I finally finished reading the many journals piled up on my dining room table, which have been shunted to other flat surfaces for projects or the visits of friends. I didn't read them all well, but I touched them all and read what interested me. The early October edition of the Annals of Internal Medicine particularly caught my eye. There were two major articles that looked at determinants of health in a slightly different way. The first used data from the Cleveland Clinic's electronic medical record to see whether the standard prediction calculator that we use to estimate a person's risk for cardiovascular disease works as well in poor as in not-poor neighborhoods. They found that it did not work nearly as well in poor neighborhoods. In fact, whether you have a heart attack or stroke is more determined by whether you live in a poor area of town than whether you have the traditional collection of risk factors for heart disease such as high blood pressure, smoking, di...
The cost of health care in the US is higher than anywhere else in the world, and yet we are not healthier than our peer nations. In fact, in terms of such measures as infant mortality and life span, we don't measure up. Why is this? Many people involved in providing or receiving care have some pretty good ideas about what costs so much, and what we can do to reduce costs and improve quality. Sharing these stories is an important step in creating affordable universal health care.