http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20040930/HPICARD30/TPHealth/?query=picard

Interestingly, the two list of health tips are not correctly referenced...
See bottom... -- dr
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 Bring on the duelling Top-10s: Two lists not to die for
 By Andre Picard
Thursday, Sep 30, 2004

 Every day in the media there are reports on the latest health research
findings. Many of these articles, implicitly or explicitly, offer advice on
how to improve your health: Walk more to prevent dementia; eat more
tomatoes to stave off prostate cancer; get regular mammograms to reduce the
risk of breast cancer; and so on.

Based on this kind of research, it's easy enough to put together a
Letterman-like Top 10 Tips for Better Living.

It would read something like this.

1. Don't smoke.
2. Eat a balanced diet.
3. Be physically active.
4. Limit your stress.
5. If you drink alcohol, do so in moderation.
6. Cover up in the sun.
7. Practise safer sex.
8. Get a regular check-up, including screening for common diseases.
9. Drive carefully: Wear a seatbelt and respect speed limits.
10. Learn first aid and CPR.

All these measures relate to lifestyle -- adapting to your social
environment. But we have long known that there are more important factors
in determining your health, including genetics and the environment in which
you live.

The environment, which academics like to call the socio-economic
determinants of health, entered the mainstream in 1974, when then-minister
of health and welfare Marc Lalonde issued his landmark report, New
Perspectives on the Health of Canadians.

Thirty years on, that perspective is more important than ever, but still
largely overlooked.

The reality is that the factors that have the greatest impact on whether we
develop life-threatening diseases are out of our control as individuals.

Income is a far better predictor of heart disease than commitment to
regular exercise. The neighbourhood you live in influences your cancer risk
more than your diet. The job you work at will give you a much better idea
of your Alzheimer risk than the amount of fish oil you consume. And your
level of education will determine your longevity more accurately than
screening tests.

In other words, general living conditions contribute more to long-term
health status and mortality rates than lifestyle practices. Factors like
education, income, employment, housing, and the environment influence your
health as much, if not more, than medical treatment (or more accurately,
sickness care).

This has led academics to come up with alternative tips for healthy living.
This Top 10 is from Joan Wharf Higgins, a professor of physical education
at the University of Victoria.

1. Don't be poor.
2. Pick your parents well.
3. Graduate from high school or, better yet, university.
4. Don't work at a stressful, low-paid job. Find a job where you have
decision-making power
and control.
5. Learn to control stress levels.
6. Be able to afford a foreign holiday and sunbathe (with SPF 30).
7. Don't be unemployed.
8. Leave in a community where you have a sense of belonging.
9. Don't live in a ghetto, near a major road or polluting factory.
10. Learn to make friends and keep them.

These goals are considerably more difficult to achieve than the usual top
10. As a result, many find this kind of talk demoralizing because they feel
powerless in the face of health threats.

But knowing more about the underlying factors influencing our health does
not discredit healthy living or absolve people of personal responsibility.

Rather, we should be empowered knowing the social, economic and political
choices we make can influence our health, and the health of the population.

If we want a healthy society, we need more than a health-care system that
delivers state-of-the-art sickness care. We need an environment and a
culture that supports healthy living.

The paradox today is that those who could benefit most from lifestyle
changes are the least likely to make them. To make healthy choices, you
need a decent income, proper housing, adequate nutrition, a good education,
a safe neighbourhood, a sense of belonging, and a modicum of control over
your life.

The countries with the best health outcomes and the highest life expectancy
have the smallest income gap between rich and poor.

And big gaps in our knowledge of these influences, and our failure to
mitigate them as best we can, is equally bad for our health.

We are fooling ourselves if we think the promotion of healthy lifestyles
will have an impact unless there is an equal or greater dedication to
creating a society in which we have the opportunity to make healthy
choices.

[log in to unmask]


-----------------------------------

The Traditional Ten Tips for Better Health
1. Don't smoke. If you can, stop. If you can't, cut down.
2. Follow a balanced diet with plenty of fruit and vegetables.
3. Keep physically active.
4. Manage stress by, for example, talking things through and making time to
relax.
5. If you drink alcohol, do so in moderation.
6. Cover up in the sun, and protect children from sunburn.
7. Practice safer sex.
8. Take up cancer screening opportunities.
9. Be safe on the roads: follow the Highway Code.
10. Learn the First Aid ABCs: airways, breathing, circulation. (Donaldson,
1999)

Donaldson, L. (1999), Ten tips for better health., London UK: Stationary
Office, available at
http://www.archive.official-documents.co.uk/document/cm43/4386/4386-tp.htm.


The Social Determinants Ten Tips for Better Health
1. Don't be poor. If you can, stop. If you can't, try not to be poor for
long.
2. Don't have poor parents.
3. Own a car.
4. Don't work in a stressful, low paid manual job.
5. Don't live in damp, low quality housing.
6. Be able to afford to go on a foreign holiday and sunbathe.
7. Practice not losing your job and don't become unemployed.
8. Take up all benefits you are entitled to, if you are unemployed, retired
or sick or disabled.
9. Don't live next to a busy major road or near a polluting factory.
10. Learn how to fill in the complex housing benefit/ asylum application
forms before you become homeless and destitute.  (Gordon, 1999)

Gordon, D. (April, 1999), Britsol University, Internet posting, Spirit of
1848

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