Body Shop | The layers of preventive health
Last week, I discussed the need to put health back into our health-care system. This means to attack problems at their source, instead of sitting back and waiting for them to occur, then scurrying to try to “fix” things before it’s too late. All in all, it’s an inefficient way to operate. Common sense says if you know your plumbing is bad, you surely wouldn’t wait for a pipe to burst before addressing it. But when it comes to health, that pretty much describes our approach.
When I write about such things, I always hear from health-care professionals who “cry foul” and tell me they take prevention seriously. Maybe so, but most don’t go nearly far enough. Let me clarify what I mean.
There are layers of preventive health. The most basic layer is going directly to the source. Since we know, for example, that a bad diet promotes heart disease, it makes sense to attack the problem right there. The same is true for getting sufficient exercise on a daily basis, and so forth. This is called primary prevention.
Our medical model typically does not practice or promote primary prevention. Rather, if there is any emphasis, it is on secondary prevention. That means screening for problems, regular checkups and so on. This, of course, is very important, and certainly has a place, but it still reflects the same issue, and that is waiting for something bad to happen, then uncovering it. Now, to be sure, secondary prevention helps discover the problem sooner, and hopefully before it erupts into something major, but it is still an approach that is much less effective than primary prevention.
HEALTHY LIFESTYLE CENTERS
Thankfully, there is change in the air with regard to including primary prevention in our approach to health care. Several months ago I discussed the work of Deborah Ballard, M.D., the medical director for integrative medicine at KentuckyOne Health. They emphasize primary prevention through their several Healthy Lifestyle Centers. The approach is innovative and nontraditional in many ways and includes a wide variety of interventions, ranging from tai chi and yoga classes, to acupuncture, massage, eating right and exercising more, etc., plus traditional medical approaches as needed. It’s a comprehensive program that goes beyond just taking care of the body, and includes the mind and the spirit as well.
Before continuing, let me digress a moment and offer an apology. When I wrote about integrative medicine a while ago, I gave the impression that it is the only source of primary prevention among health-care professionals in town. Not true. I heard from many doctors who told me of their efforts to promote health among their patients and the strategies they employ.
The distinction is, the practice of integrative medicine is a big step forward because it represents a formal recognition by the medical establishment that primary prevention matters and has a place. What’s more, it lays the groundwork for larger, system-wide change, and that is the point I was trying to make. But, let me emphasize, integrative medicine practitioners and individual doctors who take it upon themselves to promote healthy lifestyles among their patients are both critically important to our moving in the right direction.
THE ORNISH REVERSAL PROGRAM COMES TO TOWN
The Healthy Lifestyle Centers strive not only to prevent health problems, they also treat existing problems as well with the aim of promoting an enhanced quality of life. With this in mind, the centers have recently taken another huge step forward and are now offering the program created by Dr. Dean Ornish. His program is highly ambitious as it aims not only to prevent heart disease, it also is geared toward undoing damage that has already occurred. A major emphasis is reversing atherosclerosis (clogging of the arteries), the underlying cause of the vast majority of heart attacks.
More on the Ornish program next week.
Reach Bryant Stamford, a Professor of Kinesiology & Integrative Physiology at Hanover College, at stamford@hanover.edu.