Date: Fri, 8 Feb 2008 07:17:17 -0500

From: Elbert D Glover <eglover1@UMD.EDU>

Subject: Re: healthy people cost more study

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It's a rather interesting way to view the data, it's like saying that nonsmokers cost us more than smokers because...since nonsmokers live longer they are bigger drain on social security, consume more, and over a lifetime will ultimately have higher medical costs because they lived longer, etc.

This might be a good time to recommend the 1976 classic: Lies, Damn Lies, and Statistics: The Manipulation of Public Opinion in American and the 1954 classic: How to Lie with Statistics.

glover

Elbert D. Glover, PhD, FASHA, FAAHB, FRIPH Professor & Chair University of Maryland College Park School of Public Health Department of Public & Community Health (PCH) Director, Center for Health Behavior Research (CHBR)

2387 HHP Valley Drive

College Park MD 20742

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#239

Date: Fri, 8 Feb 2008 09:39:18 -0400

From: "Randolfi, Ernie" <randolfi@MSUBILLINGS.EDU>

Subject: Re: healthy people cost more study

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I have lost the reference, but a few years ago one of the multinational tobacco companies was lobbying an eastern European government to not impose taxes on tobacco because of the argument that smokers died sooner saving the country millions on social security benefits to the elderly.

Ernie

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#240

Date: Fri, 8 Feb 2008 09:36:00 -0500

From: Penny Bailey <penny.bailey@TRHD.DST.NC.US>

Subject: Re: healthy people cost more study

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Maybe it's a cultural thing ...there are a lot of groups that respect their elders.

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#241

Date: Fri, 8 Feb 2008 09:41:21 -0500

From: Heidi Steiner <steiner.he@WOOSTER.K12.OH.US>

Subject: End of Life care/cost

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Re: age related medical care costs. My father died at age 97 in his home

with Hospice care. He had a bad last week of life. Thing is he received 3

purple hearts and survived WWII never returning to the hospital until he

was 94 to remove a cancerous tumor. As I was bathing him in his last days

his scar from surgery was so well healed you could hardly see it. He was

in remarkably good health having good genes. He said to us "It just goes

to show you that if you live long enough you're going to get something". I

feel that prevention is so important. Eating right, exercising moderately

and laughing often with friends goes a long way. Our world is so very

complex and overwhelming. We all get caught up in the fast pace of

technology, and achievement...........sometimes we just need to relax. My

dad worked hard, played hard and relaxed well. He had a living will, and

all other necessary documents in place so we could care for him as he saw

fit. He didn't cost "the system" very much at all. He set the example for

me and my siblings in how to live and die.

As a school nurse I see families take their children to the doctor for

little reason. Insurance, whether through (employer) private provider or

medicaid pays for this privilege. When did this entitlement begin? I

remember 30 plus years ago my husband and I paid for all of our children's

well child check ups and immunizations. Now the young people at work can

take their children to the Dr. and walk out without paying anything. (Well

this yr. we started with a $10.00 copay) The system needs changed from all

sides......Provider costs, insurance costs/benefits, personal health care

responsibility and active engagement in prevention measure. Who's

first........paper, rock, scissors?

Heidi Steiner RN, M.Ed., NCSN

School Nurse

Wooster City Schools

"You cannot educate an unhealthy child and you cannot keep an uneducated

child healthy." Former U.S. Surgeon General Jocelyn Elders.

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#242

Date: Fri, 8 Feb 2008 09:04:25 -0600

From: "Mark J. Kittleson, PhD, FAAHB" <kittle@SIU.EDU>

Subject: Sin taxes

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Another issue that's always fun to discuss with students/colleagues.without

sin taxes (smoking, alcohol and gambling) how many state budgets would

crumble?

Mark J. Kittleson, PhD, FAAHB

Southern Illinois University

Professor, Health Education

ata\Microsoft\Signatures\www.kittle.siu.edu>

ata\Microsoft\Signatures\www.hedir.org>

Director of Graduate Studies

Health Education & Recreation

618-453-1841 Office

618-453-1829 FAX

SKYPE ID: mark.j.kittleson

618-912-4445 SKYPE Phone

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#243

Date: Fri, 8 Feb 2008 09:06:14 -0600

From: "Mark J. Kittleson, PhD, FAAHB" <kittle@SIU.EDU>

Subject: HEDIR Award

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Folks,

We're a week away from the deadline for the 2008 HEDIR Award. If you know

of any health educator who has done extraordinary things with technology,

please consider nominating them.

Mark J. Kittleson, PhD, FAAHB

Southern Illinois University

Professor, Health Education

ata\Microsoft\Signatures\www.kittle.siu.edu>

ata\Microsoft\Signatures\www.hedir.org>

Director of Graduate Studies

Health Education & Recreation

618-453-1841 Office

618-453-1829 FAX

SKYPE ID: mark.j.kittleson

618-912-4445 SKYPE Phone

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#244

Date: Fri, 8 Feb 2008 10:45:16 -0500

From: "Dr. Molly Laflin" <mlaflin@BGNET.BGSU.EDU>

Subject: What's so wrong about facing the truth?

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In contrast to others who have written of their contempt for this

study, I think it is an interesting bit of research. There is

nothing in the report about denigrating healthy people or those who

encourage people to be healthier. What it does do is suggest that

financial gain may not be a legitimate goal of many health promotion

programs. The piece ends with ''We are not recommending that

governments stop trying to prevent obesity,'' van Baal said. ''But

they should do it for the right reasons.'' That statement is

absolutely true. What is so awful about that?

Molly Laflin

>

>Healthy People Cost Society More: Study

>

>Feb 4, 2008, Associated Press

>

>London - Preventing obesity and smoking can save lives, but it doesn't save

>money, researchers reported Monday.

>

>Chicago Sun Times article:

>

--

Molly Laflin, PhD,

Professor and Program Area Coordinator of Health Promotion

School of Family & Consumer Sciences

215 Eppler North

Bowling Green State University

Bowling Green OH 43403

419-372-0301 work, 419-372-8216 fax

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#241

Date: Fri, 8 Feb 2008 08:45:42 -0800

From: "Lawrence W. Green" <lwgreen@COMCAST.NET>

Subject: Re: HEDIR-L Digest - 3 Feb 2008 to 4 Feb 2008 (#2008-32)

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Debra, Michael, et al. The question Debra poses has fascinated me since my

earliest stirrings of interest in health education. My best shot at sorting

out the issue of whether and how knowledge (belief, recognition, recall,

understanding, synthesis and its other variations) affect health and its

mediating behavioral variables was an article in the Amer J of Public Health

in 1977 (I think), called something like "Some dilemmas for the evaluation

of health education..." It probably should have been titled paradoxes rather

than dilemmas. I puzzled particularly over the placebo effect, where the

only substantive knowledge at work (in the usual placebo controlled trial;

this was before informed consent was so torturous) was the knowledge that

one had received a treatment. I argued that we might sell more health

education at least in the patient care setting if we packaged it as

"organized placebo." A recent article in the Journal of Irreproducible

Effects was titled something like "A Double-Blind Randomized Efficacy Trial

of Placebo, Extra-Strength Placebo, and Generic Placebo." I would want to

add another arm to that trial to provide for a pseudo-placebo.

Seriously, coming to Debra's core question, the best answer I have settled

on is that knowledge, like any other variable at work in affecting health

behavior, does not operate alone. It is received or recalled in a context,

and all of the environmental, interpersonal and media influence at work in

that environment, combine to produce whatever effect is observed. The best

evidence of this reality is the comparative complex trials in which

comprehensive programs are compared with not-so-comprehensive programs. To

isolate the unique effect of knowledge (in all its complexity), one would

have to conduct a randomized trial of a comprehensive program with all the

presumed efficacious interventions in the experimental group and then a

control group with everything but the intervention that would increase

knowledge.

Short answer: For the individual who has everything else, an increase in

knowledge may be sufficient to tip the scale to action; for everyone else,

knowledge is necessary but not sufficient. --Larry

Lawrence W. Green

66 Santa Paula Ave.

San Francisco, CA 94127

415-839-6360 (home)

415-205-6615 (mobile)

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#241

Date: Fri, 8 Feb 2008 10:55:52 -0600

From: Mal Goldsmith <mgoldsm@SIUE.EDU>

Subject: Re: HEDIR-L Digest - 3 Feb 2008 to 4 Feb 2008 (#2008-32)

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I have always seen knowledge a bit like common sense. When it suits us we

use it and when it doesn't we reject it. Now if we can get to the real

motivators involved in that decision we may be on to something.

Mal Goldsmith, Ph.D., CHES

Professor and Coordinator of Health Education

Department of Kinesiology and Health Education

Box 1126

Southern Illinois University Edwardsville

Edwardsville, IL 62026

618-650-3857 (ph)

618-650-3719 (fax)

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#242

Date: Fri, 8 Feb 2008 11:07:10 -0600

From: Michael Pejsach <healthedman@COX.NET>

Subject: Re: HEDIR-L Digest - 3 Feb 2008 to 4 Feb 2008 (#2008-32)

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Alas-- the word: motivators (constructs?) of behavior change. We are

on to something, as feelings, attitudes, values and/or beliefs are the

"the real motivators involved in that decision.'

Michael Pejsach, Ed.D.

healthedman@cox.net

drmichael@redphoenixmartialarts.com

Life&Health Enhancement Services

Red Phoenix Martial Arts

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Metairie, LA 70006

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#243

Date: Fri, 8 Feb 2008 09:16:59 -0800

From: Mark Fulop <markfulop@YAHOO.COM>

Subject: Re: Service Learning Syllabus

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Michael,

Don't forget to check out the service learning clearinghouse. A quick serch of their database is here:

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#244

Date: Fri, 8 Feb 2008 10:05:14 -0800

From: Mark Fulop <markfulop@YAHOO.COM>

Subject: Cynisicm and critical thinking is not contempt

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Molly,

First, I am not suggesting contempt for the study. I just think it is funny what we spend our money on trying to prove or disprove. My cynicism is for the resources wasted on flawed research.

Second, as others has more eloquently expressed, the premise of the study is oversimplified and the true cost/benefit and ROI on prevention needs to be measured by more than cost savings to the health care system. The economics of lost productivity, the lost economic opportunity represented by the excess consumption and excess production associated with fast foods are just a few other other variables that influence the true cost of obesity, (or many other behavior induced chronic diseases). Indeed, if you go to the editors comments on study rather than the media coverage of the study, you would read:

"As with all mathematical models such as this, the accuracy of these findings depend on how well the model reflects real life and the data fed into it. In this case, the model does not take into account varying degrees of obesity, which are likely to affect lifetime health-care costs, nor indirect costs of obesity such as reduced productivity."

Finally, these days I am highly cynical of the state of research overall. I mean after 8 yrs of corporate and government assault on science with a deliberate, militant and proactive suppression, misrepresentation and even falsifying research in content area after content area (lead, climate science, abstinence, formaldehyde, drug efficacy, to name a few) by agency after agency (EPA, DHS, NOAA, NIH to name a few,

===

M

Mark Fulop, MA, MPH

Portland, OR