 a visit for company employees and $40 a visit for other people The U.S. Department of Agriculture issued a report promoting “nudges” to grocery shoppers enrolled in the Supplemental Nutrition Access Program (SNAP) to buy healthy foods Apple is talking with Cleveland Clinic, Johnson Hopkins, and Mount Sinai Medical

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Over-the-counter drugs – an asset in the collaborative, DIY health economy

Nations throughout the world are challenged by the cost of health care: from Brazil to China, India to the Philippines, and especially in the U.S., people are morphing into health care consumers. Three categories of health spending in the bulls-eye of countries’ Departments of Health are prescription drugs, and the costs of care in hospitals and doctors’ offices. In the U.S., one tactic for cost containment in health is “switching” certain prescription drugs to over-the-counter products – those deemed to be efficacious and safe for patients to take without seeking treatment from a doctor. Over-the-counter drugs (OTCs) are available every

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Self-care – the role of OTCs for personal health financial management

Make-over your medicine cabinet. That’s a key headline for International Self-Care Day (ISD) on July 24, 2014, an initiative promoting the opportunity for people to take a greater role in their own health care and wellness. Sponsored by the Consumer Healthcare Products Association (CHPA), consumer products companies, health advocacy organizations, and legislators including John Barrow (D-GA), a co-sponsor of H.R. 2835 (aka the Restoring Access to Medications Act), the Day talked about the $102 billion savings opportunity generated through people in the U.S. taking on more self-care through using over-the-counter medicines. After the 2008 Recession hit the U.S. economy, industry analysts

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Stress Is US

“Reality is the leading cause of stress among those in touch with it,” Lily Tomlin once quipped. Perhaps in 2014, America is the land of stress because we’re all so in touch with reality. THINK: reality TV, social networks as the new confessional, news channeling 24×7, and a world of too much TMI. So no surprise, then, that one-half of the people in the U.S. have had a major stressful event or experience in the last year. And health tops the list of stressful events in This American Life in the forms of illness and disease (among 27% of people)

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In pursuit of healthiness – Lancet talks US public health

It’s Independence Day week in America, and our British friends at The Lancet, the UK’s grand peer reviewed medical journal, dedicate this week’s issue to the Health of Americans – exploring life, death (mortality), health costs, chronic disease, and the Pursuit of Healthiness. This project is a joint venture between The Lancet and the U.S. Centers for Disease Control (CDC) which took 18 months to foster, called The Health of Americans Series. Americans mostly die from chronic diseases, aka non-communicable diseases, which are largely amenable to lifestyle changes like eating right, quitting smoking, drinking alcohol in moderation, and moving around more. 1 in

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Go, You Chicken Fat, Go! Kennedy Met the Music Man for Health (and Apple Takes a Bite)

What do you get when you pair Meredith Wilson, the writer-composer of The Music Man, with Robert Preston (who acted the starring role of Harold Hill, the traveling music-band instrument salesman) with a President committed to reversing the “softness” he saw in American health citizens? You get “Go, You Chicken Fat, Go,” a rousing band-and-choir backed anthem to promote people to engage in more exercise and shed their “chicken fat.” President Kennedy was the public health Prez who, in 1960, asked Meredith Wilson to pen a national anthem to motivate Americans who he considered were growing “soft.” Back in the

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Apple and Google and Samsung, Oh My!

Three of the world’s biggest technology companies – Apple, Google and Samsung — have made big announcements in the world of connected health in the past few weeks. A fourth is positioned to enter the fray. These major announcements illustrate the convergence of consumer technology, health, and wearables, with the potential for Big Data and population health impacts. Among the three tech giants, Samsung announced its consumer health/tech story first, on May 28, 2014, at its Digital Health Initiative meeting. Samsung unveiled the Samsung Architecture Multimodal Interactions platform, SAMI, along with the Simband prototype wristband that would enable users to

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World No Tobacco Day v2014 – let’s raise (more) taxes on tobacco

Tomorrow is World No Tobacco Day. The use of tobacco is one of the most preventable public health issues on the planet. And the global tobacco epidemic contributed to 100 million deaths around the world in the 20th century. 6 million people die every year due to tobacco use — including 600,000 deaths due to exposure to secondhand smoke. About 500 million people living today will be dead from the use of tobacco products if current smoking habits continue, the World Health Organization (WHO) expects. WHO sponsors the World No Tobacco Day every year on May 31. For this year’s

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The retailization of digital health: Consumer Electronics Association mainstreams health

The Consumer Electronics Association (CEA) has formed a new Health and Fitness Technology Division, signalling the growing-up and mainstreaming of digital health in everyday life. The CEA represents companies that design, manufacture and market goods for people who pay for stuff that plugs into electric sockets and operate on batteries — like TVs, phones, music playing and listening, kitchen appliances, electronic games, and quite prominent at the 2014 Consumer Electronics Show, e-cigarettes (rebranding “safe smoking” as “vaping” technology). In its press release announcing this news, CEA President and CEO Gary Shapiro says, “Technology innovations now offer unprecedented opportunities for consumers to

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Wearable tech + the workplace: driving employee health

Employer wellness programs are growing in the U.S., bundled with consumer-directed plans and health savings accounts. A wellness company’s work with employee groups is demonstrating that workers who adopt mobile health technologies — especially “wearables” coupled with smartphone apps — helps change behavior and drive health outcomes. Results of one such program are summarized in Wearables at Work, a technical brief from Vitality, a joint venture of Humana and Discovery Ltd., published April 23, 2014. Vitality has been working in workplace wellness since 2005, first using pedometers to track workers’ workouts. In 2008, Vitality adopted the Polar heart rate monitor for

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Affordable medicine: a preferred future

The price of medicines is a barrier for about one billion people on the planet, for citizens in developing countries as well as middle-class families in the richest country in the world, the United States.  Today is World Health Day, when for 24 hours public health advocates (including me) are calling out key issues preventing people from fully living life. One obstacle for too many people is the cost of drugs and supplies that save lives and help people add life to years. For example, bug bites can be deadly if you’re talking about the 50% of the world’s population

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Health care in a multiscreen world

In 2014, we are digital omnivores. Most people “consume” information and entertainment on more than one screen: 7 hours’ worth over a 5-hour period. You read that right: most people who watch TV, use a laptop or PC, smartphone or tablet are multitasking use of these devices in parallel. And above all, people are using smartphones as their primary screen. The AdReaction: Marketing in a multiscreen world report from Millward Brown paints a picture of global consumers who are cobbling together multiscreen experiences. The smartphone has become the “do it all” device if you don’t carry a laptop or tablet around, especially favored

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Why a grocery chain supports health data liquidity

The CEO of a family-owned grocery store chain wrote a letter to New York State lawmakers to support $65 million worth of spending on a computer system for health information in the state. That grocer is Danny Wegman, and that project is the Statewide Health Information Network, aka SHIN-NY. In his letter beginning, “Dear New York Legislator,” Wegman identifies several benefits he expects would flow out of the health IT project: 1. Improve health care for all New Yorkers 2. Lower health care costs, through reducing hospital readmission rates and reducing duplicate testing. 3. Lead to health data “liquidity” (my

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Health data data everywhere – let’s human-scale it / Report from #SXSW #SXSH

Health data is everywhere, but not much useful to drink. Is #bigdata in health care at the top of the Hype Cycle? And how do we humanize it, make it relevant and useful for our everyday life? In other words, can this data help us hack our lives and health for the better? That question has been on my mind for the past couple of years since the convergence of big data and data analytics and health has emerged. Yesterday at the 2014 South-by-Southwest happening, I attended a panel discussion called Hacking Your Life For Better Health (#hacklife on Twitter).

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Employers spending more on wellness in 2014, with growing focus on food

Employers continue to invest in wellness programs aimed at improving employees’ health. In 2014, 3 in 4 employers plan to offer incentives to employees who participate in health improvement programs compared = and the financial value of these incentives has grown to $500, up from $338 in 2010. In its fifth year, the National Business Group on Health (NBGH)/Fidelity Investments have conducted their benefit consulting survey, culminating in the report, Employer Investments in Improving Employee Health. In the past 5 years, employers have increased their investments in wellness: the chart illustrates the growth of programs addressing physical activity/weight management and health eating,

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The new retail health: Bertolini of Aetna connects dots between the economy and health consumers

3 in 4 people in America will buy health care at retail with a subsidy within just a few years, according to Mark Bertolini, CEO of Aetna. Bertolini was the first keynote speaker this week at the 2014 HIMSS conference convened in Orlando. Bertolini’s message was grounded in health economics 101 (about which frequent readers of Health Populi are accustomed to hearing). A healthy community drives a healthy local economy, and healthier people are more economically satisfied, Bertolini explained. The message: health care can move from being a cost driver to being an economic engine. But getting to a healthy

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Watson goes wellness

IBM’s data analytics engine Watson, having cut its teeth on complex health care conditions like cancer, is now entering an even more challenging space: wellness. Why is wellness more challenging? Because understanding a person’s wellness goes beyond mining data from health care claims silos in hospitals, pharmacies, and physicians’ electronic health records. Wellness happens where we live, work, play and pray. Wellness is nurtured through choices made every day at home, in the workplace, and at moments-of-truth in the grocery store and restaurant where slick marketing messages planted in our subconscious compete with our more rational minds that tell us to

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What CVS going tobacco-free means for health and business

Bravo! to CVS/pharmacy who today announced it would pull tobacco products from store shelves by October 2014. “The sale of tobacco products is inconsistent with our purpose,” the company’s press release asserts. The move will cost CVS $1.5 billion in revenue annually, as the company seeks to consolidate its position as a health company. CVS/pharmacy is part of CVS Caremark, which includes the retail pharmacy chain (the second-largest in the U.S.), a pharmacy benefit management company (Caremark), and retail health clinics (Minute Clinics). CVS Caremark also participates in a healthy communities program issuing grants for projects that focus on health

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Connected Health – the technology is ready, providers on the cusp

The convergence of technology developments – such as the internet, mobile phone adoption, cloud computing, sensors, electronic health records – with societal evolution including consumerism, demand for transparency, and “flatter” organizations – enable the phenomenon of Connected Health. Connected Health by definition includes mobile health (mHealth), telehealth and telemedicine, as presented in the February 2014 issue of Health Affairs which is dedicated to this theme. Why Connected Health’s time is Now relates to those factors cited above, and the underlying challenge of managing health care costs. While all nations in the developed world are facing difficult health economies, the U.S. spends so

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Mars and Venus and the challenges of healthy eating

Americans have been eating more healthfully in the past couple of years, according to the USDA which examined eating patterns among working-age adults in the U.S. between 2005 and 2010. And most people do believe they are indeed healthy eaters: three-quarters of people in the U.S. say they eat healthfully. On the other hand, it’s difficult to do that consistently. Why? Lack of motivation (37%), busy schedules (33%), lots of stress (30%), and money (29%).  Underneath these numbers are differences between women and men. When it comes to food and healthy eating, it seems men are from Mars and women,

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U.S. families face medical financial burdens; health care in the SOTU

  A growing proportion of American families are facing money problems related to health care, according to the report, Financial Burden of Medical Care: A Family Perspective, No. 142 in the NCHS Data Brief series from the CDC, published January 2014 and based on 2012 data. 1 in 4 families are dealing with some financial burden due to medical care. “Financial burdens” in health include problems paying medical bills in the past 12 months, shared by 16.5% of families; and medical bills being paid over time, faced by 21.4% of families. 1 in 10 families (9%) have medical bills they are

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Food and money matter for health – more hospital admissions at the end of the month

If your wallets are lighter at the end of the month, you’re likely to have less access to quality food, and more likely to be admitted to the hospital if you have diabetes. The hypothesis that people with low incomes whose household budgets are spent before the end of the month have greater health inequities was tested in the article, Exhaustion of Food Budgets At Month’s End And Hospital Admissions For Hypoglycemia, published in the January 2014 issue of Health Affairs. Researchers from the University of California – San Francisco found that, indeed, the health in households with low-income suffer from

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Do People Really Want To Tech Their Health? in Huffington Post

This post appeared in my Huffington Post column on January 16, 2013. In the afterglow of the 2014 Consumer Electronics Show (CES), away from the neon lights of Las Vegas, 4D curved TV screens, and uber-hip Google Glass wearers, a big question remains: Do we, the people, really want to tech our way to self-health? The number of digital health companies exhibiting at CES grew by 40 percent, exceeding 300 based on the count of the International Consumer Electronics Association, sponsor of the event. The hockey-stick growth of “wearable technology” seen at the 2014 Consumer Electronics Show begs the question: Are there

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Schizo about smoking

There’s truly good news for public health about smoking: January 11th marked the 50th anniversary of the U.S. Surgeon General’s Report on Smoking and Health. That’s five decades’ worth of progress raising peoples’ awareness about the toxic impact of nicotine and chemicals embodied in cigarettes, and deleterious impacts on health and the economy. As a result, smoking rates have been cut in half since 1964, as the downward-sloping graph illustrates. With that happy news in my subconscious, I took a long walk, tracked by my digital device, through the Venetian Hotel in Las Vegas last week, bound for the 2014 Consumer Electronics

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Health Care Everywhere at the 2014 Consumer Electronics Show

When the head of the Consumer Electronics Association gives a shout-out to the growth of health products in his annual mega-show, attention must be paid. The #2014CES featured over 300 companies devoted to “digital health” as the CEA defines the term. But if you believe that health is where we live, work, play, and pray, then you can see health is almost everywhere at the CES, from connected home tech and smart refrigerators to autos that sense ‘sick’ air and headphones that amplify phone messages for people with hearing aids, along with pet activity tracking devices like the Petbit. If

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Sleep is the new black – digital health at the 2014 Consumer Electronics Show #CES2014

In the battle of wearable devices for digital health at this year’s Consumer Electronics Show, it’s sleep that’s the #1 new extension on activity tracking. Sleep, or lack thereof, is a prevalent challenge for people who increasingly live electronic lifestyles on-the-grid. And, lack of sleep is a major health risk for obesity, heart conditions, and mental acuity. A new Swedish study published in the peer-reviewed journal Sleep has found that sleep protects brain health. With the demise of the dedicated sleep device Zeo in 2013, popular sleep trackers with market shares have the opportunity to add sleep functions to their tools.

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Color us stressed – how to deal

Coast-to-coast, stress is the modus vivendi for most Americans: 55% of people feel stressed in every day life, according to a study from Televox. A Stressful Nation: Americans Search for a Healthy Balance paints a picture of a nation of physically inactive people working too hard and playing too little. And far more women feel the stress than men do. 64% of people say they’re stressed during a typical workday. 52% of people see stress negatively impacting their lives. And nearly one-half of people believe they could better manage their stress. As a result, physicians say that Americans are experiencing negative

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Bundles in health care are the prix fixe menu

Ordering up and financing health care in the U.S. looks like the proverbial Chinese food menu, picking and paying for “one from column A, and one from column C.” But that’s no way to operate a well-oiled machine for delivering quality health care, according to Healthcare Shifts from á la Carte to Prix Fixe from Strategy&, an analysis of the fragmented, high-cost and only fair quality American health system. One solution to this challenge is bundled payment. “No one has an overarching view of the entire process,” the report opines, “with an eye toward improving customer service, quality, or costs.” Further exacerbating the sub-optimal

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Gamification in health – make the person the quarterback

Games are part of peoples’ lives in the 20-teens. Gamification has been used in military and business training and now is a growing method to help change peoples’ behavior across a variety of issues — health, among them. But it’s not all “fun and games” when it comes to succeeding in applying gaming methods in health, according to Gaming to Engage the Healthcare Consumer, a report from ICF International. ICF’s roots are in the defense industry, and the team that wrote this paper together have decades of experience in military applications. These learnings can be quite useful when translated into the

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Self-service health – how consumers can help solve the primary care shortage

Self-service – people DIYing health care — can help solve the primary care shortage in America, based on the findings of 23 studies published this week. If health information technologies (health IT) were “fully implemented” in 30% of doctors’ offices, demand for physicians would fall by 4 to 9%, according to The Impact of Health Information Technology and e-Health On the Future Demand for Physician Services, published in the November 2013 issue of Health Affairs. Weiner, Yeh and Blumenthal did a meta-analysis of the literature on health IT and its potential to improve productivity and extend physician services and found

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Getting to health engagement will require more than a patient portal

Patient and health engagement is the flavor du jour in health circles these days, from the corridors of hospitals to the caffeinated marketing meetings in Big Pharma’s east coast meet-ups. But there’s no standard agreement on what we mean by peoples’ health engagement, whether by patient or well consumer. In Market Insights: The Evolution of Consumer Engagement in Health Care, Porter Research endeavors to deepen our understanding of this important concept. In the introductory section of the paper, “Understanding Engagement,” Porter proffers that industry – providers, payers and employers – consider engagement as “changing consumer behavior through increased participation in consumers’ own health

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Innovating and thriving in value-based health – collaboration required

In health care, when money is tight, labor inputs like nurses and doctors stretched, and patients wanting to be treated like beloved Amazon consumers, what do you do? Why, innovate and thrive. This audacious Holy Grail was the topic for a panel II moderated today at the Connected Health Symposium, sponsored by Partners Heathcare, the Boston health system that includes Harvard’s hospitals and other blue chip health providers around the region. My panelists were 3 health ecosystem players who were not your typical discussants at this sort of meeting: none wore bow ties, and all were very entrepreneurial: Jeremy Delinsky

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Delaying aging to bend the cost-curve: balancing individual life with societal costs

Can we age more slowly? And if so, what impact would senescence — delaying aging — have on health care costs on the U.S. economy? In addition to reclaiming $7.1 trillion over 50 years, we’d add an additional 2.2 years to life expectancy (with good quality of life). This is the calculation derived in Substantial Health And Economic Returns From Delayed Aging May Warrant A New Focus For Medical Research, published in the October 2013 issue of Health Affairs. The chart graphs changes in Medicare and Medicaid spending in 3 scenarios modeled in the study: when aging is delayed, more people qualify

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Economics of obesity and heart disease: We, the People, can bend the curves

The “O” word drives health costs in America ever-upward. Without bending the obesity curve downward toward healthy BMIs, America won’t be able to bend that stubborn cost curve, either. The Economic Impacts of Obesity report from Alere Wellbeing accounts for the costs of chronic diseases and how high obesity rates play out in the forms of absenteeism, presenteeism, and direct health care costs to employers, workers and society-at-large. Among the 10 costliest physical health conditions, the top 3 are angina, hypertension and diabetes — all related to obesity and amenable to lifestyle behavior change. The top-line numbers set the context:

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7 Women and 1 Man Talking About Life, Health and Sex – Health 2.0 keeping it real

Women and binge drinking…job and financial stress…sleeplessness…caregiving challenges…sex…these were the topics covered in Health 2.0 Conference’s session aptly called “The Unmentionables.” The panel on October 1, 2013, was a rich, sobering and authentic conversation among 7 women and 1 man who kept it very real on the main stage of this mega-meeting that convenes health technology developers, marketers, health providers, insurers, investors, patient advocates, and public sector representatives (who, sadly, had to depart for Washington, DC, much earlier than intended due to the government shutdown). The Unmentionables is the brainchild of Alexandra Drane and her brilliant team at the Eliza

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Health care and survey taking at the Big Box Store

Where can you shop the health and beauty aisles, pick up some groceries and a prescription, get a flu vaccine, and weigh in on Obamacare and what digital health tools you like? Why, at one of several thousand retail stores where you can find a SoloHealth kiosk. As of yesterday afternoon, over 32 million encounters were recorded on SoloHealth kiosks, based on an app I saw on the company CEO Bart Foster’s smartphone. Kiosks are locatted around the United States in retailers including Walmart and Sam’s Clubs, along with major grocery chains like Schnuck’s and Publix, and the CVS pharmacy

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Taking vitamins can save money and impact the U.S. economy – and personal health

When certain people use certain dietary supplements, they can  save money, according to a report from the Council for Responsible Nutrition and Frost and Sullivan, the analysts. The report is aptly titled, Smart Prevention – Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements. Its subtitle emphasizes the role of dietary supplements as a way to “combat unsustainable health care cost growth in the United States.” Specifically, the use of eight supplements in targeted individuals who can most benefit from them can save individuals and health systems billions of dollars. The eight money-saving supplements are: > Omega-3 > B

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Chief Health Officers, Women, Are In Pain

Women are the Chief Health Officers of their families and in their communities. But stress is on the rise for women. Taking an inventory on several health risks for American women in 2013 paints a picture of pain: of overdosing, caregiver burnout, health disparities, financial stress, and over-drinking. Overdosing on opioids. Opioids are strong drugs prescribed for pain management such as hydrocodone, morphine, and oxycodone. The number of opioid prescriptions grew in the U.S. by over 300% between 1999 and 2010. Deaths from prescription painkiller overdoses among women have increased more than 400% since 1999, compared to 265% among men.

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Eat fruits and vegetables: it’s worth $11 trillion to you and the U.S. economy

More than 127,000 people die every year in America from cardiovascular disease, accruing $17 billion in medical spending. Heart disease is a “costly killer,” according to the Union of Concerned Scientists, who has calculated The $11 trillion reward: how simple dietary changes can save lives and money, and how we get there, published in August 2013. That $11 trillion opportunity is equal to the present value of lives saved. The solution to bolstering heart (and overall health) and saving money (medical spending and personal productivity) is in food. We’re not talking about genetically engineering anything special or out-of-the-ordinary. We are talking

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Happy today, nervous about health and money tomorrow: an Aging in America update

Most older Americans 60 years of age and up (57%) say the last year of their lives has been “normal” – a large increase from the 42% who said life was normal in 2012. And nearly 9 in 10 older Americans are confident in their ability to maintain a high quality of life in their senior years. The good news is that seniors are maintaining a positive outlook on aging and their future. The downside: older people aren’t doing much to invest in their future health for the long run. They’re also worried about the financial impact of living longer.

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Healthways buys into Dr. Ornish’s approach: will “Ornish-inside” scale wellness in America?

People who live in U.S. cities with low levels of well-being have twice the rate of heart attacks as people who live in healthier America. That’s 5.5% of the population in sicker America versus 2.8% of the population living in healthy America. The first chart illustrates this disparity, taken from the Gallup-Healthways index that examined 190 metropolitan areas in 2012. Based on this study, it’s good to live in parts of Utah, Nebraska and Colorado, but not so healthy to be a resident in West Virginia, Alabama, and parts of Kentucky and Ohio. Heart disease and diabetes are killing a plurality

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Google, your new-tritionist

Your new-nutritionist is now Google, which launched a nutrition utility through Google Search. “From the basics of potatoes and carrots to more complex dishes like burritos and chow mein, you can simply ask, ‘How much protein is in a banana?’ or ‘How many calories are in an avocado?’ and get your answer right away,” the official Google Search blog explains. Over 1,000 items – fruits, vegetables, meats, dairy items, and prepared meals like Chinese and Mexican take out, as mentioned in Google’s quote above – are searchable via web and mobile, powered by Google’s Knowledge Graph. The Knowledge Graph is the

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Health and wellness, the economy and the grocery store

Consumers in America are spending more, and especially at the grocery store. Most people say they want to eat healthy — but, although they’re spending more at the food store, one-half of supermarket shoppers say cost is the main obstacle for healthy eating. 2 in 3 U.S. grocery shoppers define health and wellness as being physically fit and active, and over half believe that feeling good about yourself is another facet of health. Not being overweight equals health for about one-half of U.S. shoppers. The Why? Behind the Buy, from Acosta Sales & Marketing, explores buying patterns among U.S. consumers

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Cost prevents people from seeking preventive health care

3 in 4 Americans say that out-of-pocket costs are the main reason they decide whether or not to seek preventive care, in A Call for Change: How Adopting a Preventive Lifestyle Can Ensure a Healthy Future for More Americans from TeleVox, the communications company, published in June 2013. TeleVox surveyed over 1,015 U.S. adults 18 and over. That’s the snapshot on seeking care externally: but U.S. health consumers aren’t that self-motivated to undertake preventive self-care separate from the health system, either, based on TeleVox’s finding that 49% of people say they routinely exercise, and 52% say they’ve attempted to improve eating habits.

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Americans’ health not keeping up with the world: why to spend more on social determinants of health

The American health infrastructure is not First World or First Rate, based on the outcomes. This, despite spending more on health care per-person than any country on the planet. Two seminal reports are out this week reminding Americans that our return-on-investment in health spending is poor. The first research comes from JAMA titled  The State of US Health, 1990-2010:  Burden of Diseases, Injuries, and Risk Factors. There is some good news in this report at the top line: that life expectancy for Americans increased in the two decades from 75.2 years to 78.2 years. But this positive quantitative outcome comes with

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1 in 3 people is interested in doing mobile health, but they skew younger

The headline for the HarrisInteractive/HealthDay mobile health (mHealth) survey reads, “Lots of Americans Want Health Care Via Their Smartphones.” But underneath that bullish forecast are statistics illustrating that the heaviest users of health care services in America — people 65 and over — have the least interest in mHealth tools. Overall, 37% of U.S. adults are interested in managing health via smartphones or tablets: about 1 in 3 people. As the chart shows, the greatest interest in communicating with doctors via mobile phones and tablets is among people 25-49. Reminders to fill prescription and participate in wellness programs is also

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The emerging economy for consumer health and wellness

The notion of consumers’ greater skin in the game of U.S. health care — and the underlying theory of rational economic men and women that would drive people to greater self-care — permeated the agenda of the 2nd annual Consumer Health & Wellness Innovation Summit, chaired by Lisa Suennen of Psilos Ventures. Lisa kicked off the meeting providing a wellness market landscape, describing the opportunity that is the ‘real’ consumer-driven health care: people getting and staying well, and increasing participation in self-management of chronic conditions. The U.S. health system is transforming, she explained, with payors beginning to look like computer

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The health and wellness gap between insured and uninsured people

If you have health insurance, chances are you take several actions to bolster your health such as take vitamins and supplements (which 2 in 3 American adults do), take medications as prescribed (done by 58% of insured people), and tried to improve your eating habits in the past two years (56%). Most people with insurance also say they exercise at least 3 times a week. Fewer people who are uninsured undertake these kinds of health behaviors: across-the-board, uninsured people tend toward healthy behaviors less than those with insurance. This is The Prevention Problem, gleaned from a survey conducted by TeleVox

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A physical activity shortage: Let’s Move!

Only 1 in 5 Americans got the minimum recommended amount of physical activity in 2011, based on guidelines offered by the U.S. Centers for Disease Control. More men than women met the standard: 23.4% of men versus 17.9% of women. There are wide variations across the 50 states, as the map shows, with the healthiest folks exercise-wise living in the west, Alaska, upper midwest, and New England. The range runs from a 12.7% low in West Virginia and Tennessee to 27.3 at the high end in Colorado. That bar is set at 150 minutes a week (that’s 2.5 hours) of

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Dietitians provide a health bridge between food and pharmacy

The registered dietitian is an in-demand labor resource for grocery stores around the U.S. Advertising Age covered the phenomenon of the growing clout of dietitians in food chains (April 14, 2013). Let’s dig further into this phenomenon through the Health Populi lens on healthcareDIY and peoples’ ability to bend their personal health care cost curves. Stores such as Giant Eagle, Hy-Vee, Safeway and Wegmans are morphing into wellness destinations, with pharmacies and natural food aisles taking up valuable square footage to meet consumers’ growing demands for healthy choices. Some stores are formalizing their approach to food = health by formulating a

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Food = Health for employers, hospitals, health plans and consumers

Food is inextricably bound up with health whether we are well or not. Several key area of the Food=Health ecosystem made the news this week which, together, will impact public and personal health. On the employer health benefits front, more media are covering the story on CVS strongly incentivizing employees to drop body mass index (BMI) through behavioral economics-inspired health plan design of a $50 peer month penalty. Michelin, whose bulky advertising icon Bibendum has more than one “spare tire,” introduced a program to combat health issues, including but not limited to BMI and high blood pressure, according to the

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An American Nanny State? Most Americans support government tactics addressing lifestyle impacts on chronic disease

  Most people like government policies targeting reducing tobacco use, requiring food manufacturers and restaurants to reduce salt content, and mandating schools to require 45 minutes of daily activity for students. A large majority of Americans (at least 8 in 10 people) support government actions to promote public health that stem chronic disease, from preventing cancer (89%) and heart disease (86%) to helping people control their diabetes (84%) and preventing childhood obesity (81%). A Survey Finds Public Support For Legal Interventions Directed At Health Behavior To Fight Noncommunicable Disease (NCD). This poll, published in the March 2013 issue of Health Affairs, profiles the

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The Sitting Disease: health is growing at SXSW

If it’s March, it must be time for South by Southwest (SXSW), the annual conference weaving music, film and interactive tracks of speakers and conferees that overcrowds and excites Austin, Texas, with a cool vibe and even cooler ideas. I’ll be participating on Sunday 10 March 2013 at 5 pm on a panel, Sitting Will Kill You: Can Mobile Save Us?, featuring Fran Melmed, developer of the HotSeat app that nudges us to all Get Up Offa Our Things when living our typical sedentary lives; Peter Katzmarzyk, public health researcher who knows all about the relationship between too much sitting

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Bill Clinton’s public health, cost-bending message thrills health IT folks at HIMSS

In 2010, the folks who supported health care reform were massacred by the polls, Bill Clinton told a rapt audience of thousands at HIMSS13 yesterday. In 2012, the folks who were against health care reform were similarly rejected. President Clinton gave the keynote speech at the annual HIMSS conference on March 6, 2013, and by the spillover, standing-room-only crowd in the largest hall at the New Orleans Convention Center, Clinton was a rock star. Proof: with still nearly an hour to go before his 1 pm speech, the auditorium was already full with only a few seats left in the

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Americans are first in un-health: the US health disadvantage

In the U.S., we’ll be the #1 oil producer by 2020. We’re the largest national economy in the world (to be surpassed by China before 2030). And, we’re #1 in terms of the lowest taxes paid as a percentage of national GDP. That’s all heartening news for the time being. But we’re also #1 in what I’ll call “un-health:” in auto accident mortality for adolescents, obesity rates, infant mortality, prevalence of sexually transmitted diseases, and among other public health metrics. A report from the National Research Council and Institute of Medicine (NRC/IOM) calls out what JAMA terms The US Health Disadvantage:

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