Saturday, October 3, 2015

Health Measurement Watching and Disease Prevention

An ounce of prevention is worth a pound of care

Benjamin Franklin (1706-1790)

Measurement as a key to maintaining health and preventing disease isn’t new. Franklin’s “ounce” and “pound” were, after all, measurements.

Similarly, commercial organizations like Weight Watchers and Nutrisystems used body weight as measurement to track progress of their programs, which are based on the premise that thin is good and fat is bad for your health. Then there’s the Apple Watch. It’s a fitness tool that measures your pulse and other responses to exercise
Fitness is big, as is wellness. It is said we have a sickness society rather than a wellness society, hence the proliferation of fitness centers, which are extremely profitable because many who sign up for fitness training never return after plunking their money down and never returning after several sessions.

Health is measurable. I recognized this 30 years ago when I came up with the concept of the Health Quotient (HQ), the analogue of the IQ. I reasoned that health could be measured by an algorithm composed of body physical measurements (weight, height, waist circumference, blood pressure), blood measurements ( cholesterol and its components, glucose, hemoglobin A1C ), and gender and age. The laboratories with which I was associated set out to measure populations of people (company employees and public health participants), and sure enough, we found people with low HQs tended to be hypertensive, diabetic, and overweight.

Furthermore, people understood why their HQs were low, and that they could take preventive steps to raise their HQ. Measuring HQs was fairly simply, taking demographic data, taking physical measurements, and taking a blood sample, then sending the patient a letter explaining what had been done and what they could do about their problem, e.g. seeing a physician to help reduced their HQ. For various reasons, the HQ idea never caught on sufficiently to be economically feasible.

But today, with the ubiquity of computers, the power to aggregate masses of megadata, and the widespread interest in prevention as a means of preventing disease and saving money, it would be easily technically possible to measure “population health” for any group of people whose health you wanted to document and improve. Furthermore, the data needed is available in almost any doctor’s office or any other health facility.

The leading causes of death in the U.S. are smoking-related disorders, cancer, diabetes, cardiovascular-related conditions, and respiratory disease. The main things missing in my original HQ evaluation were stress response to exercise and respiratory measurements. Today a company in St. Paul, Minnesota, SHAPE, by means of simple stress testing through a minimal walking test, an ECG, and a simple measurement of expelled breath bases can measure respiratory function.

\It was Ben Franklin (1706-1790) who said “An ounce of prevention is worth a pound of cure.” Perhaps we ought to take Ben at this word, and set about measuring the health of individuals and populations so that we can set about preventing disease by alerting people to the state of their measurable health. Franklin also said, “God helps them that helps themselves.” To this, given our current state of measurement, we might add,” In God we trust, all others use data.” First though, people need to know their data.

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