FROM THE EDITOR'S KEYBOARD

SOCIAL FACTORS AND HEALTH

This month's issue of the American Journal of Public Health seems to be getting its share of lay press coverage. On page 341 of the March 1996 issue is an article entitled: "Does Religious Observance Promote Health? Mortality in Secular vs Religious Kibbutzim in Israel." The answer to the question posed in the title was a resounding "yes." The religious Jews had less deaths from cancer, heart disease and other circulatory conditions, as well as external causes (such as "accidents", and suicide). Besides these major killers, the religious observers also fared far better in the category of "all other causes" of death. At any given age, the religious Jews had only about half the risk of death as their secular peers--peers who seemed to be similar in all other studied characteristics.

I believe the study has many interesting implications. However, my purpose is not to discuss this research in detail today. I cite it as an example of the explosion in our understanding of how social factors affect health. In the current WEJ issue we begin with three radio scripts that deal with social and demographic factors and how they affect health. We close today's featured subject matter with a personal look at my social situation--as I make a major transition with my family. Sandwiched in between are selections dealing with social health issues from Phylis Austin's popular "Science/Health Abstracts." DJD

A PREVIEW OF WHAT'S COMING IN FUTURE ISSUES

Here are some of the topics that are planned for WEJ in the months of April, May and June:

     Food Allergies 
     Vitamins and Cancer 
     Protein and Kidney Disease:  The amount of protein in your diet
	 may affect the health of your kidneys
     Shellfish and Health 
     Glutathione and Disease:  Some evidence on how to increase 
	your natural protection against heart disease and cancer.
     Soy Foods and Health 
     Exercise and Diabetes

Coming In June: "Homeopathy Revisited." Our last issue that dealt with Homeopathy generated some of the most lively correspondence ever. We will feature your letters and my commentary on this subject. If you have other submissions regarding Homeopathy please submit them by May 15.

SECTION II

TRANSCRIPTS FROM THE WELLNESSWISE RADIO PROGRAM

(All scripts copyright 1995 and 1996 by David J. DeRose, MD, MPH)

THE HEALTH ADVANTAGE OF WOMEN

Do women really have a health advantage? I'm Dr. David DeRose, in a moment we'll look for an answer on WellnessWise.

Dr. Leonard Syme, the renowned epidemiologist recently stated "One of the most well established facts among students of health and disease is that men have higher mortality rates than women." Dr. Syme went on to state that the average man is nearly twice as likely to die as a woman of the same age. Furthermore, men have a 7 1/2 year shorter life expectancy.

We've all heard statistics like this for years. But perhaps the biggest question is: "are men genetically less hardy compared to women?" Or is there something about the way men live and behave that increases their risk of premature death? These questions are more than academic. If we discover that women make healthier lifestyle choices, then men could make similar choices and reap similar benefits. On the other hand, if it's just genetic, then men should learn to make the best of a less healthy set of genes.

Another researcher, Dr. Wingard, attempted to find a difference in health behaviors between men and women. She did a detailed review of such habits as smoking, hard-driving behavior, physical activity, marriage, parenting and employment. However, none of these factors alone or in combination could explain the sex differences in risk of death.

Further attention to women's health is important not only for the health of women, but also for the health of men. Only as we understand better the relationship between gender and health will we all reap the benefits.

For WellnessWise, I'm Dr. David DeRose

Reference: Syme, LS, "Social Determinants of Disease", in Last, JM and Wallace, RB, (ed) Maxcy-Rosenau-Last Public health and Preventive Medicine, 13 th edition, Appleton and Lange, 1992, p. 690.

SEX DIFFERENCES IN SMOKING RISK

Another case of sexual discrimination in medical science? I'm Dr. David DeRose. In a moment: "Disease and Discrimination"-- on WellnessWise.

Many research initiatives have been accused of sexual discrimination. However, diseases can also discriminate.

One recently recognized case of discrimination relates to smoking and lung cancer risk. Researchers at the American Health Foundation now have evidence that women are more susceptible to the cancer-producing effects of cigarette smoking. Their results are based on interviews with over 2000 lung cancer patients and some 3500 individuals without lung cancer. For all six different types of lung cancer studied* women had a higher risk than men of developing cancer. Depending on the lung cancer type, risk was increased anywhere from 25-100%.

The researchers could find nothing that could account for this increased risk other than sex. Specifically, it was not explained by differences in the amount smoked or the type of cigarettes smoked. They concluded that women are more susceptible to the cancer-producing effects of tar. Within 20 years, this fact-- combined with current smoking trends-- will likely result in more women than men dying from lung cancer every year.

It may appear discriminatory, but the results indicate that--given identical smoking habits--a woman has up to twice the risk of developing lung cancer than a man.

For WellnessWise, I'm Dr. David DeRose

* the six types of lung cancer studied were: squamous, epidermoid, small, large, adeno, and alveolar

Ref: Dr. Edith Zang, et.al. American Health Foundation

JOB STRESS AND SOCIAL FACTORS

A different approach to business management may be improving the health of workers. I'm Dr. David DeRose: "Job Stress and Social Factors" in a moment on WellnessWise.

"What the boss says goes"; "the CEO makes the decisions, we just follow." We've heard statements like these for decades, but there is evidence that they are being heard less frequently. Top executives are realizing that quality and productivity generally improve when they give rank and file workers more say into how things are done.

This changing management strategy may be doing more than improving quality and productivity--it may actually be helping to improve the health of workers.

Drs. Karasek, Theorell and associates discovered that work-related stress does not always increase the risk of disease. They found that job stress usually only affects health if the worker has little control over the workplace and work methods.

Workers who are not involved in deciding how things are done tend to have higher stress hormone levels. They have higher rates of mental strain, heart disease, and other health problems.

The bottom line is that if management finds more ways to involve workers and allow _them_ to help make decisions, the health of those workers may actually be better.

The news is encouraging--because what make good business sense also makes good health sense--and that's usually the way it is.

For WellnessWise, I'm Dr. David DeRose.

Reference: Syme, LS, "Social Determinants of Disease", in Last, JM and Wallace, RB, (ed) Maxcy-Rosenau-Last Public health and Preventive Medicine, 13 th edition, Appleton and Lange, 1992, p. 687-690.

SECTION III

SCIENCE/HEALTH ABSTRACTS

A work program decreases the number of hospital days required for schizophrenic patients, according to a study from Connecticut. A group of schizophrenic patients on a structured work program were compared with a non-working group. The working group spent fewer days in mental hospitals, and had fewer symptoms than the non- workers. The authors observed that the benefits from the work program disappear when the work program is discontinued. They feel that work therapy is beneficial in the treatment of schizophrenia. (Schizophrenia Research 9(2,3)93, April 1993)

SECTION IV

TRANSITIONS: ANOTHER IMPORTANT SOCIAL FACTOR

Most of you probably realize that some three weeks have passed since our last WEJ issue "rolled off the press." Hopefully, such a three week hiatus is the worst you'll see over the next few months as I continue to go through a major transition. Let me explain. My family and I are in the process of pulling up roots in New York and moving to Ardmore, Oklahoma.

If you're like most people I know, Oklahoma is a place you've heard about, but never visited. Sure, some of you have perhaps "passed through" that Southwestern state on a cross country road trek. Few of you, however, have ever _really_ spent any time there. Even if you've beat the odds and actually visited Oklahoma, Ardmore was not likely on your itinerary. I'm told it's the largest city on the road from Dallas to Oklahoma City; still, with some 25,000 inhabitants, Ardmore is pretty small by most standards.

Well, why would a physician with a vision for preventive medicine want to move from the New York City area to Ardmore, Oklahoma? The answer really is simple.

One reason we're making the move is to be in the vicinity of a new health center, one that I believe has the potential to become one of the premiere clinical preventive medicine centers in the nation. The new "Lifestyle Center of America" is located about 30 minutes from Ardmore on some 2000 acres in the Arbuckle mountains. The center is impressive, and I've also been impressed with the highly professional staff they're pulling together.

In conjunction with the insights of the recent American Journal of Public Health, it's only fair that I tell you that there is a more important reason for our move. My wife and I share the conviction that there is a God who wants us to relocate in Oklahoma. I know for some of you this may sound a bit eccentric, but we've really been convinced in our lives that there is such an all powerful Being who is willing to indicate to us what we should do in life. (If you have a problem with this concept, that's OK. Feel free to let me know. I'd be happy to hear your perspective; and if you like, I'll tell you more about my personal conclusions.)

.So we're making a move to what promises to be one of the hottest areas in preventive medicine in the country. Even if that promise never materializes, we know that for now, we are making the right decision as we move nearly 2000 miles away.

By the way, as far as your free WEJ subscription: our two-week cycle may continue to suffer somewhat between now and June. However, our goal is to be firmly back on our biweekly regimen by the Summer.

DJD

SECTION V

PARTING WORDS

OFFERS FROM OUR SPONSORS

Our sponsors continue to offer special services to WEJ readers

"The Health Connection" offers a large variety of health education resources that are popular with parents, teachers and health professionals. They offer posters, charts, anatomical models, a wide range of health educational videos, books, magazines and curricula. Currently, "The Health Connection" is offering WEJ readers their free catalogue and a coupon good for 10% off on your first order. Simply call "The Health Connection" at 1-800-548-8700 (for other countries: 301-790-9735). Mention "WellnessWise" and they'll send you a free catalogue and the 10% off coupon.

Total Life Creations, Inc.(TM), is still offering a special discount on an important educational resource. The new "Fatigue Busters(TM)" video is guaranteed to boost your energy level. For a limited time, WellnessWise readers save over 15% by receiving FREE shipping and handling (US & Canada only)!! Get your copy for only $29.95 by calling 1-800-827-9445. Send mail orders to: Fatigue Busters, P.O. Box 41, Selah, WA 98942. (Fatigue Busters is a trademark of Total Life Creations, Inc.)

The daily WellnessWise radio broadcast is available on cassette. WEJ readers receive a 10% discount on program audio tapes. For $9.00 post paid (regular $10) receive an information packed cassette with a minimum of twenty of Dr. DeRose's 90 second WellnessWise radio programs. Send e-mail to docderose@aol.com for further details.

SUBSCRIPTION INFORMATION

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BACK ISSUES

Back issues of WEJ are available at several sites in cyberspace. Some of the more popular sites are as follows:

     (1)  http://fermi.jhuapl.edu/wej/
     (2)  http://www.glasscity.net/~tolsda/wej/
     (3)  http://www.tagnet.org/InfoCenter
     (4)  http://www.social.com/health/news.html