In your view, what is the No. 1 health crisis in America today?
Health literacy. We have a lot of science and a lot of information, and we can talk all about prevention and medications, but if people don't understand what health pros are trying to do, all is for naught. And it's not just the people we serve, but also on the part of health professionals.
Health professionals often talk "doctorese." Sometimes people don't fully understand what we are trying to advise them to do. I don't want to demonize doctors. We are all trying to do the right thing. What we need to remember is communication is not a one-way street. We may think we have made a point, but have not. And we may think patients have understood, but they don't. Communication is not one-size-fits-all. It is modified and modulated by culture, gender, language -- all these things are important as we communicate. The Institute of Medicine reports that low health literacy adds $50 billion to health care costs. Ninety million Americans can't adequately understand basic health information. Can you imagine what we could do if we could get even half of these Americans to understand health better?
Are Americans getting smarter about smoking?
We are. In 1964, when the first Surgeon General report on smoking came out, the majority of American men and women smoked. Most don't now. We are getting smarter. When the report came out a few years ago, we are very heartened to learn that people are understanding [the risk] and taking it to heart. We were able to communicate the message in such a way that people hear it, understand it, and put it into action. What about teens? The number of teens taking up smoking continues to go down compared to the late '90s. It's the lowest ever since 1991. The not-so-good news is that the rate of decline is beginning to stall. We can't be complacent. We need to communicate to teens in ways they can hear the message, embrace it, and put it into action. And we need to appreciate that our young adults are educated people who can learn to make the right choices for themselves.
Why is organ donation such an important issue to you?
Organ donation is a professional and personal issue. As a physician, I have always been a proponent of organ and tissue donation. I have seen the life-giving benefits it provides to other individuals. It became personal to me when my wife was killed in an auto accident. Because she and I talked about it, we had the privilege of donating her organs. Four people received solid organs and had a longer life because of her. Four years later, my 22-year-old daughter was struck by a car while crossing the street. Because of her gift, another five people had a renewed life. Today, 93,000 people are on a waiting list for a transplant. If we could only find enough donors, people who are generous enough. When we are faced with the sudden death of a loved one, we are in the depths of grief. But in our grief, we see that good can come of it, helping us to remember our loved ones and what they were able to do as organ and tissue donors.
When you put a human face in front of the issue, that makes a difference. That is why I feel so passionate both professionally and personally about this issue.
Do you believe there is a connection between environmental pollutants and certain cancers?
Certainly we have the science to show that. We learn more every day. We don't know what causes certain cancers, and there is a relationship, positive as well as negative, between health and environment. Look at the Surgeon General report on environmental tobacco smoke -- it definitely does have an impact on well-being of children as well as adults.
If more women die of lung cancer than breast cancer, then why do so few know this startling fact?
I think it goes back to the need to improve health literacy. I am sure there is a discussion in doctors' and nurse practitioners' offices across the country about the dangers of lung as well as breast cancer. But I'm not sure people [always] have access to reliable information. A lot of info is on the web, but we have to discriminate. We need to make sure those we serve understand what we are talking about.
What simple thing can Americans do right now, today, to ensure a healthier tomorrow?
Americans can right now, today, take more of a personal interest in their health. They need to be more interested, and understand that what affects all of us tomorrow are the choices we make today. Whether that means environmental exposures -- such as smoking, choosing to exercise, or what to put in our mouths.
What disease or condition would you most like to see eradicated in your lifetime, and why?
When you look at health from a public health standpoint, the condition with the most impact is cardiovascular disease. Second is cancer. I would focus on cancer, because it is so devastating to the individual and those around them. We are closer to addressing what causes cancer and what we can do about it. We are on the verge of the knowledge and the science to do this.
What is your personal health philosophy?
My personal health philosophy is to take control of my own health and health habits.
What is your best health habit? Your worst?
My best habit is not a single thing, such as eating right -- that gives the impression that is really all you have to do. That is not the case. Your health is the result of the sum total of what you do. My best habit is constantly trying to make the right choices for my health, whether that means what I eat, how I exercise and when -- we are faced with the choices [you make] every single day. We have to make the right choices every day but we are not going to be perfect. My bad habit is making excuses ... as to why I can't do something. It is very bad, because it justifies in your mind why you can't do it. But say I may not have had best meal for lunch. I say to myself, I will do better next time.
Who is your health hero?
C. Everett Koop. He is the modern communicator. He is still going.
If you had to share a hospital room with any one person from history, who would it be?
Mother Teresa. Why? She cared for others, always focused on the human perspective, and had a true, ingrained philosophy of caring for others.
Published November 2006.