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medpundit |
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Thursday, September 04, 2003As you might suspect, people who don't have regular access to medical care tend to end up sicker than people who do, since it's through regular checkups that you're most likely to catch things like cancer or heart disease before they kill you. And, naturally enough, people who don't have health insurance tend to be sickest of all. So, because Hispanics in the United States are far more likely to be uninsured than the average American, it ought to follow that they're also much less healthy than the average American. But that's the paradox: They aren't. Quite the contrary: Hispanics in the United States are healthier than the rest of the country. Far healthier, in fact. According to surveys by David Hayes-Bautista, a professor at UCLA who has conducted some of the most authoritative work on the matter, the rate of heart disease among California Latinos is actually lower than for the population as a whole--this, despite the fact that Latinos are more likely to be overweight and smoke (both major risk factors for heart disease). Latinos are also less likely to have strokes or suffer from cancer. By better avoiding heart attacks, strokes, and cancer--the three leading causes of death in the United States--Latinos enjoy unusually long life expectancies. A Latina woman living in the United States, for example, will probably live longer than the average American female. Do we know for sure that people who have the best access to healthcare (i.e. the most insurance benefits and easy access to doctors) are healthier? We assume they are, but we might be wrong. To be sure, someone with diabetes who has no access to medicine will be a lot sicker than a diabetic who does, but for the average person with no chronic illnesses, does it really make much of a difference if they see a doctor for regular check-ups? As much as I hate to admit it - with the exception of screening for colon cancer,cervical cancer, and diabetes - regular check-ups aren't that likely to save a life. Regular check-ups don’t prevent heart disease. (Even screening for cholesterol and treating it aggressively only lowers the chances of heart attacks or sudden death by a few percentage points. It doesn't prevent the aging process of the coronary arteries that is, ultimately, what's behind heart disease.) And regular check-ups aren’t likely to detect early heart disease, unless the patient’s fortunate enough to have symptoms, which means it isn’t really “early.” Every family doctor or internist who's practiced long enough has had the unfortunate experience of having a patient die shortly after a normal physical exam. It is humbling. We all labor under the assumption that regular check ups will find any and all malfunctioning parts - like an auto check-up would. Even those of us who should know better sometimes think this. The truth is, there’s a lot of very common disease out there that we just can’t detect at early stages. And perhaps we’ve done the public a bit of a disservice by promoting the importance of regular check-ups, as if we can predict a patient’s future by listening to their hearts and lungs, probing their every orifice, and looking deeply into their eyes. In the end, all we can really say after a check up is that there’s no obvious illness at that moment. But in the moments to come, anything goes. posted by Sydney on 9/04/2003 08:17:00 AM 0 comments 0 Comments: |
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