Wednesday, March 28, 2012

Friendships for the Ages (and Your Health)

Two of my closest friends in the world are visiting me in California this weekend. Sara will be flying all the way from Massachusetts and Pam all the way from Virginia! In honor of their visit, I wanted to write a brief post about friendship and health.

As it turns out, having a complex social network is significantly linked to lower mortality rates. According to a 2010 article in Forbes, researchers from Brigham Young University conducted a mega-study (by combining the results from multiple other studies) and found that those with adequate or high social relationships have a 50% greater likelihood of survival in a given time period than those who are more isolated. Some of the highlights of the study show that, in terms of mortality, low social interaction is:
  • as bad for your health as smoking 15 cigarettes a day.
  • as dangerous as being an alcoholic.
  • as harmful as never exercising.
  • twice as dangerous as obesity.
Wow, those are pretty striking comparisons! And it's not just about having one solid friend. Those individuals who have more complex networks, including family, friends, neighbors, coworkers, and such, are better off in terms of health than those who do not engage with such an elaborate network.

Just this week, I read an article on CNN that links living alone with depression. In a seven-year study of 3,500 men and women, among those who lived alone, nearly 25% filled a prescription for an anti-depressant, compared to just 16% of people who lived with a spouse or roommate. Of course, this brings up the question, does living alone lead to depression, or are people who are already more likely to become depressed also more inclined to live alone? I would imagine that the answer is likely a bit of both. Although the study did not show specific causation of depression from the solitude, it seems to correspond, at least in part, to the above article about lack of complex social networks posing a health threat.

An article in the New York Times describes other effects of friendship. One particularly interesting study placed University of Virginia students at the bottom of a steep hill with heavy backpacks and asked them to estimate the steepness of the incline. Some students were placed next to friends and others were placed alone. Those who were next to friends estimated the hill to be less steep, and the association was stronger the longer the friends had known each other. (And how appropriate, since Pam, one of my two friends coming this weekend, went to University of Virginia, where the study was conducted, and has been in my life since first grade. I bet that hill would look like a valley to us! I have known Sara no short time, either - since one fateful day in sixth grade.)

In the training to become a Court Appointed Special Advocate (CASA), I learned that lack of a strong social network for a parent is one potential predictor of child abuse. Raising children is stressful and confusing for many parents. Having the emotional, sometimes financial, and even babysitting support of family can ease the burden of the constant stressors or prevent a parent from feeling pressured to leave a young child alone in order to attend work or run errands (which would constitute child neglect). Having close friends can help an adult stay connected to the outside world and remain emotionally stable. In addition, social contacts can act as accountability partners, guiding and correcting behaviors, or pointing parents to appropriate support agencies and resources, if necessary, while sharing life together.

There are a host of other studies which tout many of the same or similar statistics. Friendship changes our risk of heart attack, depression, death. Friendship helps us rebound from trials. Friendship changes our attitudes and enhances our hope for the future.

I know this firsthand, as I have ridden many ups and downs of life with those who are closest to me. I have had some very dear friends turn me away from the most destructive habits and idols in my life, and I thank God daily for putting them in my path to radically change me. I have made many mistakes that have been deeply hurtful, and my true friends have shown me the strong power of forgiveness. I have received many hours of counsel from the wisdom of those who care about me and have done my best to support them in their times of need, as well. I have been blessed with fun and laughter through friends found in a new place and have felt myself deeply connected to a town where I thought my heart would have no ties. I have no doubt that having these incredible men and women in my life has transformed my journey, character, and outlook. Where would I be without them?

So today, I just want to say that I am thankful for my friends. The statistics confirm what I have known all along. Friends are good for my health!

Tuesday, March 27, 2012

Unanswered Questions: Baca Ortiz

What is the best thing for an under-funded hospital to do with the little money it receives? This was the question I first asked in 2007, when I was studying abroad in Quito, Ecuador. And I still do not feel that I have a suitable answer. This post is more of a description of my despairing feelings than an offer of solutions. I know that many readers do not like such a lament. But I truly don't have an answer. My hope is that this will at least cause others to ask the same questions, and perhaps it may even inspire a spark of innovation to find an answer.

During the fall of 2007, I had the chance to visit Baca Ortiz Children's Hospital in Quito, the premier children's hospital in the country. It is very difficult to find specific information about the hospital, so I have scraped up what little I could locate to provide a general picture. According to "Volunteers Abroad," Baca Ortiz was founded July 14, 1948. Approximately 140,000 children are treated at the hospital annually. Families come from around the country to the facility, because it offers specialized treatment that is not available in other regions.

The hospital has a paid staff of doctors and nurses, as well as a number of volunteers with a range of skills, from medical professionals, to individuals who visit with the children, to those who help fund raise for the most needy families.

Although Baca Ortiz receives funds from the government, it is significantly under-funded, and families are therefore required to pay for the treatment they receive at the facility.

Based on the accounts of my friend who volunteered at Baca Ortiz regularly and based on the information I received during my time there, the facility itself has so few resources that it cannot stock basic supplies, such as soap, toilet paper, bandages, or medicine to keep on-hand, unless these happen to have been recently donated. If a child is admitted to the facility, his or her family is responsible for providing soap, toilet paper, and other supplies for the child's room. If the child requires any sort of treatment, the family has to go to a local pharmacy and purchase bandages, sterilized surgical instruments, oxygen tubes, anesthetics, sanitizing agents, antibiotics, etc. There is no surplus to have these items readily available.

For many families, this simply means going without sufficient treatment. According to the CIA World Factbook, 33.1% of Ecuadorians live below the poverty line. Many more make enough to be deemed above the line, but are underemployed and still struggle to provide for their families on a daily basis. Additionally, income disparities are extremely pronounced between various regions of the country and between different racial groups.

Families are also provided meal tickets to eat in the hospital's cafeteria a certain number of times per week. For some, these are the only meals they will eat at all due to general poverty or due to the costs of traveling to the hospital and paying for treatment. However, my friend who volunteered handing out meal tickets told me that she frequently ran out before every family had received their share, as the hospital was extremely over-crowded (see the image of children being treated in the hallway on the right due to room shortages) and had a very limited budget to prepare a certain number of meals per week.

Some families have little hope of paying for treatment once they have received a diagnosis, and they go home without assistance. Others may gain funding through organizations that donate specifically for their treatment, such as The Mashi Foundation, which used social workers to identify ten children of highest priority and funded the surgeries for those children in 2010. Assuming that 33.1% of the 140,000 children who visit the hospital in a given year are impoverished, as is the case with the general population, that would be 46,000 impoverished children who come through the doors. Ten funded surgeries is an amazing thing, but it is astonishing to realize that the figure represents only 0.02% of children who are likely too poor to afford treatment at Baca Ortiz. My understanding is that such donated funding is sporadic, at best. Since the need for this type of financial intervention is so overwhelming, the situation is quite desperate and the poorest may never obtain the assistance they need.

After visiting Baca Ortiz, I felt disheartened and confused. Where should the hospital direct its scarce resources? Medicine for those who cannot otherwise purchase it, without which children will suffer from pain or parasites, possibly die from cancer or even treatable infections? Soap to prevent the spread of infection throughout the facility? (It was hard for me to imagine how a hospital functions without having medical supplies on hand, never mind free access to soap? The basic act of washing one's hands is crucial to the prevention of infection, yet some families have to choose between sanitation and medication.) What about meals for those who would not be able to afford a stay without the provision of this sustenance? Without the meal tickets, many families would not only be unable to afford treatment, but could not visit at all due to the extreme hardship it would pose.

I would be interested to hear if you know have ideas about how the hospital can best use its funds. What are ways this conundrum is being addressed in other nations? What has been proven to work? Do you have any novel ideas yourself?



Photo Credits:

Saturday, March 17, 2012

Chocolate to the Rescue

Since I love chocolate so much, I thought it would be fun to explore the health benefits! Not that I'm trying to justify my actions or anything....

As it turns out, chocolate, in moderation, has some of the same properties as red wine. Chocolate is high in flavonoids, a type of antioxidant which may combat aging and heart disease. According to an article on About.com, dark chocolate is eight times as antioxidant dense as some of our favorite fruits, like strawberries. (For more information on antioxidants, which are frequently classified as phytonutrients, check out the first blog post I ever wrote.)

The Cleveland Clinic says that the main types of flavonoids in chocolate are called flavanols, and these have been shown to lower blood pressure and LDL cholesterol. The About.com article mentioned above also says that the affect on LDL cholesterol may be as high as a ten percent reduction! As you may know, when LDL cholesterol oxidizes, it tends to build up and stick to your arteries. In that case, it can block the way for blood flow and increase the risk of heart attack or stroke. Some of the substances found in chocolate prevent the LDL cholesterol from oxidizing (hence the term "antioxidant"), which helps stop the build-up. According to a Huffington Post article, "Research performed at the department of nutrition at the University of California, Davis, found that chocolate thins the blood and performs the same anti-clotting activity as Aspirin." As you may be aware, Aspirin is often prescribed in low doses as a blood thinner for individuals at risk for heart disease. Harvard Medical School also reports that chocolate has been linked to lower levels of C-reactive protein, a marker for inflammation.

Not only does chocolate affect blood flow, but it has also been shown to elevate mood! Chocolate stimulates the production of endorphins, the same chemicals that make us feel happy when we exercise. Chocolate also contains serotonin, which acts as an anti-depressant, in addition to a variety of stimulants, such as theobromine and caffeine. In fact, the Huffington Post article stipulates that the serotonin in chocolate may be a partial explanation for why women crave chocolate during PMS and menstruation, since their natural serotonin levels are typically down on those days.

Despite these health effects, the research comes with a caution! According to the Cleveland Clinic, not all forms of chocolate provide equal benefit. The flavanols naturally found in cocoa are also largely responsible for the bitter taste of unsweetened chocolate. The more cocoa is processed to make the palatable goodies we enjoy, the more the flavanols are depleted. While nearly all of the websites I found agree that dark chocolate contains the most flavanols, the Cleveland Clinic states that recent research shows the level of flavanols is not universally consistent in dark chocolate, as it depends on how the dark chocolate was processed (fermentation, alkalizing, roasting, etc.) Nevertheless, dark chocolate or non-Dutch processed cocoa are typically much better bets than milk chocolate. (So I guess all those years of loving dark chocolate weren't just a result of strange taste in flavors; I was being healthy!)

Many people may worry about the high fat content in chocolate. Interestingly enough, there are three main types of fat in chocolate, each found in about equal proportions, and they are not all considered harmful. According to both About.com and the Cleveland Clinic, one of the fats is called oleic acid, which is a healthy monounsaturated fat that is also found in olive oil. The second is stearic acid, which is a saturated fat, but research has shown this particular fat does not adversely affect cholesterol. The third type is palmitic acid, which is one type of saturated fat known to contribute to higher cholesterol. So the good news is, only about 1/3 of the naturally occurring fat in chocolate is bad for you!

A lot of the problems come in with the ingredients we add to cocoa. Milk chocolate, in particular, typically has added butterfat and significantly more sugar, both of which are linked to a variety of health concerns. And even dark chocolate can be made significantly less healthy by adding caramel, nougat, marshmallow, and other ingredients. These unhealthy additions typically outweigh the benefits of the chocolate itself. Furthermore, consuming a king-sized candy bar is not going to help your heart health. The ideal serving size to maximize the benefit of chocolate is one to three ounces a few times per week. And remember that even healthy chocolate has calories. If you add chocolate to your diet regularly, you may need to exercise more or cut out an equal number of calories from another meal or snack to maintain a consistent body weight.

So the lessons seem to be: enjoy chocolate for the healthy benefits it provides, savor each bite for the delicious flavor, and consume in moderation. Mmmm, chocolate!


Photo credit: http://experiencechocolate.com/

Tuesday, March 13, 2012

Fotoshop

As a follow-up to my post on obesity and physical appearance, I wanted to share a video that sheds a humorous bit of light on the beauty expectations of our culture. It made me laugh and think! I hope it will do the same for you.


I came across this video while reading a very interesting article on CNN about activists who are challenging popular notions of beauty. A similar theme to the above satire pervades a short film, made by Dove, to show the transformation from natural beauty to makeup model.

As I discussed in my commentary on childhood obesity and appearance, I do believe that the media shapes our sense of what is desirable, and even our concept of what is "normal." Children are especially vulnerable to having their expectations and opinions shaped. Even subtle advertising can make a difference when we consider how often we see the same message day after day. After a lifetime of exposure, it would be naive to assume we don't soak in anything from what we see, hear, and read.

For those who are skeptics, consider this passage from "Cinderella Ate My Daughter," by Peggy Orenstein (pg 17). "...Even can-do girls can be derailed - and surprisingly quickly - by exposure to stereotypes. Take the female college students, all good at math, all enrolled in advanced calculus, who were asked to view a series of television commercials: four neutral ads (showing, say, cell phones or animals) were interspersed with two depicting cliches (a girl in raptures over acne medicine; a woman drooling over brownie mix). Afterward they completed a survey and - bing! - the group who'd seen the streotyped ads expressed less interest and math- and science-related careers than classmates who had seen only the neutral ones. Let me repeat: the effect was demonstrable after watching two ads. And guess who performed better on a math test, coeds who took it after being asked to try on a bathing suit or those who had been asked to try on a sweater? (Hint: the latter group; interestingly, male students showed no such disparity.)"

I encourage you to read the CNN article that led me to this video and other pieces about similar topics. Consider how advertising is affecting our lives, from one math test (per the studies mentioned above) to career opportunities in general, from distorted self-image to unhealthy dieting, from peer relationships in the classroom to expectations in our dating and spousal relationships. All of these aspects of life are profoundly related to our mental, emotional, and physical health.

I hope that being even slightly more aware of how these messages affect us will change both our decisions about the images we choose to allow into our minds and the way we interpret the advertising we do take in. If enough people react against the practices of our media culture, the advertisers will have no choice but to take notice!


For more information on this video, check out Jesse Rosten's website: http://jesserosten.com/2012/fotoshop-by-adobe