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Disability – the cost of modern life

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This chart shows the shift in the nature of disability in America since the early 1960’s. What is hows is that the stress of how we live is crushing millions of people. The images in this post come from an excellent article here.

Back pain is strongly linked to issues of lack of control. It shows itself in a physical way, but its roots are in stress that comes from not having enough control. Depression has the same connection.

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As the job world shrinks, millions are left out of society and so we see the disability grow.

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There are close to 10 million people on disability. There is no “cure” in a medical sense. For the root cause is within the psyche of the person. Medication for you back does not touch this.

The cure will be a different kind of economy. My first book – You Don’t Need a Job – describes what is going on and what I mean by a new kind of economy. I se a trend where many are now taking making a living into their own hands and are starting a life as networked artisans. But for many who are disabled and who will be, I fear for their future. For they have given up. How many million will be in this position in the next 10 years? The current cost to society is $240 billion a year.

Time to look at this and to start a conversation abut what we can do.

There are worse things than death

February 6, 2013 Context, Personal Health No Comments

Today is my father’s birthday. He died age 55. Not a good age to die. But my mum has been an invalid since her late 40’s. Without his pension I don’t know what we would have done. But who has such a pension today?

Much of the discussion about health is about living longer. But what about our life? What is our life like as we live into our 60’s and 70’s?

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Here are the stats for men on Prince Edward Island. The average man is disabled by chronic illness by the age of 65. He cannot work. He cannot contribute. He has to be looked after. And for women, add 5 years and the results are the same.

On average we live for another 10 years like this. THIS is where the costs are found. PEI is not unique. This long period of disability is what all of us can expect in this epidemic of chronic illness that is our new normal.

And when we are disabled, who is going to look after us? Will we burden our kids? And by the way, what Kids? With low birth rates, there are not many of them. And where do our kids live? Near us? So maybe then the state? But when we look at their costs, we know that they cannot help us either.

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There will simply not be the tax payers or the  tax dollars to pay to look after us.

This is why I am millions of people are starting to take charge of our own health. Suffering from chronic illness is not inevitable if we make the changes that are discussed in detail in this blog.

More on this later.

 

Health – Mortality is the wrong place to look now – Look at “Disability”

Most of our health statistics still focus on mortality. This is a left over of the time when infectious disease was what concerned us the most. Infection kills quickly. It was the correct focus to have when this was the battleground.

But today infection has largely been pushed into the corner and we face instead long term chronic illness that takes years to kill but that can and does disable us – making it impossible to work or even look after ourselves. On PEI the average man becomes disabled by 65 and lives for 9.6 years in this state. This is where the real costs are to be found. Costs to each of us as we are unable to earn or cope with daily life. And costs to us as a society – for medicine can only keep us ticking over.

This group do die at the latest in their 70’s. Leaving another group the Very Old who have been fit and active all their lives. Why is another question for later. But this group too reach a stage when they too become disabled and this is where the costs and the burden mount. For their families and for the state. Until now there have been so few of these that we could afford to shelter them in institutions. But with so many that will live well into their 90’s in the pipeline – we will not be able to afford this.

Ironically, the worst thing we can do for people like this is to institutionalize them. Their health collapses when they have all control and role taken away. But as I am finding with my own mother, medicine can keep us ticking over for decades.

CIBC and VAC have worked for over 15 years on reducing the load on their medical systems.

Together they offer a useful model for how any population might look at its own load issues. Load being defined here as the impact of those people that become disabled by illness and live a long time. For the most important cost drivers in any health system are not mortality or morbidity but disability. It is disability and not acute illness that drives the costs. Once we understand this term, many options open up for us to reduce costs and increase care.

  • Disability Load = incidence X duration of reduced capacity.
  • Disability rate – has to be addressed though policy, better support for wellness activity, working conditions etc.
  • Reduced capacity – person perceives that they cannot fulfill their full function.  More likely to seek medical care and as a result drive other benefit costs.

The total population contains two Disability risk segments. The “Young” aged up 65  and the “Very Old” aged 75 – 110.

The Young increasingly develop chronic illness such as Type 2 Diabetes. This segment becomes progressively more ill until they are disabled and require both ongoing treatment and social support sometimes for decades. We call these diseases, the Diseases of Modern Civilization

Diabetes drives many other conditions including cardiovascular disease. On PEI adults in 2006 with diabetes had to be hospitalized much more often than those without it. 16 times more often for lower limb amputations. 6 times more often with kidney disease. They had 5 times more heart attacks. 4 times more heart failure. 3 times more strokes. They stayed 3 times longer in hospital. Had 2 times more visits to physicians and 2 times more to specialists

Most diabetics don’t just take one medication, but several. A typical regimen for an adult diabetic after a couple of years of treatment and following the dietary advice of the American Diabetes Association includes Metformin, Januvia, and Actos, a triple-drug treatment that costs around $420 per month. Two forms of insulin (slow- and fast-acting), along with two or three oral medications, is not at all uncommon

The real societal problem is not that we die of these diseases but that we that suffer from them. All or concerns in the past have been mortality. But with this large and growing group of people, the issue becomes not mortality but care.

Diet is at the core of this epidemic. Most of the information related to diet today is at least misleading or even wrong. A new understanding of our evolutionary past shows that grains, the core of the recommended diet, are in fact the pathway to insulin resistance and so to this family of diseases.

Social Status and Managerial Culture then act as an amplifier on vulnerable people. Those in organizations with the least amount of control will have a mortality rate 4 times greater than executives with more control and status.

The breakthrough then in costs and care are that diet and issues of managerial culture can be positively affected by social intervention.

The issue of control and social status is the vector for Load in the very old as well. Social Intervention works best here as well.

The  “Very Old” aged from 75 – 110. This group has usually avoided the chronic illness and has remained well and independent until they become too frail to live on their own. But if they are institutionalized, they tend to lose their health and then can also live for many years.

Currently we just treat these groups medically. CIBC and VAC treat them socially to great effect. They can prevent, reverse and mediate the illness. I will offer up 2 case studies to show you how.

CIBC – the under 65 set

VAC – the over 75 set

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What is the Missing Human Manual All About?

Do you want to age well? Most of us do. If you are my age, 60, this is more important a question that if you are 30. But most of us would not wish to have heart disease, cancer, dementia when we get old.

Most of us think it is normal that we will get ill like this.

But science today tells us that this is not "Normal". Our evolutionary past designed us to be active and fit until we drop dead. Why? Because raising human children takes so long. Mature adults had to do most of the hard work enable us to invest up to 25 years in our kids.

We are designed by our evolution to reach a plateau of fitness in mid life. So why do most of us not live like this?

We don't because, we have strayed away from the best way of living that fits our evolution best. Our culture has got too far ahead of our biology. We eat foods that make us ill. We have lost our social identity and power and that makes us ill. And we have lost touch with the circadian rhythms of the Natural World, and that has made us ill too.

We have lost our fit with our true nature.

This site will be a Manual. It will show you what the best fit is. It will show you the science behind this. It will share with you some methods for getting your fit back with your true human nature.

So welcome to the "Missing Human Manual" . I hope that we can help you and I hope that you can help others as a result.

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