Ted Eytan, MD

Photo Friday: The right answer is to involve patients in every decision

Ted Eytan — Fri, 27 Jan 2012 11:06:12 +0000

View 2012 Care Innovations Summit DC 8505 on Flickr.com

Ted (me), Mark Scrimshire ( @ekivemark ), Kait Roe ( @kaitbr ), at the Kaiser Permanente Center for Total Health ( @kptotalhealth ), for the Care Innovations Pre-summit. Photograph taken by Jason Bhan, MD ( @gomedivo ), jackets by Regina Holliday ( @ReginaHolliday ).

#cisummit “the right answer is to involve patients in every decision.” Patrick Conway, MD, CMO for @cmsgov

— Ted Eytan, MD (@tedeytan) January 25, 2012

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Being human and HIV care – Our generation does have the power to change it

Ted Eytan — Thu, 26 Jan 2012 15:00:15 +0000

Today’s announcement by Kaiser Permanente that (1) disparities in survival with HIV are a thing of the past in a coordinated, caring health system and (2) the tools and best practices can be implemented anywhere changes a lot of things.

The dawn of the AIDS epidemic predates my medical career. When I was in college, my biology graduate teaching assistant said to our class one day, “AIDS could wipe out the human race,” and he was right. It could have.

In medical school, I experienced a medical profession that was in shock, unable and in many cases, unwilling to care for people with AIDS. In my experience in training, there were few disparities – everyone received equally discriminatory care.

When papers were published that used terms like “unexplained differences” in outcomes, I could explain the differences easily. I saw with my own eyes how people were treated. For me, there were, “I can’t believe I’m seeing this, won’t anyone help?” moments.

At the same time, I learned, there was an emerging culture of empowered patients with AIDS, and the physicians/clinicians who took care of them. What I was told by one of these physicians was that they were shunned by their medical colleagues because they shared data and explored options with their patients. These are the physicians that I am descended from.

The medical profession learned a lot about treating HIV and AIDS, and then the pattern that we see with so much health care emerged – disparities based on race, ethnicity, sexual minority status. I always thought these would be the hardest to smash, because they depended less on science and more on attitudes.

The physicians/nurses/clinicians/patients and their descendants who continued to stay up to date and create models of care that work for everyone are the ones that have ushered in a new era.

I think of this photo that I took in 2007 in Dupont Circle, Washington, DC – the sign that says “Miracles can Happen” – we can wipe away the inhumanity that formerly predisposed us to being mediocre care providers for certain people and excellent ones for others.

“Miracles Happen” – Whitman Walker Clinic, December, 2007

Here are two videos that accompany today’s announcement. Enjoy. (Note, these may not embed properly until the announcement, you can access them at YouTube.com directly here and here.

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Now Reading: Don’t believe in reducing disparities in HIV Care, believe in eliminating them

Ted Eytan — Thu, 26 Jan 2012 13:00:00 +0000

Silverberg MJ, Leyden W, Quesenberry CP, Horberg MA. Race/Ethnicity and Risk of AIDS and Death Among HIV-infected Patients with Access to Care. Journal of General Internal Medicine. 2009;24(9):1065-1072.

Horberg M, Hurley L, Towner W, et al. HIV quality performance measures in a large integrated health care system. AIDS patient care and STDs. 2011;25(1):21-8.

Kaiser Permanente (KP) is the largest civilian provider of HIV care in the United States and is the second largest provider of HIV care in the United States (the largest provider being the Veterans Administration). There were nearly 17,000 active HIV-infected KP members in 2007. Our HIV mortality rate is 1.6%, compared to 3.4% nationwide in the United States.

These two papers provide the data behind a major announcement today, which is that you don’t have to be Black, White, Latino, Heterosexual, or Homosexual to have the best chance at HIV viral suppression, avoiding AIDS, and avoiding death anymore. You only need to be a human being.

Here are the numbers:

Kaiser Permanente has demonstrated excellence in HIV clinical care outcomes with:

HIV mortality rates that are half the national average
94 percent median treatment adherence among patients regularly in care and on antiretroviral therapy·
No disparities among its black and Latino HIV-positive patients for both mortality and medication rates, compared to a 15 percent higher rate in the United States for mortality and for medication
89 percent of its HIV-positive patients are in HIV-specific care within 90 days, compared to 50 percent in the U.S. within one year·
69 percent of all its HIV-positive patients have maximal viral control compared to 19 percent to 35 percent nationally

The other part of the announcement is that the best practices and tools that made this possible are being shared with the nation, http://kp.org/hivchallenge

Let us never see another study that talks about “unexplained differences” in the death rate of people with HIV based on their race, ethnicity, or sexual minority status.

Let us also never see another study about anything in health care that talks about “unexplained differences” for minority populations.

Thanks to Michael Horberg, MD, and the team of clinicians, staff, and members of Kaiser Permanente for demonstrating that being successful comes from people being cared for because they are human beings first.

Tune in to watch the announcement this morning at the Care Innovations Summit, around 10:00 am EST, http://www.hcidc.org

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Siri, show me my lab test results

Ted Eytan — Wed, 25 Jan 2012 12:51:36 +0000

View Siri, show me my lab test results on Flickr.com

“Ted, I cannot find your lab test results. You can view them in Kaiser Permanente’s mobile optimized kp.org”

It’s here.Similar Posts:

Siri, email my doctor

Ted Eytan — Wed, 25 Jan 2012 12:48:13 +0000

View Siri, email my doctor on Flickr.com

“Ted, I cannot email your doctor. You can email her through Kaiser Permanente’s mobile optimized kp.org”

It’s here.

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DC Care Innovations Summit Viewing Party at KP Center for Total Health

Ted Eytan — Tue, 24 Jan 2012 13:23:24 +0000

Care Innovations Summit Viewing Party at KP Center for Total… – Eventbrite. Washington, DC is at it again!

I’ve been spending this week gearing up for the Care Innovations Summit in Washington, DC, which will be on January 26, 2012, as well as a pre-event happening the day before. From what I have seen so far, I can say that passion for innovation will be filling the DC sky this week.

As luck/serendipity would have it, the actual summit is “checked in full,” however, Kaiser Permanente is hosting a viewing party with live link to the Summit at the Center for Total Health. That’s where I’ll be.

Hashtag is #cisummit , feel free to register at the link above before it fills and we’ll see you there.Similar Posts:

Photo Friday: Life’s better here – It’s True, DC is diverse

Ted Eytan — Fri, 20 Jan 2012 13:33:55 +0000

It’s True: We Have Little Tolerance For Stupid Rankings: DCist – I slightly modified the title of the post from DCist that I am referring to. However, it turns out that the frustration with the DailyBeast’s rankings about “tolerance” provided a good platform to list all the ways Washington, DC, doesn’t tolerate, it lives diversity.

As I wrote in this post back in 2008 (See: “Diverse communities are…” ), the data shows that diversity is positively correlated with happiness and fulfillment in a community, and in business, with increased profitability. Check it out.

In the meantime, this week’s photograph, taken in Washington, DC speaks for itself. This is why we love it here, because love always wins.

View ‘Love, Support, and Acceptance in 2012 – Miss Adams Morgan’s Glorya H in the Shaw Neighborhood, Washington, DC, USA’ on Flickr.com

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Are you integrating Intensive Behavioral Therapy for Obesity into your medical practice?

Ted Eytan — Thu, 12 Jan 2012 23:50:12 +0000

I recently posted about the “CMS Proposed Decision Memo for Intensive Behavioral Therapy for Obesity (coverage by Medicare)” and received this query. I don’t know the answer, so I’m posting it here to see about the wisdom/experience of the crowd. Please add what you know/what you’re doing in the comments!

(we are) trying to learn more about this is being done in the real world, post ACA. We’re just trying to learn the nuts and bolts to help providers get reimbursed for this service so that they will be encouraged to actually provide this counseling.

Incidentally, the final CMS Decision Memo for Intensive Behavioral Therapy for Obesity (CAG-00423N) – is now posted, feel free to look to it for reference, it discusses guidelines for coverage, along with the science behind the effectiveness for Intensive Behavioral Therapy for obesity (and there is documented effectiveness).

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A Patients Speakers Bureau you can use – SpeakerLink

Ted Eytan — Tue, 10 Jan 2012 18:49:08 +0000

SpeakerLink.org

On my walking meeting last week with Regina Holliday ( @reginaholliday ) and Kait Roe ( @kaitbr ) I left with an assignment, which was to write about SpeakerLink.

Not that long ago, a colleague said to me, “Ted, we can’t find a patient to be present at upcoming event x.”

I thought, “Out of 307,006,550 possible people in the United States, you couldn’t find anyone?”

I’m being hyperbolic; that’s not what they meant. They meant, a patient who’s available, interested, passionate, a good fit for an audience, can leave their job and family responsibilities, etc etc.

So really, the question wasn’t “does a patient exist in the world?” The question was, “Can we enter into a respectful relationship with another person who will teach us about their experience,” which we can now answer, “yes.”

Regina reminded me that my question about this was recorded by Dave deBronkart in 2009 (see: A Call for a Patients Speakers Bureau)

So now SpeakerLink exists, and it’s in full operation now. It has an engine to review potential speakers’ capabilities, requirements, and stories and enter into a respectful relationship where their contribution of time and passion is valued. In my initial complaint to Dave, I said that everyone at the meetings was getting paid to be there – except the patient.

SpeakerLink will reduce the friction of finding “the patient.” It will also broaden the field of patient speaking. All the rockstars I know are there, Regina, Sorrel King, Sue Sheridan, Dave, Trisha , as well rockstars-in-training like Kait .

What we could also see is any patient getting the chance to describe what’s needed for them to take time away from other responsibilities to share their experience. It could be a day off work and a taxi-ride (or in DC, Capital Bikeshare ). There hasn’t been a place to put these requirements together before so no matches could be made beyond the patients/people who are the most dedicated to being heard.

The network of speakers on SpeakerLink is actually patients AND professional caregivers and healthcare leaders – Regina’s gone through all of the design decisions in detail on her blog here. The site is not profit generating, and when registration fees are instituted in April, 2012, the proceeds will go to help other speakers get started. I believe all of this, because I was there in that room with all of the cameras rolling talking about it (see pic: http://flic.kr/p/9RGpBw ). Those were big cameras .

As Regina describes it to me, there are literally hundreds of details that impact a patient/person’s access to the podium that a health professional, with an advanced degree working in a marquee organization, takes for granted. This is also what SpeakerLink is managing behind and in front of the scenes.

Speaking of which, my next assignment is to write a letter of reference for Regina’s past work with my organization. It apparently has to be an actual letter because some health care organizations are unable/afraid to click through to hyperlinked content. I have an image in my head of a paper letter being part of the ramp onto that bridge that Regina talks about….

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Building of the global movement for health equity: what health care can do

Ted Eytan — Mon, 09 Jan 2012 17:37:44 +0000

ScienceDirect – The Lancet : Building of the global movement for health equity: from Santiago to Rio and beyond – Thanks to @katellington for sending this my way.

Contained within is a concise statement of where health care fits into social determinants. Worth a read to see what’s new in social determinants. And from the read, social determinants is more new than I thought….

…. there are three important roles for the health-care system (webappendix p 1). First is to ensure universal access to high-quality care, with increased focus on prevention and health promotion.13 Second, people in the health sector—from the Minister of Health to primary care professionals and medical and health organisations—should be the advocates for action on social determinants of health. There are good examples of cooperative working between health and other sectors. Third, ensure that routine monitoring systems are in place for health equity and the social determinants of health, undertake evaluation of policies on these topics, and increase the knowledge base.

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Photo Friday: A Year of Photos Edition

Ted Eytan — Sat, 07 Jan 2012 15:37:21 +0000

As I review my photographs from 2011, I can see what a image-filled place Washington, DC is, and how much innovation, dissent, equality, compassion, optimism, brilliance, that went on in the world touched my life personally.

Two of my photographs were selected by Washington, DC Metropolitan Blog WeLoveDC.com as bests for 2011. One of those is below, the other is the first in the series from 2011 below it ( Fireworks in Malcolm X Park )

In 2012 I have decided to take more photographs of people in Washington, DC. Let’s see how that works out. In the meantime, Enjoy my photo stream from 2011, sorted in order of “interestingness” from the Flickrnets.

Occupy DC, McPherson Square, Washington, DC, USA, October 22, 2011

Next Page ›

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Photo Friday: A new year with Kait and Regina

Ted Eytan — Fri, 06 Jan 2012 21:46:12 +0000

View Lunch with Regina and Kait 2012 8128 on Flickr.com

This week’s photograph shows Kait Roe ( @kaitbr ) and Regina Holliday ( @reginaholliday ) in front of Washington, DC’s most excellent Capital Bikeshare, in one of our most revered neighborhoods, Dupont Circle. We wanted to try the new ShopHouse Southeast Asian Kitchen, Chipotle’s New Asian Spinoff. I like prototypes .

I asked what we were going to do in 2012. I learned that Kait is working diligently to establish her employed presence (i.e. she’s looking for a job), and Regina is working diligently to promote the fabulous and long-awaited innovation that SpeakerLink.org is. It deserves its own post, coming shortly. It’s going to be a good year.

Isn’t Washington beautiful?

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Now Reading: Place, not race: disparities dissipate when blacks and whites live under similar conditions

Ted Eytan — Wed, 04 Jan 2012 17:33:07 +0000

Laveist T, Pollack K, Thorpe R, Fesahazion R, Gaskin D. Place, not race: disparities dissipate in southwest Baltimore when blacks and whites live under similar conditions. Health affairs (Project Hope). 2011;30(10):1880-7.

When I was reading about social determinants recently, I came across an error in one of Sir Michael Marmot’s writings, in this JAMA article (“Action on Health Disparities in the United States“). In it, he says:

The gap in life expectancy between men in Washington, DC, and in suburban Maryland is 17 years.

The error he made is that the 17-year gap is for African American men in Washington, DC, compared to men in Montgomery County, MD (I assume that’s the suburban he’s talking about), not the average of all men in Washington, DC. That gap is 9.1 years (as of 2007).

This paper is useful because it calls the racial distinction into question. It might be more accurate to say “a man living in Ward 8, Washington, DC” above, taking race out of the picture altogether, and therefore focus more on the Ward 8 neighborhood.

What the authors did was choose a community with a mix of African American and white residents with similar income, education, and location (they’re in the same community), interviewed 42 percent of them (1,489 people), and took their blood pressure. They then compared what they found to national statistics for the measures they assessed.

And….whites and African Americans with the same social determinants looked a lot more similar than different. There were a few notable differences.
African Americans still had higher blood pressure, albeit not as higher in this matched community
African Americans were no more obese, no more likely to have diabetes than their white counterparts
African Americans smoked less than their white counterparts
African Americans were more likely to have a health care visit within the past year

With this conclusion:

When whites are exposed to the health risks of a challenging urban environment,15 their health status is compromised similarly to that of blacks, who more commonly live in such communities.

I wonder even further if whites are less able to tolerate an unhealthy neighborhood environment, given that they smoke more and use health care less. This is just speculation on my part, though.

The study points out and reinforced what’s being discussed about social determinants already, which is that local conditions have a huge bearing on health and looking to customize interventions based on an individual’s genetics or behavior may not be as useful as taking a walk down the street where they live.

Tying this all back to Washington, DC, there’s a vibrant neighborhood blog scene here, so you can electronically walk the neighborhoods in an authentic, personal way. I’ve put together a link cloud of the major ones. Anacostia is Ward 8. See if you see the differences in place. If the differences aren’t obvious there, you can check out this post on local blog TheFightBack for a more intense view of life in Ward 8.Similar Posts:

Economist: Blogs blamed for cheapening debate yet they have enriched economics ( my experience with JAMA )

Ted Eytan — Wed, 04 Jan 2012 16:09:55 +0000

I found this article in the Economist very timely in the context of a recent experience I had with a well known peer reviewed journal (more on that below).

Economics blogs: A less dismal debate | The Economist -

Research (by two blogging economists at the World Bank) suggests that academic papers cited by bloggers are far more likely to be downloaded. Blogging economists are regarded more highly than non-bloggers with the same publishing record. Blogs have given ideas that failed to prosper in the academic marketplace, such as the “Austrian” theory of the business cycle, another airing (see article). They have also given voice to once-obscure scholars advancing bold solutions to America’s economic funk and Europe’s self-inflicted crisis.

The experience i recently had was when I sent this note to Journal of the American Medical Association, and got the attached response.

On Dec 27, 2011, at 12:19, jama-comments wrote:

Thank you for your comment. If you would like to send a letter to the
editor, you are welcome to do so at http://manuscripts.jama.com.

—–Original Message—–
From: Ted Eytan, MD
Sent: Monday, December 12, 2011 11:44 AM
To: jama-comments
Subject: Inquiry re: recent editorial Should Patients See Their Lab
Results? (JAMA Feedback Form)

————————————————————
Comments sent via JAMA Feedback Page
————————————————————
TO: jama-comments@ama-assn.org
NAME: Ted Eytan, MD
PREVIOUS PAGE:

http://jama.ama-assn.org/content/early/2011/11/22/jama.2011.1797.full

PROMOTIONAL USE: (not answered)
————————————————————
COMMENTS:
Dear JAMA,
Wondering if you would entertain another editorial, co-written by a
physician and patient, entitled “Shouldn’t patients get direct access to
their lab results?” that would be based on actual data rather than on
speculation?

I wrote a blog commentary here, thanks for entertaining the idea,

http://www.tedeytan.com/2011/12/09/9637

Ted Eytan, MD
Washington, DC

The response is a reasonable one in the world of the peer-reviewed journal (“format it the way we expect and maybe we’ll publish it”), however, it leaves one wondering “why go to the effort when I can just post my response in the blogosphere?”

The JAMA article itself has multiple links to share the article out in the social media space, but no space to comment directly on the article or receive trackbacks from social media responses, to share in. In other words, there’s talking, but not listening.

For that, there are now multiple channels outside of the peer-reviewed world, and as the Economist reports is happening in the field of economics, I think there is second guessing happening about the best venue to get ideas accepted in health care. See what you think, feel free to post your experiences.Similar Posts:

Photo Friday: Beautiful view of the US Capitol from Eckington Neighborhood, Washington, DC

Ted Eytan — Sat, 31 Dec 2011 02:40:34 +0000

View ‘Morning in Eckington 8117′ on Flickr.com

This week’s photograph was taken in one of Washington, DC’s most fascinating neighborhoods-in-transition, Eckington, as the sun rises, framing the United States Capitol Dome.

North Capitol street replaced Truxton Circle, which some hope will one day be restored as this neighborhood continues its dynamic rise like so many others have in this city.

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What we are up against in motivating health: Cognitive Science, Sex and advertising | The Economist

Ted Eytan — Thu, 29 Dec 2011 12:47:21 +0000

Cognitive Science, Sex and advertising: Retail therapy | The Economist – Cognitive sciences are now back in.

It is no wonder we are out-personned in motivating people to live healthy:

“It is now fashionable to study brain waves to see what lights up upon hearing the words “Coca Cola”, or to measure pupil dilation in response to brand logo.”

Mention of the IKEA effect:

“Baking is an expression of femininity, he explained, so when a woman pulls a cake or loaf out of the oven, “in a sense it is like giving birth”. Thus mixes that require the cook to add only water are threatening to women, since their role is marginalised; these days, thanks to Dichter, nearly all such mixes involve adding eggs, a symbol of fertility. In her book “Food is Love”, Katherine Parkin notes the way he encouraged advertisers to impress on women the importance of cooking as a way of showing love.”

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New Yorkers Living Longer Than Ever, Outpacing National Trend, a look at the data

Ted Eytan — Wed, 28 Dec 2011 13:17:23 +0000

New Yorkers Living Longer Than Ever, Outpacing National Trend – speaking of life expectancy:

From 2000 to 2009, New York City life expectancy rate at birth increased by nearly 3 years, far greater than the nationwide increase of nearly 1.5 years. The life expectancy of both men (78 years) and women (83 years) increased.

Since I had just reviewed this article on life expectancy of US counties, I pulled the supplemental data on New York (note, this analysis ends at 2007), and here’s what it shows (click to enlarge):

From: “Kulkarni et al 2011 Falling behind life expectancy in US counties from 2000 to 2007 in an international context”

New York county is indeed just 1 year behind the 10 international countries with the highest life expectancies in the world, up from being 6 years behind in 2000. For women, there is also improvement, from 7 years to 3 years behind.

When you plot this on a map (thanks again, Community Commons !), you can see nearby county Queens also enjoying a high life expectancy (1 year ahead and 3 years behind international peers for men and women, respectively:

Life Expectancy, New York City and adjacent counties (note data source, not as current as NYC’s data, this is just for relevant comparison)

You can also see, though, that Bronx county is not as fortunate, with its 2007 data showing a 21 year and 18 year lag in life expectancy advancement compared to its international peers (see table and image together).

As I read the information linked in the press release above, it appears that New York City has genuinely adopted a social view toward improving the health of its society (and my past visits support this):

The City’s health interventions – including its smoking prevention programs and expanded HIV testing and treatment – have contributed to this success, with improved outcomes in HIV infection, heart disease and cancer prevention and treatment playing the largest role in the increase in life expectancy.

So, They appear to cite success in improving their health system, and that there is more to be done…

Going beyond life expectancy as a measure of health

If you’d like to do some sleuthing on your own, you can go to the Community Commons site and overlay lots and lots of data over these counties to understand what the differences might be.

You can also saunter over to County Health Rankings and compare counties for dimensions beyond life expectancy. You can see a comparison I set up here between New York, Bronx, and Queens, and when you factor in other factors, you can see more nuances, such as New York City’s lower unemployment rate, higher education rate, but also higher reported “poor or fair health” self-assessment, higher poorer physical health and mental health days relative to Putnam county (the leader), and more children in poverty and higher air pollution days, that balance things out. County Health rankings scores New York City above average (25 out of 62) for Health Outcomes, and leading for Health Factors (9 out of 62). Bronx is 62 out of 62 in both.

I would less lament that a subway trip to Bronx County from New York results in a drop in life expectancy than I would celebrate that a subway trip into New York City brings knowledge about what’s successful in improving health (glass 3/4 full). It seems like New York is on a good track, improving clinical care access, and next understanding the impact of the social environment beyond health care:

We will keep working to make New York City a healthier environment, which will not only lengthen life expectancy but also improve the quality of life of New Yorkers.

See what you think, post in the comments.

Thanks to Emily Hackel ( @emilyhackel ) for the tweet that started this exploration.

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Now Reading: Understanding the science of life expectancy #SDOH

Ted Eytan — Tue, 27 Dec 2011 15:06:55 +0000

Kulkarni S, Rector AL, Ezzati M, Murray C. Falling behind: life expectancy in US counties from 2000 to 2007 in an international context. Population Health Metrics. 2011;9(1)

The concept of tracking life expectancy as a measure of a society’s health hasn’t been a part of my (should I say most?) physician’s experience – it’s just been a yearly announcement on a news show. When I went to England in 2010 I was impressed that it’s much more deeply thought of (see below), and more recently in my social determinants reading, as a key metric to understand social determinants of health.

It’s done in the lead in on this paper:

In the Washington, D.C., metropolitan area, for example, there is a nine-year increase in life expectancy as one takes the subway ride on the Blue Line from downtown Washington to Fairfax County, Virginia.

I decided to dig deeper and reviewed the paper referenced in this post, and I was immediately taken aback by this piece of information:

Tracking county disparities after 2002 until 2009 was impossible, because the US government did not release county-level mortality data during this time period.

The paper doesn’t say why this is, other papers from this time period (by these same authors) confirm this lack of access, but none say why (if anyone knows, post in the comments).

What they did here is look at the life expectancy “frontier,” which is the expectation of where the life expectancy of a particular county was compared to the life expectancy trajectory of the countries with the highest life expectancy. And,

there’s huge variation in US counties around life expectancy
US counties are mostly behind the frontiers of peer nations
US counties have been falling behind from 2000-2007

In 2007, county-level life expectancies range from 15 years ahead of the international frontier to over 50 years behind for men and 16 years ahead to over 50 years behind for women.

There’s a nice discussion at the end of what to do about this and how the health system fits in to this issue. Data point: 1.8% of US deaths annually are attributed to lack of health insurance coverage, and there isn’t a difference in access to health care between people in the lowest and the highest life expectancy tiers. It’s worth reading this section because a person can interpret the health system’s role in multiple ways when looking at this data.

As a comparison example, I did some searching around online (okay, a lot of searching around online), to compare the England experience to ours, and the concept of watching life expectancy seems much more ingrained. See: Mortality Monitoring bulletin: Life expectancy and all-age-all-cause mortality, and mortality from selected causes, overall and inequalities . And within a Primary Care Trust (most closely equivalent to a US Health Plan), a thorough analysis of the trend, and causative factors. See page 5 of “Joint Director of Public Health Anuual Report 2011 – Warwickshire NHS” ). There’s even an animated map showing the increase in life expectancy across England.

I don’t know for sure what our health system should be doing differently. Life expectancy is tracked within the United States’ HealthyPeople 2020 under General Health status. What would it be like if we started with life expectancy (or disability free life expectancy) in our health planning and innovation, though? Would people (patients) identify better with “the health system is allowing me to live a longer healthier life” than “the health system is lowering my cholesterol level”?

Of course, I looked up the data for Washington, DC, and in the appendix of this paper, it shows that the 2007 life expectancy of a Washington, DC male and female are 31 and 28 years behind the international frontier. At least this is better than 49 years in 2000 for men, a little better than 29 years for women in 2000. But far worse than Montgomery County, Maryland, just a few miles away that’s 12 years ahead of the international frontier for men, 3 years ahead for women. If you’d like to see a more graphical version, tied to DC metro maps, check out A Short Distance to Large Disparities in Health.

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Photo Friday: National Menorah and Occupy Freedom Plaza, Diversity of ideas in Washington, DC

Ted Eytan — Fri, 23 Dec 2011 22:33:39 +0000

View National Menorah on Flickr.com

View 2011 Occupy Freedom Plaza 7838 on Flickr.com

This week’s photograph is a pair. One, of the National Chanukkah Menorah framing the White house. The other, taken about 500 feet away, of a rainbow flag celebrating LGBT diversity, framing Freedom plaza and the Occupy camp that exists there (The DC Occupy Camps are among the last ones standing in the United States). Behind the Occupy camp include the Department of Treasury, and the Willard Hotel, where the term “lobbying” came from.

Both scenes were peaceful.

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