Culture
Culture and Mortality, Part 1: Abortion
This is the first of four articles about Culture and Mortality
In some ways we are a culture that resorts to extremes, that resorts to terminal means of settling psycho-emotional conflicts (homicide and suicide) and that is quite self-destructive in terms of self-care (chronic disease.) We must have criteria by which we may make decisions about the moral status of our culture; and, we need some structure by which we may determine the lethality involved as we persevere living in this culture. What in the world is happening in our culture? Is this a post-truth era? Is this the age of dishonesty? Morality around the issue of abortion has to do with rights and duties and obligations between people.
So, abortion appears to be a toxic and lethal byproduct of the relativistic trend in our culture that allows extremes of boundary violations. Just what is it in the psyche of the abortion industry that allows them to terminate human life? Who do they think they are? What level of arrogance and narcissism are we dealing with here? Who are they accountable to? And, it is not just an issue of the abortion industry but also the political apparatus and the judicial apparatus that allows this to go on and on. Also, we see culpability on the part of aggressive activists who appear to be giving credence to women’s rights for a cause that is clearly psychologically and spiritually and physically very unhealthy. Many women carry with them for a lifetime the abortion decision; it becomes for many, an indelible psychological injury.
In my casual conversations with people about abortion, I see a remarkable sense of futility, I see and discuss statistics but seldom do I hear folks discussing tangible remedies. It is as if many people continue to accept this high incidence of abortion in our country as a given, as a norm, as a situation about which we can have little influence. Yes, there is a decrease in the incidence of abortion and that is a very positive statistic.
One of the initiatives that I have given a good deal of thought about is the whole issue of the man’s role in the abortion process. If we could motivate most men to stand up and be advocates for their children, for their unborn children, we may very well see a very powerful counter activist movement; but, this would require men to take a stand, to break through their denial and to quit pretending that they do not have responsibility here. And, equally important, to quit pretending like they do not care whether their child is aborted or not. Men need to be present to view their child in the womb and to allow themselves to come to grips emotionally with the fact that this is a product of their DNA. I don’t want to leave the impression that I think this is a simple process, it is certainly not that. Many of these men are terrified when they find out that their female partner or even their spouse is pregnant. But, these men need to come to grips with what it means to be resilient, to be psychologically hardy, to be responsible, and to set an example for our youth. Healthy men are able to cope with this. My hope is that as they dig themselves out from layer after layer of denial and inertia that they could then stand up for what is obviously theirs’ and, in the process set a great example for all men. Finally, I want to mention that this is not about an aggressive confrontation about women’s rights. It is about the rights of the unborn baby. If we could define fatherhood as one of the most critically important roles that men have, perhaps we could then have more intact families where we can raise children, healthy children, that can have a complete sense that both a mother and a father are essential to the development of our children.
So, as we look at options during pregnancy, adoption is (obviously) a critical issue. Adoption needs to be available, affordable, and it needs to be an industry that has integrity and the support of our communities. It is an imperative that prospective parents are screened for their ability to parent a child or another child in a responsible way. It is also very important that the amount of red-tape involved in this process be minimized, as we do not want this process to be a burden that discourages adoption.
Also, grandparents can be an incredibly positive aspect of these decisions about pregnancy, abortion, and adoption. Many grandparents are bonded eternally to their children and grandchildren; often, they can give good guidance and tangible assistance, as an integral part of the family legacy.
That we have now moved toward considering late-term abortion is not only discouraging, but it is a new and unfortunate level of moral decline. Where is our sense of basic right and wrong? Where are the boundaries?
Is abortion an appropriate task for the medical profession? Abortion appears to be a necessary medical procedure in some cases. And, we can only hope that the medical industry is using professional discretion in the decision to carry out abortions.
And, what about trafficking in body parts? Planned Parenthood has apparently been implicated in this. This sort of behavior is at the intersection of greed and moral sickness. It reflects a lack of conscience which is an absolutely essential asset for mental health, cultural health and spiritual well-being. This illegal human organ trafficking involves an apparently insatiable demand for these body tissues. This brief article cannot go into much detail about this topic but we do need to beware that in some cases abortions are being performed in order to provide for this ongoing demand for illegal body parts.
It appears that the following statistics are accurate:
• About 1.5% of abortions are due to rape or incest.
• About 85% of abortions involve unmarried women.
• About 50% involve women under the age of 24
• 60% of women who have abortions have at least one other child.
• About 78% of abortions are surgically performed; about 22% are chemically induced.
• In the past several years the incidence of abortion has decreased significantly.
• Providing women and men with the knowledge and resources necessary to make decisions about their sexual behavior and use of contraception can help them avoid unintended pregnancies.
• Providing contraception for women at no cost can increase use of these methods and reduce abortion rates.
References:
• Centers for Disease Control and prevention (CDC): ‘Reproductive health, Data and statistics,’ published online, updated February, 2018.
• Mohler, R. Albert: ‘Culture shift: the battle for the moral heart of America,’ Multnomah Books, 2011, Chapter 13.
• Peipert, Jeffery F. et al.:’Preventing Unintended Pregnancies by Providing No-Cost Contraception,’ Obstetrics and Gynecology, December 2012, 120(6): 1291-1297.
• Zahler, William A: ‘Synergy and the Dynamics of Lifestyle Change’, Create Space and KDP, published January 2019, Pgs. 200-201.
William Zahler, MSW, DipACLM
November 2019
Culture and Mortality, Part 2: Suicide
This is the second of four articles about Culture and Mortality
Yes, the statistics on the rising rates of suicide in the United States are very concerning. It appears to me that we learn the same lessons over and over and over again. Without a moral compass, we are in trouble, big trouble.
We are in a culture that is often confusing, hyperactive, and without boundaries. As a result of this, many of our citizens are searching diligently for meaning in life, for a way to eliminate alcohol and other drugs from their life, and for a way to dampen their depression. Many of these folks have lost hope, and find themselves entertaining ideas about self-destruction; as I have said elsewhere, rehearsing a suicide plan is a hugely destructive place to be. This group of people lack self- efficacy, a sense of being in control and being capable of functioning successfully. They also have a deficient sense of well-being, of happiness. In many cases they are lonely; interestingly loneliness is an all too common negative mood state; some authors believe that it is a cultural epidemic involving not only loneliness but also isolation and alienation. Up to 40% of adults in the United States report feeling that way.
You may not know that physicians have among the highest rates of depression and suicide of any group; more than one doctor a day kills themselves. Overall, suicide rates in the USA have increased by 25% in the past 20 years. This is not a sign of a healthy culture, it is a sign of desperation, sickness, psychopathology, and hopelessness.
Risk factors/ etiology for Suicide include:
• Depression is a key risk factor for suicide. Suicide often stems from a deep feeling of hopelessness. The inability to see solutions to problems or to cope with challenging life circumstances may lead people to see taking their own lives as the only solution to what may really be a temporary situation; and most survivors of suicide attempts go on to live full, rewarding lives. Dopamine is the neurotransmitter pathway to pleasure and may be interrupted in folks with depression. This, clinically significant depression, is without question, the most common reason people die by suicide.
• Psychosis: Evil inner voices often command self-destruction for reasons that are difficult to understand. Psychosis is much harder to mask than depression, and can arguably be even more tragic. The worldwide incidence of schizophrenia is 1 percent and often strikes otherwise healthy, high-performing individuals, whose lives, though manageable with medication, are often derailed. Schizophrenics are just as likely to talk freely about the voices commanding them to kill themselves as not, and also, give honest answers about thoughts of suicide when asked directly. Psychosis, too, is treatable, and usually must be treated for a schizophrenic to be able to function at all. Untreated or poorly treated psychosis almost always requires hospital admission until the voices lose their commanding power and until the associated delusions lose their potency.
• Substance abuse (Addiction): Although many addiction treatment programs will not accept clients with recent suicidal behavior, up to 40% of patients seeking treatment for substance dependence report a history of suicide attempts. Several predisposing and precipitating risk factors such as marital and interpersonal relationship disruption, occupational and financial stressors, recent heavy substance use and intoxication as well as a history of previous suicide attempts and sexual abuse combine in an additive fashion with personality traits and mental illnesses to intensify risk for suicidal behavior in addiction patients. Major depression, bipolar disorder, borderline personality disorder and post-traumatic stress disorder are especially associated with suicidal behavior in people with addictive disorders.
• Chronic pain (CP). Studies indicate that suicide ideation, suicide attempts, and suicide completions are commonly found in chronic pain populations. In addition, a number of controlled studies about suicide completion rates indicated that CP may be a suicide risk factor. Finally, a review of known suicide risk factors from other populations indicated that CP populations commonly exhibit other suicide risk factors. Psychiatric examiners should consider CP to be a potential suicide risk factor.
• A family history of suicide
• A prior suicide gesture that is often a sign of impulsivity.
• Made a mistake: This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems, is education.
• Impulsiveness often plays a role among adolescents who take their life. If a person deemed at risk due to any of the above risk factors exhibits sudden mood changes—even a suddenly upbeat mood—or completely new behaviors, they may be actively suicidal. Those who speak about being a burden to others, having no reason to live, feeling trapped or in unbearable pain may also be contemplating suicide. Often related to drugs and alcohol, some people become foolish and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is often genuine, but whether or not they'll ever attempt suicide again is unpredictable.
• A cry for help. and don't know how else to get it. These people don't usually want to die but do want to alert those around them that something is seriously wrong. They often don't believe they will die, frequently choosing methods they don't think can kill them in order to call attention to their challenges, but they are sometimes tragically misinformed. For instance, a young teenage girl suffering genuine angst because she feels lonely or has gotten into a devastating fight with her parents, may swallow a bottle of Tylenol—not realizing that in high enough doses it can be lethal.
• A philosophical reason to die. These people aren't depressed, psychotic, maudlin, or crying out for help. They're trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. This is a reasoned decision that may be prompted by a painful terminal illness where there is no hope of reprieve.
• Stress: we see that a number of successful suicides were related to acute stress in a person who may have poor coping skills, a co-existing depression, and a history of troublesome relationships. This person may have abruptly lost their job, have been rejected in a critical relationship, or may otherwise have had a financial setback, an ego insult, or a narcissistic affront that is highly anxiety producing. Stress-related diseases have been increasing for decades; these include heart disease, hypertension, obesity, diabetes, addiction, anxiety and depression.
• Perpetrators in mass shootings are not only homicidal, but clearly have some level of awareness that they will lose their lives in the process. They are suicidal.
• Suicide Contagion is an increase in suicide attempts and completed suicides following exposure to a suicide in the media or one’s personal circle. The suicide of a prominent celebrity or a member of a specific community, such as the military or an elementary school, have been shown to correlate with a rise in suicides. Although many studies have reported the correlation, they cannot conclude that exposure caused the elevated rates. Those who are especially susceptible to suicide contagion, also referred to as copycat suicide, include adolescents, people who already struggle with suicidal thoughts, and people with mental health conditions such as depression, bipolar disorder, and post-traumatic stress disorder.
So, How do we engender hopefulness and a sense of well-being in all age groups … in an increasingly complex world?
References:
• Fishbain DA: ‘The Association of chronic pain and suicide,’ Seminars in clinical neuro- psychiatry, [01 Jul 1999, 4(3):221-227]
• Mohler, R. Albert: ‘Culture shift: the battle for the moral heart of America,’ Multnomah Books, 2011, Chapter 13.
• Ornish, Dean and Ornish, Anne ‘UnDo It: how simple lifestyle changes can reverse most chronic diseases,’, Ballantine Books, 2019.’
• Yuodelis-Flores C and Ries, RK: ‘Addiction and suicide: A review.’ The American Journal on Addictions, [02 Feb 2015, 24(2):98-104]
• Zahler, William A.: ‘Health, Inertia and Information: Why are we sick?’ Create Space and KDP, published 2018. Chapter 8.
• Zahler, William A: ‘Synergy and the Dynamics of Lifestyle Change’, Create Space and KDP, published January 2019, Chapter 8.
William Zahler, MSW, DipACLM
November 2019
Culture and Mortality, Part 3: Homicide
This is the third of four articles about Culture and Mortality
Here we have another interesting, complex, and important topic area concerning our culture and the loss of life. We have seen and are continuing to see a series of so- called ‘mass shootings’ that are perpetrated by men, many of whom are mentally ill and who lack an intact sense of impulse control, moral conscience, and ability to reason in a sensible way. ‘Hate Crimes’, another fairly recent term, are defined by the FBI as a ’criminal offense against a person or property motivated in whole or in part by an offender's bias against a race, religion, disability, sexual orientation, ethnicity, gender, or gender identity.’
Researchers have identified three types of lethal violence:
• Homicide related to other criminal activities: involves organized criminal groups or other criminal acts
• Interpersonal homicide is perpetrated by intimate partners/family or relating to other interpersonal homicide
• Socio-political homicide is related to social prejudice or to other socio-political agendas
Unfortunately, in our culture ‘Hate Crimes’ are all too common; hate is obviously not a healthy emotion and it is a mental health issue that is destructive to one’s internal emotional state, to the community, and to any number of interpersonal relationships. An interesting and important psychosocial issue has to do with what interacting and complex factors contribute to the genesis of these intense and destructive emotions.
There were 14,123 murder victims in the United States in 2018. It is very important to understand that in many of these cases, perhaps most, the perpetrator left behind rather clear signs that they were a threat. So, a very important part of the instigation to aggression has to do with blatant verbal threats, hostile interpersonal interactions, collecting lethal weapons, a history of poor impulse control and other clear antisocial behaviors.; some of this acting out is made obvious in social media. After the hostile, murderous act, investigators encounter family members, fellow students and others who confirm their concern about the perpetrator. So, one of the things that we need to work on within our communities is to identify these potential perpetrators early on, in an attempt to prevent further homicidal acts. In a culture that is relativistic in many ways, it is increasingly difficult for folks to discern what is acceptable, and what is not. In a culture where we are ambivalent about and normalize many asocial behaviors, there is a good deal of confusion about boundaries. We are making some headway in terms of identifying potential perpetrators with slogans like: ‘If you see something, say something.’ The whole issue of how we orient a community to take action in these cases is worthy of further study. When someone speaks in a bizarre manner, threatens the life of others, or otherwise threatens the community, we need to take action and there needs to be policies and agencies available that can intervene promptly and effectively to stop these people
Overly liberal policies and intentions can get people killed. Some of this is the same mentality that fails to hold criminals accountable in so-called ‘Sanctuary Cities.’ These sorts of behaviors by city officials feed the whole relativistic movement that normalizes all sorts of aberrant behavior. Not only is this sort of thing contrary to common sense, but it adds an unnecessary level of unpredictability and lethality to the cultural mix.
The perpetrators of homicide may have serious mental health issues like paranoid schizophrenia, antisocial personality disorder, clinically significant depression, as well as a history of problematic interpersonal relationships. At some level they are also suicidal, knowing that there is a good chance they will be killed as law enforcement authorities mobilize a response to their criminal actions. Substance abuse of all sorts can be a factor in many these cases and this should not be down- played as many of the drugs of abuse alter brain function dramatically and negatively.
Terrorism is obviously a significant part of the homicide issue, but the motives have to do with toxic ideologies that propel the terrorists to launch efforts to exterminate their perceived enemies. These terrorists feel quite justified, based on their sick ideologies, to train children to be of a similar mindset. So, this is highly organized, purposeful homicide. It may involve flying airplanes into buildings, setting off explosives, running down people with vehicles, and using any variety of weapons to carry out their hostile acts. The actions of terrorists have become an ingrained aspect of our culture and has instilled a potent threat to our survival; it reinforces our sense of vulnerability and adds to the long list of cultural challenges that contribute to emotional turmoil. And, the results of terrorist attacks are a major input to Post Traumatic Stress Disorder (PTSD).
School shootings: Children exposed to violence, crime, and abuse are more likely to abuse drugs and alcohol, suffer from depression, anxiety, and posttraumatic stress disorder. They may fail or have difficulties in school, and engage in criminal activity.
The data from five decades of school shootings shows the most typical age for a school killer is 16 or 17 and these perpetrators are highly likely to be male. The attacks are not often "indiscriminate", but are more usually an "escalation of a dispute" or a gang-related incident.
A database, going back to 1970, shows there were more incidents and more deaths in 2018 than any other year on record from gun violence in schools.
So, here is a 10-year review of school shooting statistics in America:
• 2008, 11 school shootings, 16 killed, 28 injured
• 2009, seven school shootings, three killed, 12 injured
• 2010, 12 school shootings, eight killed, 14 injured
• 2011, seven school shootings, five killed, 12 injured
• 2012, 12 school shootings, 43 killed, 16 injured
• 2013, 26 school shootings, 18 killed, 33 injured
• 2014, 37 school shootings, 17 killed, 35 injured
• 2015, 21 school shootings, 21 killed, 41 injured
• 2016, 15 school shootings, nine killed, 26 injured
• 2017, nine school shootings, 15 killed, 26 injured
• 2018 (YTD- as of July, 2018), 22 school shootings, 40 killed, 66 injured.
Mass Shootings: According to the Gun Violence Archive, a nonprofit that tracks shootings in the US, 373 people died from mass shootings in 2018 and 1,346 others were injured. Although it is important to recognize that most people suffering from a mental illness are not dangerous, for those persons at risk for violence due to mental illness, suicidal thoughts, or feelings of desperation, mental health treatment can often prevent gun violence. Policies and programs that identify and provide treatment for all persons suffering from a mental illness, need to be a national priority. The mental health community must take the lead in advocating for community-based collaborative problem-solving models to address the prevention of gun violence. It is also important to note that many mass shooters are also suicidal, are willing to give up their lives as they murder others. Many of the shooters left a blueprint for their alleged actions on social media. And, most of the shooters planned and prepared the act; many spent almost 2 years planning their attack. Unfortunately, in the majority the cases people who see signs of trouble before the mass shooting often do not call police.
Several other profile issues include being male, being single, divorced or separated and most had concerning behavior’ in common like abuse, harassment, bullying and sometimes violence. 35% of mass shooters have been convicted of a crime as an adult and history of or acting in an abusive, harassing or an oppressive way. More than half of these shooters discussed the idea of committing the violent act with someone else!
References:
• Mohler, R. Albert: ‘Culture shift: the battle for the moral heart of America,’ Multnomah Books, 2011, Chapter 13.
• United Nations office on drugs and crime, Global study on homicide, publish online, July 2019.
www.statista.com
• Zahler, William A.: ‘Health, Inertia and Information: Why are we sick?’ Create Space and KDP, published 2018. Chapter 8.
• Zahler, William A: ‘Synergy and the Dynamics of Lifestyle Change’, Create Space and KDP, published January 2019, Chapter 8.
William Zahler, MSW, DipACLM
November 2019
Culture and Mortality, Part 4: The Epidemic Disease Burden
This is the fourth of four articles about Culture and Mortality
Despite the fact that we have more scientific research, health related research, pharmaceutical products, self-care products, and more sophisticated medical interventions than ever before in history, we continued to have a remarkable disease epidemic. This includes a significant increase in suicides, and a persistence in cancer, heart disease, autoimmune disease, type II diabetes, gastrointestinal disorders, Alzheimer’s disease and other dementias.
Here are some 2017 United States statistics: Number of deaths for leading causes of death:
• Heart disease: 647,457
• Cancer: 599,108
• Accidents (unintentional injuries): 169,936
• Chronic lower respiratory diseases: 160,201
• Stroke (cerebrovascular diseases): 146,383
• Alzheimer’s disease: 121,404
• Diabetes: 83,564
• Influenza and Pneumonia: 55,672
• Nephritis, nephrotic syndrome and nephrosis: 50,633
• Intentional self-harm (suicide): 47,173
Addiction
• Drug overdose deaths continue to increase in the United States.
• From 1999 to 2017, more than 700,000 people have died from a drug overdose.
• Around 68% of the more than 70,200 drug overdose deaths in 2017 involved an opioid drug.
• In 2017, the number of overdose deaths involving opioids (including prescription opioids and illegal opioids like heroin and illicitly manufactured fentanyl) was 6 times higher than in 1999.
• On average, 130 Americans die every day from an opioid overdose.
• Cigarette smoking remains a persistent source of chronic disease, including cancer, with about 7% of the population smoking.
• Vaping has developed into a profitable industry that is now killing people; people need to be breathing good clean air not tobacco smoke or vaping liquids
• What about cannabis? Well, cannabis is a gateway drug for many people. It is a mood-altering drug with habituation and addictive potential. There are certain curative characteristics with cannabis use and we believe that medical personnel should be making decisions about therapeutic use of cannabis. In an accident culpability analysis, persons testing positive for THC and particularly those with higher blood levels, were 3 to 7 times as likely to be responsible for a motor-vehicle accident as persons who had not used drugs or alcohol before driving. In comparison, the overall risk of a vehicular accident increases by a factor of almost 5 for drivers with a blood alcohol level above 0.08%, the legal limit in most countries, and increases by a factor of 27 for persons younger than 21 years of age. Not surprisingly, the risk associated with the use of alcohol in combination with marijuana appears to be greater than that associated with the use of either drug alone.
• Food addiction is real for millions of people who continue to consume highly processed foods that are loaded with high levels of fat, sugar, and salt that create hyper-palatability and addiction. These foods are directly linked to type II diabetes, obesity, dementia and other conditions.
• We need to operate from a good dose of common sense when it comes to normalizing the use of mood-altering substances. It is not mentally or emotionally healthy to be reliant on the brain-altering compounds contained in addictive drugs.
• Millions of people are in trouble with alcohol, and in my view, one of the worst things we could do would be to add additional mood- altering substances to the mix.
Healthcare costs continue to climb, and this system is quickly becoming unstable and unsustainable. In this context is important to understand that’s only about 3% of our population maintains healthy levels of all four of these health behaviors: non-smoking; healthy weight and BMI, body mass index; consuming five fruits and vegetables daily; regular physical activity. Given this, we can readily see that most of this disease burden is a lifestyle related and is under the control of the patient.
Some believe that psychosocial risk factors need to be given a much higher priority as we negotiate the impact of disease economically, and in terms of mortality and morbidity. This includes such issues as stress, mental illness, isolation, and the addictions. We will elaborate on the issue of addiction in a separate article.
A significant part of the disease burden involves taking medications and all of the huge number of side effects from these medications. The European Commission estimates that adverse reactions from prescription drugs cause 200,000 deaths; so together, about 328,000 patients in the U.S. and Europe die from prescription drugs each year. This makes prescription drugs a major health risk, ranking 4th with stroke as a leading cause of death.
Dr. Beth Frates, a leader in Lifestyle Medicine, has some very important comments about this disease epidemic. She expresses great concern about our country being absorbed in a health care crisis. There is a clear increase in the incidence of morbidity , in the number of Americans who are coping with chronic disease. One of the repercussions of this is the incredible burden of healthcare costs that have become out of control and unsustainable. It is time for action; actually, we are way into the process of an entrenched pattern of more and more of our GDP being targeted at healthcare costs. We need to adopt a new cultural understanding of how critically important it is for folks to adopt a new lifestyle that is healthy and prevents the onset of chronic diseases. We know how to do that and we need to get on with the business of public policy change, positive change within the healthcare industry, and a reorientation of peoples understanding about disease prevention. Without shifts in how people live their lives and how they view their health, we are setting up an unnecessary toxic and lethal endpoint.
The main point we want to make here is that perhaps 70% or more of all chronic disease is related to lifestyle factors that we have control over; lifestyle Medicine initiatives target needed changes in our daily activities in order to prevent and reverse the epidemics of cancer, diabetes, heart disease, dementia and all the rest.
References
• Cannizzaro, Joseph: ‘Answers for the 4A epidemic, healing for kids with autism, ADHD, asthma, and allergies,’Siloam Publishing, 2012.
• Centers for Disease Control and Prevention, National Center for Health statistics, CDC.gov, 2017.
• Davis, Brenda: ‘Kick diabetes essentials: the diet and lifestyle guide,’ Book publishing Company, 2019
• Frates, Beth et al.: lifestyle medicine handbook, an introduction to the power of healthy habits, Healthy Learning, 2019.
• Greger, Michael and Stone, Gene: ‘ How Not to Die,’ Flatiron Books, 2015.
• Hughes, K. et al., ‘The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis, The Lancet Public Health, 2017.
• Monnat, S.M. and Chandler, R.F.: ‘The long-term physical health consequences of adverse childhood experiences.’ The Sociological Quarterly, 2015.
• Scholl L, Seth P, Kariisa M, Wilson N, Baldwin G. Drug and Opioid-Involved Overdose Deaths – United States, 2013-2017. WR Morb Mortal Wkly Rep. ePub: 21 December 2018.
• Zahler, William A: ‘Health, inertia, and information: why are we sick?’ Create Space and KDP, paperback and Kindle editions, March 2018.
• Zahler, William A: ‘Synergy and the Dynamics of Lifestyle Change’, Create Space and KDP, published January 2019.
William Zahler, MSW, DipACLM
November 2019
Culture and Health-Related Misinformation
(Confusion, Inertia and Illness)
We see the misinformation issue throughout our culture, and increasingly so. As we distance ourselves from moral guidelines, we see an increasing amount of lying, deception, exaggeration and confusion about right and wrong. So, we are talking about one of the many evidences of cultural moral decline. Where in our culture do we see this going on? Well, most everywhere; we see it in the medical industry, the pharmaceutical industry, in all levels of government, in all the food industry, in graduate schools of marketing and in most other areas of our educational system. It is easy to rationalize the issue away because it has become so ingrained in American culture. Some of it is hard to believe, especially when high-level Government officials feel free to lie in court as if their personal integrity is a non- issue. What an example for our youth …
It is now indisputable that nutrition and consumption of toxic, unhealthy foods is the major player in our disease epidemic; it is not the only issue, but it is likely the main issue, together with several other lifestyle factors. It follows that probably 60 to 70% of our chronic disease epidemic is preventable. There are many issues that contribute to the behavioral inertia and keeps people stuck in unhealthy lifestyle practices; this is the thrust of our first book, Health, Inertia, and Information: Why Are We Sick? (Zahler, 2018)
Dr. T. Colin Campbell emphasizes that governmental health agencies practically ignore nutrition as a factor in public and individual health. These governmental agencies clearly mislead the American public in favor of profits for the pharmaceutical, medical and junk food industries. Given this, we have the best government that money can buy! With easy access to government officials at all levels, industry applies a mix of carrots and sticks to keep the pro-disease policies in place even though it contributes tremendously to our chronic disease burden; so, industry gets rich and the rest of us get sick. Misdirection and misinformation is everywhere and is seldom talked about. (Campbell, 2015)
Being an advocate for lifestyle medicine and its inherent focus on having control over our own lifestyle practices and our health, I am an inclined to agree with Dr. Campbell’s overview of governmental misdirection in the management of our healthcare system. It is hard to believe, but nonetheless true, that while we have more scientific research, and a more sophisticated medical system than ever before in human history, that we are also likely sicker than we have ever been; well, we could scrutinize statistics but that skirts the point that our disease burden is very significant. Our healthcare system is focused on disease maintenance, not disease prevention. Confusion and misinformation is at the core of it all. There are major efforts underway to not level with our citizens about the cause of most disease.
Overdiagnosis as Bias and Lead-Time Bias
Overdiagnosis bias means you picked up evidence of cancer via screening and that the cancer would have never caused a problem, or even would have disappeared on its own. Since the cancer was harmless, five years later, the patients are still alive—assuming their unnecessary cancer treatment didn’t kill them. Disease screening does not necessarily save lives. And, one’s survival rate does not predict a decrease in one’s mortality rate, the rate at which patients were dying of a particular cancer.
As an example, let’s say that without screening, a thousand people had progressive cancer and only 400 lived for five years; that is a five-year survival of 40%. But let’s hypothesize that with screening, an additional 2,000 cancers are over-diagnosed, meaning that screening detected cancers that would never have caused the problem because the cancer was harmless; five years later they were all still alive, the same number of people die from cancer, and you doubled the five- year survival rate. The misinformation here is that all cancers require treatment, if not aggressively treated. There is no correlation at all between “increases in survival rates,” and “decreases in mortality rates!
Lead-Time Bias: Lead time is the length of time between the detection of a disease (usually based on new, experimental criteria) and its usual clinical presentation and diagnosis (based on traditional criteria). Studies indicate that the majority of primary care physicians did not know which screening statistics provide reliable evidence on whether screening works. There is no way to disentangle the lead time bias and the overdiagnosis bias from screening survival data. That’s why these statistics are meaningless when it comes to screening. Yet, that’s what you see in the ads and the leaflets from most of the cancer charities. That’s what you hear coming from the government. Even prestigious cancer centers, like M.D. Anderson, have tried to hoodwink the public like that.
What’s the Beef?
Texas doctors with the nonprofit Physicians Committee for Responsible Medicine (PCRM) filed a legal complaint on March 13, 2018 to stop the Texas Beef Council from publishing false and misleading health claims about beef products. Despite clear scientific evidence linking red meat to an increased risk for heart disease, the Texas Beef Council publishes brochures claiming that beef is a safe choice for patients with high cholesterol and other cardiac conditions. The Council then distributes the brochures to Texas physicians and their patients. Studies clearly show that beef and other red meats, which are packed with fat, saturated fat, cholesterol, toxins and calories, can increase the risk for heart disease. (Barnard, 2017)
The Status of Milk
A Federal Petition submitted by a doctor’s group, the Physicians Committee for Responsible Medicine, urges the USDA to ditch dairy products in the ‘My Plate recommendations. The U.S. Department of Agriculture (USDA) created MyPlate, an easy-to-follow food guide, to help parents to figure out how to feed their kids nutritious, balanced meals. Unfortunately, however, the recommendations are to consumed dairy products as a source of protein, even though dairy has been shown to fuel diet-related diseases; scientific evidence shows that dairy products offer little if any protection for bone health and increase the risk of breast, ovarian, and prostate cancers, cardiovascular disease, Parkinson’s disease, Alzheimer’s disease, and early death. Dairy products also harm a significant portion of the U.S. population who suffer from lactose intolerance, which causes bloating, diarrhea, and gas. The National Institutes of Health estimates that 30 million to 50 million American adults are lactose intolerant, including 95 percent of Asians, 60-80 percent of African-Americans and Ashkenazi Jews, 80-100 percent of American Indians, and 50-80 percent of Hispanics.
MyPlate could more successfully help Americans fight diet-related diseases if the U.S. Department of Agriculture removed the dairy group and replaced the protein portion of the plate with legumes, a safe and high-protein plant-based food. The USDA’s MyPlate is making Americans sick! It is a myth that protein is absent in vegetables, fruits, and grains and beans and that people must consume animal-based foods in order to have adequate protein intake. So, here we have a government-sponsored source of misinformation. (Barnard, 2017)
Advertising Targets Children
For ages now, food manufacturers have aggressively targeted children to consume sugary cereals that create food addiction, compromise immunity, and sets up food preferences for a lifetime. It’s interesting that these specific advertising initiatives are also targeting parents, the adults in the family, who have primary responsibility for these decisions. It takes a strong parent to cope with a demanding child who is addicted to Fruit Loops. Is this an important topic? You’ are darn right it is! It has to do with peddling misinformation in the sense that these sugary cereals are legal to sell, giving the impression that they are not harmful; this is deceptive misinformation that legislators behave as if they have no control over. Yes, I understand there is all kinds of politics and shenanigans going on here and that money is a big factor. However, it also remains true is that some of the most vulnerable members of our society, our children and their respective families continue to be targeted with products that contribute in a major way to our disease burden in this country. I wonder how many of these parents are also addicted to these sugary cereals?
Decades ago the Federal Trade Commission tried to intervene but the food industry lobbyists spent millions of dollars to counter opposition to these toxic foods. One of the tentative outcomes here was a suggestion that these cereals should not be marketed to children if they contain over 26% pure sugar; interestingly, not one of the top 10 breakfast cereals related to children would meet that standard! At every level of government, the food and beverage industries have prevailed in their efforts to prevent meaningful change. Agencies like the FTC, FDA, and USDA have been involved in the process and the White House has often been silent, sadly silent in this critical issue involving our children. (LoDolce, 2013) This process reminds me of the unethical maneuvering by the tobacco industry decades ago and all of the lying and misinformation that was part of that process.
Miscellaneous Comments About Misinformation
• Carbs: To discuss carbohydrates without distinguishing between simple carbohydrates (cookies) and complex carbs (kale) adds to confusion and is probably irresponsible; now we have millions of people who are avoiding all carbohydrates, to their great detriment. Complex carbs are an essential food group for everyone. I eat about 80% of all my calories as healthy, complex carbs. This includes fruits, vegetables, whole grains, legumes, nuts and seeds and etc. So, this is another half-truth that adds to confusion and contributes to ill health.
• Fast Food:
Fast food is mostly a nutritional nightmare! Many of their unhealthy product ingredients are misrepresented, hidden in slick advertising, and it has taken aggressive food activists to uncover the truth. Dimethyl polysiloxane is a silicone with anti-foaming properties that is used in silly putty, breast implants and cosmetics; it has been found in Subway salad dressing, ChicK-Fil-A chicken sandwiches, McDonald’s French fries, KFC mashed potatoes and biscuits, Taco Bell cinnamon twists, Five Guys French fries, and on and on. Other toxic ingredients might include artery clogging trans-fat, genetically modified ingredients, antibiotics, MSG and other excitotoxins, artificial food dyes, to name just a few. And yes, to be fair, some of the fast food chains are including some healthier options. (Fuhrman, 2017)
• Diets:
Another area in which we find much confusion and misinformation has to do with choosing a healthy eating plan. Millions of people are going gluten-free, or choosing Paleo or Ketogenic eating plans. We know that animal-based eating options have their disadvantages because poultry and eggs, fish, meat, and dairy products all can contribute to our epidemic disease burden. On the other hand, most of the science indicates that plant strong eating contributes to our longevity and helps us to avoid the chronic diseases. Even the Academy of Nutrition dietetics, and the American Heart Association are involved in misinformation at times about what foods are healthy or not. (Zahler, 2019)
References
Barnard Neal: The Physician’s Role in Nutrition-Related Disorders: From Bystander to Leader, AMA Journal of Ethics, published online,2013.
Barnard, Neal: ‘Strategic nutrition research program update,’ Physicians Committee for Responsible Medicine, published online, March 2017.
Campbell, T.C: ‘USDA Adds to Your Confusion About What to Eat,’ published online, July 2015
Campbell, T.C.: ‘Whole, Rethinking the Science of Nutrition,’ Ben Bella Books, 2013.
Fuhrman, Joel with Phillips, Robert: ‘Fast food Genocide: how processed food is killing us and what we can do about it,’ HarperCollins Books, 2017.
LoDolce, ME, Harris,JL, Schwartz, MB: ‘Sugar as part of a balanced breakfast? What cereal advertisements teach children about healthy eating’ J Heal Comun, 2013.
Zahler, William A. ‘Health, inertia, and information: why are we sick?,’ Create Space and KDP, paperback and Kindle editions, 2018.
Zahler, William A. ‘Synergy and the dynamics of lifestyle change,’ Create Space and KDP, paperback and Kindle editions, 2019.
William Zahler, MSW, ACLM
July 2019
