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The Ultimate Health Outcome, Mortality, Is Rising in America

How long can people living in the U.S. expect to live? 78.6 years of age, if you were born in 2017. That’s a decline of 0.1 year from 2016. This decline especially impacted baby boys: their life expectancy fell to 76.1 years, while baby girls’ life expectancy stayed even at 81.1 years. That’s the latest data on Mortality in the United States, 2017, soberly brought to you by the Centers for Disease Control and Prevention, part of the U.S. Department of Health and Human Services. Underneath these stark numbers are the specific causes of death: in 2017, more Americans died

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Be Thankful by Engaging With Grace and Talking About Your End-of-Life Wishes With Loved Ones

“Thanksgiving.” Merriam-Webster’s dictionary defines the word, first, as “the act of giving thanks.” Second, it’s “a prayer of expressing gratitude.” And, third, the word means a public acknowledgment or celebration of divine goodness. We each have our own stories about how a loved one’s life has ended. If we’re lucky, that beloved person had a good death: in sleep, perhaps, or simply of old age with no hospital events or trauma. Then there are the Rest-of-Us who share family stories and experience of long and painful endings, in institutional settings often coupled with costly, so-called “heroic” but unwanted, futile care. When

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Obese, Access-Challenged and Self-Rationing: America’s Health Vs Rest-of-World

          The U.S. gets relatively low ROI for its relatively exorbitant spending on healthcare, noted once again in the latest Health at a Glance, the annual OECD report on member nations’ healthcare systems. The report includes U.S. country data asking, “How does the United States compare?” with its sister OECD countries. The answer is, “not well across most population health, access, and mortality measures.” For the Cliff’s Notes/Where’s Waldo top-line of the research, find the two long bars in this chart heading “south” of the OECD average, and one long blue bar going “north.” The northern climbing bar

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Thinking About Kate and Anthony – Suicide and Depression Is US

Yesterday at 1 pm, we learned that the incidence of suicide is up in America in a report from the Centers for Disease Control (CDC), an agency in the U.S. Department of Health and Human Services. This morning, we awake to news that Anthony Bourdain, the witty and prolific travel and food expert, took his own life. Earlier this week, Kate Spade, fashion designer and creative force, took her own life. The loss of these two bright lights, gone from our lives to suicide within a few days of each other, gives me the sad compulsion to say something, again, about

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The U.S. is a Nation in Pain – America’s Life Expectancy Fell Again in 2016

American saw the greatest number of deaths from suicide and alcohol- and drug-induced fatalities was recorded in 2016. That statistic of nearly 142,000 equates to deaths from stroke and exceed the number of deaths among Americans who died in all U.S. wars since 1950, according to Pain in the Nation Update from the Well Being Trust and Trust for America’s Health. The line graph soberly illustrates the growing tragic public health epidemic of mortality due to preventable causes, those deaths of despair as Anne Case and Sir Angus Deaton have observed in their research into this uniquely all-American phenomenon. While this

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A Tale of Two America’s for Health

  Disparities in Americans’ health vary among people living in each of the 50 states. These differences in health status generally fall into two regions: north and south, found in the Commonwealth Fund’s 2018 Scorecard on State Health System Performance. The map shows this stark geography-is-health-destiny reality: the worse-than-average states, the Fund found, run from Nevada southeast to Arizona, through New Mexico and Texas all the way to Atlantic Ocean and the Carolinas, then north west all the way up through the industrial Midwest states through Michigan to the north. Wyoming is the only non-contiguous state in the worse-performing U.S. state

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Engage With Grace and Your Family on Thanksgiving: Have an End-Of-Life Chat at the End-Of-the-Feast

“Thanksgiving.” Merriam-Webster’s dictionary defines the word, first, as “the act of giving thanks.” Second, it’s “a prayer of expressing gratitude.” And, third, the word means a public acknowledgment or celebration of divine goodness. We each have our stories about how a loved one’s life has ended. If we’re lucky, that beloved person had a good death: in sleep, perhaps, or simply of old age with no hospital events or trauma. Then there are the Rest-of-Us who share family stories and experience of long and painful endings, in institutional settings often coupled with costly, so-called “heroic” bit unwanted, futile care. When you’re

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U.S. Healthcare Spending & Outcomes in Five Charts: #EpicFail in the 2017 OECD Statistics

“Spend more. Get less.” If a retailer advertised using these four words, how many consumers would buy that product or service? This is the American reality of healthcare spending in 2016, told in the OECD report, Health at a Glance 2017. I present five charts from the study in this post, which together take the current snapshot health-economic lesson for the U.S. First, look at health expenditures as a share of gross domestic product: the U.S. is number one above Switzerland, France, and the UK, and about two times the OECD average. Note, too, the proportion of out-of-pocket and so-called

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Income Inequality For Older Americans Among Highest in the World – What This Means for Healthcare

Old-age inequality among current retirees in the U.S. is already greater than in ever OECD country except Chile and Mexico, revealed in Preventing Ageing Unequally from the OECD. Key findings from the report are that: Inequalities in education, health, employment and income start building up from early ages At all ages, people in bad health work less and earn less. Over a career, bad health reduces lifetime earnings of low-educated men by 33%, while the loss is only 17% for highly-educated men Gender inequality in old age, however, is likely to remain substantial: annual pension payments to the over-65s today are

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How We Live and Die in 2017: Obesity, Conflict and Mental Illness

Obesity, conflict, and mental illness contribute most to the ill health and mortality of the world’s population – especially in the U.S., according to the annual Global Burden of Disease study published this month in The Lancet and funded by The Bill & Melinda Gates Foundation. There’s good news and bad news in this research: on the upside, people are living longer. On the downside, there’s a lot of morbidity – that is, sub-optimal health – in those years. The study examines both YLLs (years of life lost) and YLDs (years lived with disability). “Death is a powerful motivator, both

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Talk #EndOfLife at the End of the Thanksgiving Meal: Engage With Grace

“Thanksgiving.” Merriam-Webster’s dictionary defines the word, first, as “the act of giving thanks.” Second, it’s “a prayer of expressing gratitude.” And, third, the word means a public acknowledgment or celebration of divine goodness. We each have our stories about how a loved one’s life has ended. If we’re lucky, that beloved person had a good death: in sleep, perhaps, or simply of old age with no hospital events or trauma. Then there are the Rest-of-Us who have the stories of long and painful endings, in institutional settings and costly, futile care. When you’re already in the situation of making tough health

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Color Me Well – Coloring Books As Rx for Wellness

Coloring books are best sellers in bookstores, craft merchandisers, newspaper stands, and on Amazon. Now, they’re joining the health and wellness world. The market growth of coloring books has been recognized in national media like the Washington Post, who called the phenomenon, “a bright spot in the financial results of publishers and retailers alike.” Nielsen Bookscan estimated that 12 million were sold in 2015, up from 1 million in 2014. Publishers Weekly covered the craze in November 2015. A Forbes column said, “The adult coloring craze continues and there is no end in sight.” Some of the mental health benefits

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Palliative Care: Getting End of Life Care (W)right

I lost a best friend last week. His memorial service, held this past weekend, was a celebration of his life. And part of that well-lived life was a very conscious planning of his last days. The Economist published its 2015 Quality of Death Index, a data-driven treatise on palliative care, the very week my dear friend Rick died. This gives me the opportunity to discuss palliative care issues with Health Populi readers through The Economist’s lens, and then in the Hot Points below through my personal context of this remarkable man’s end-of-life choices. The Economist ranks 80 countries on several

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Doctors who write right: Gawande, Topol and Wachter put people at the center of health/care

There’s a trifecta of books written by three brilliant doctors that, together, provide a roadmap for the 21st century continuum of health care: The Patient Will See You Now by Eric Topol, MD; The Digital Doctor from Robert Wachter, MD; and, Being Mortal, by Atul Gawande. Each book’s take provides a lens, through the eyes of a hands-on healthcare provider, on healthcare delivery today (the good, the warts and all) and solutions based on their unique points-of-view. This triple-review will move, purposefully, from the digitally, technology optimistic “Gutenberg moment” for democratizing medicine per Dr. Topol, to the end-game importance of

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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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Be thankful for your good life. Now think about what a good death would be.

This Thanksgiving, we’re once again participating in the annual Engage With Grace blog rally, encouraging those who haven’t considered their end-of-life preferences to start thinking about them, and asking those who have done it to consider how their decisions may have changed over time. It’s good food for thought. Wishing you all a happy, healthy holiday season.  Most of us find ourselves pretty fascinating… flipping through photos and slowing down for the ones where we’re included, tweeting our favorite tidbits of information, Facebook-ing progress on this or that… We find other people captivating as well.  In fact, there’s a meme going around

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