Optimal Health: Live to Work or Work to Live?

Monday, 01 June 2009 08:20 Last Updated on Monday, 01 June 2009 08:40 Written by Dee Koloski

Optimal Health:

Live to Work or Work to Live?

Many people come to our clinic hoping to achieve “optimal health.”  For some, this means that they can return to work.  For others, it may mean survival.  For a few, the phrase has a preventative connotation.

Whatever the motivation for seeking “alternative” health care, we must be realistic in what can be achieved.  If “Susie” presents with a fractured ankle, the following story may explain the cast: she tripped over the dog while running into the house with the groceries hoping against all previous evidence she’d make it to the bathroom in time, tried to catch the eggs in a Todd Helton dive, protected her mouse hand in the imminent crash, and snapped said ankle which really… hurts… now.  So, do we address the pain and leave it at that, or do we look at why she thought she couldn’t make it to the bathroom in the first place?  

“Alternative” health care tends to deal with the whole picture… that pesky bathroom issue “Susie” doesn’t really want to discuss.  This type of health care seeks to address the “whys” rather than just the end result.  Most chronic, debilitating illnesses do not happen overnight.  There are usually years worth of warning signs and admonitions before the dreaded diagnosis is made (i.e. “Paul, you have diabetes…”) that you knew in your heart of hearts would be coming one day, so you ate as many doughnuts as you could, gaining only 75 pounds since you were 18, before the inevitable doughnut prohibition was imposed.  Upon hindsight, the trend is obvious in the last five years of blood work.  Why didn’t anyone say anything!!!???

The first and perhaps most important step in establishing “optimal health” after the initial acute complaint has been addressed, is removing any obstacles to cure.  For “Susie,” it may mean finally addressing her incontinence that she was too embarrassed to tell anyone about.  Perhaps she has a uterine prolapse after her four children, or maybe it is as simple as a food sensitivity causing chronic bladder irritation. Then she hires an obedience trainer for the dog…  

“Paul’s” situation is not quite as simple, because now he has a chronic disease.  It took him 10 years or more to develop diabetes, and now his pancreas is simply not able to keep up.  Furthermore, all he really wants is to return to his job as Joe Nacchio’s financial advisor and he is not really interested in giving up his doughnuts.  The best option for Paul may not be “alternative” medicine.  This is why:

Each of us must ask ourselves, “What do I find important in my life?” and “What do I really want out of my life?”  For many Americans, the answers often involve happiness that is dependent upon things… the seeking and acquiring of them:  bigger, better, more expensive, prettier …things.  This center of balance requires us to work longer and harder in order to have enough money for the acquisition of things.  How often do these answers involve “my health?”  Yet, without one’s health, how is one to achieve any life ambition … no matter the goal?  “Alternative” health care practitioners seek to place “my health” at the very top of the list.

As a rule, we Americans live an extraordinarily unhealthy lifestyle.  We work too long and hard.  We drive to work.  We do not exercise (unless you count that mad dash to the bathroom) and instead are often in our cars commuting and “doing errands” more than 2 hours a day.  We do not have time to cook healthy meals so eat fast food---again in the car, and have no family time unless it runs late into the evenings, leaving little time for sleep, or even rest.  Most Americans get only 5 to 7 hours of sleep daily when it is well known most of us need 8 to 10 hours of good quality sleep every day for optimal health.  (The body does most of its repair work while we sleep.)  We are overburdened with sensory input all day (computer screens, stressful work meetings, loud or constant noise, advertising, sales pitches, interpersonal relationships…) and as a result tend to go home and collapse in front of the television watching more mindless or stressful programming.  We are “stressed out” so we self-medicate with alcohol, nicotine, prescription drugs, and food.  Most Americans take no more than 2 weeks of vacation annually, if they take any vacation at all.  In these economic times, it is quite likely many families will forgo any type of vacation.We are living to work.

“Among the advanced economies, the United States is the only one that does not require employers to provide a minimum number of paid vacation days.  While most U.S. businesses typically provide five to 10 days in vacation for new employees and an average of eight paid holidays -- such as Christmas and New Year’s Day, days on which the business is closed -- government data indicate it takes about 10 years with the same employer to earn three weeks of vacation.   The data also show that about 10 percent of full-time workers do not get any paid vacation days.

In contrast, workers in the European Union can count on a minimum of 20 days of paid leave every year, and most get substantially more than that.  When paid leave and paid holidays are combined, workers in many EU countries enjoy a minimum of 30 or more paid days off every year.  They often get more.  The World Tourism Organization pegs average vacation time at 42 days a year in Italy, 37 days in France and 35 in Germany.  It says Japanese and South Korean workers enjoy 25 days off every year.” Source

Admittedly, there may be problems with so many days away from work.  However, it appears that Europeans, in general, work to live.
Are Europeans generally healthier than Americans as a result of this different ‘center of balance’ allowing them to work less and play more?  This is very difficult to measure completely objectively because of differences in study formats and reporting methods; however we can make a few observations by comparing statistics on obesity rates as a marker for health.  Obesity can be considered a “gateway condition” for many serious and debilitating chronic diseases, notably cardiovascular disease, the most common cause of death worldwide.  It is generally worsened by “stressful” lifestyles lacking in exercise.

Obesity (Body Mass Index greater than 30) is one measure of a population’s general health.  Colorado turns out to be a great place to stay ahead of the trend:

In 2007, only one state (Colorado) had a prevalence of obesity less than 20% of its population. Thirty states had a prevalence of obesity equal to or greater than 25%; three of these states (Alabama, Mississippi and Tennessee) had a prevalence of obesity equal to or greater than 30%.  Source

The recent IHRSA/ASD Obesity/Weight Control Report publishes “real” research statistics on America’s growing obesity epidemic. These alarming statistics reveal a dangerously overweight U.S. population.   Obesity in proliferating in the United States: 3.8 million people are over 300 pounds, over 400,000 people (mostly males) carry over 400 pounds and the average adult female weighs an unprecedented 163 pounds.
•    Between 1962 and the year 2000, the number of obese Americans grew from 13% to an alarming 31% of the population.
•     63% of Americans are overweight with a Body Mass Index (BMI) in excess of 25.0.
•    31% are obese with a BMI in excess of 30.0.
•     Childhood obesity in the United States has more than tripled in the past two decades.
•    According to the U.S. Surgeon General report obesity is responsible for 300,000 deaths every year. Source

In a worldwide survey of obesity in those aged 15 or older, the United States is number one, with an overall obesity rate of 30%.  The United Kingdom ranks 3rd and has an obesity rate of 23%; Canada ranks 11th with an obesity rate of 14.3%; Ireland, with all those pubs, ranks 13th and has an obesity rate of 13%; France, with all its rich food and wines ranks 24th and has an obesity rate of 9.4%; Italy, the land of pasta and more wine ranks 26th with an obesity rate of 8.5%; and Japan and South Korea rank 29th and 30th respectively with obesity rates of 3.2%.  Source

Interestingly, in 2002, Americans spent 53 percent per capita on health care more than the next highest country (Switzerland) and 140 percent above the median industrialized country, according to new research from the Johns Hopkins Bloomberg School of Public Health.  Source

Americans spend more money per capita in health care than any other nation, are working longer, and getting less healthy.  

Americans spend more than 100 hours commuting to work each year, according to American Community Survey (ACS) data released by the U.S. Census Bureau.  This exceeds the two weeks of vacation time (80 hours) frequently taken by workers over the course of a year.  For the nation as a whole, the average daily commute to work lasted about 24.3 minutes in 2003.

States with some of the longest commute times (one way) are New York (30.8 minutes), Maryland (30.0), New Jersey (28.3), Illinois (26.7) and California (26.6) — all above the national average of 24.4 minutes. States with the shortest commute times are North Dakota (14.8 minutes), South Dakota (15.0), Nebraska (16.1) and Montana (16.7).  Source

What is the take home message?  “Paul” with diabetes has a choice to make.  He needs to decide what he really wants in life and what his priorities are.  Does he want to park the car and start riding his bike to work or is he willing to start a regular, daily exercise program?  Will he commit to sleeping 8 hours every day?  Does he want to take some cooking classes and acquaint himself with ‘heart healthy’ foods?  Perhaps he needs a career change and will find great joy in discovering the outdoors.  He may even meet “Susie” out walking her dog, because her ‘bathroom issue’ has been resolved!  

Or, perhaps he rather likes his life just as it is and would prefer to manage his chronic disease with pharmaceuticals only, rather than pursue optimal health by addressing his unhealthy lifestyle.  

If “Paul” is truly interested in “Optimal Health,” he will be willing to evaluate every aspect of his lifestyle and discard those habits that are obstacles to his health while adopting new habits that will promote good health.  This is the essence of “alternative” health care.

The question we ask each of you to evaluate from this day onward:

Do you intend to LIVE TO WORK or WORK TO LIVE?