Our Stone Age Bodies in a Modern World

We all know we’re supposed to eat sweets sparingly, but the CRAVING is still there. It can be unstoppable, and NPR Books just published an article that explains the cause from an evolutionary biological perspective.In short, our Paleolithic bodies were trained to crave sugars because they were a quick energy supply that wasn’t usually available. Now that we have a lot of access to sugary foods, we’re running into a variety of conditions that are caused by our bodies not being able to process this (relatively) recent  uptake in this type of food.

Fascinating, right? The article was prompted by an upcoming book called The Story of the Human Body by Daniel Lieberman of Harvard University. The entire article is a very interesting insight into the book’s content, but perhaps the most relevant part was a discussion of how our ancient bodies deal with modern stress:

Stress creates this vicious cycle, this positive feedback loop. When you’re stressed you crave unhealthy foods, but when you’re stressed you also have a harder time sleeping, and when you have a harder time sleeping that elevates your levels of stress. It just sets off this chain reaction that keeps going on and on. Now normally, when we’re stressed, the stimulus that causes the stress should be a short-lived one; that’s what evolution predicted. … So a lion chases you, that’s a very stressful event, obviously, hopefully you managed to run away from the lion … life goes on. But much of the stress we create today results from social conditions. If you think about the most stressful things we experience, they’re often our lives — they’re our jobs, our commutes, not having enough money, the list goes on. Those, of course, elicit chronic levels of stress. And when stress becomes chronic, then it helps feed a variety of mismatch diseases that make us ill, that make us depressed, that make us anxious, that make us overweight, which causes more stress and then keeps the cycle going.

To learn more about how the human body has evolved to land us in our current state, check out Dr. Daniel Liebarman’s website.

Libraries and New Health Care Laws

"Health Care" by Jerry Wang, the Noun Project CC By 3.0

“Health Care” by Jerry Wang, the Noun Project CC By 3.0

Starting today, consumers in all states will be able to choose new affordable health insurance options through the new Health Insurance Marketplace.  The following organizations received money from the Center for Medicare & Medicaid Services (CMS) to serve as Navigators, “in-person resources for Americans who want additional assistance in shopping for and enrolling in plans”, in Michigan: Community Bridges Management Inc., Arab Community Center for Economic & Social ServicesAmerican Indian Health & Family Services of SE Michigan, Inc., and Michigan Consumers for Healthcare.

As a library serving the U-M campus and surrounding community, the library’s blog is a place to provide the public with access to information.  Libraries, like THL, may receive queries about these new options.

“Although the role of libraries seems clear to most in such a rollout—the neutral provision of information and resources about ACA to those who need it—some critics aired concerns that libraries were being used as pawns to advance a partisan agenda.” (American Libraries Magazine)

American Library Association President Barbara Stripling issued a statement in July 2013 about how libraries will respond to inquiries about the Affordable Care Act:

“The American Library Association and other groups are working to be sure librarians and the public are aware of information on the new law.

Just as our communities turn to libraries for help to learn about citizenship and passport requirements, use public access computers to get disaster relief information and obtain assistance with copyright and patent questions, we expect libraries will receive many inquiries from the public about the Affordable Care Act.

Decisions about how libraries will respond to inquiries about the ACA will be made by local libraries. As always, libraries do not promote specific programs or points of view, but provide the public with balanced, unbiased access to information.”

With more specific questions about how the ACA affects you, please refer to the following resources: University of Michigan Record Update Healthcare.gov, and the Center for Consumer Information and Insurance Oversight.

The American Diet: Lots of Cheese

The Center for Science in the Public Interest released a report card called “The Changing American Diet” yesterday and, as usual, there’s good news and there’s bad news. . Let’s start with the good news…


  • Eating less sugar, shortening, beef, whole milk and flour
  • Eating more chicken and yogurt
  • Eating about 100 less calories a day than in 2000-2007

Not so good..

  • We’re still eating about 500 more calories/day than in 1970
  • Fruits and vegetable intake hasn’t budged
  • Americans earned a D+ on sweeteners thanks to sugary drinks
  • We are eating A LOT of cheese, about 23 pounds/year

Overall, it seems that there are some positive trends underway, but they’re moving slowly. If Americans want a better report card, the

It’s time to eat less—less red meat, less cheese, less starches, and less sweets (and the shortening that they often contain). If Americans want straight A’s, they’ve got a little work to do.

I know- cutting down on cheese will be hard. But The Center for Science in the Public Interest has made a strong case for the cut back and it seems prudent to follow their lead. Or at least make sure you’re eating lots of grapes with your occasional cheesey treat.

UMHS 5th Most Social Media Friendly Hospital

Congratulations are in order! MHADegree.org, an organization that advocates for healthcare administration worldwide, recently cultivated a list of the 50 most social media friendly hospitals. They found that UMHS was the 5th best hospital in terms of social media use.

To compile the list, they looked at the number of followers each institution has on different platforms. They also weighted more popular social networking sites to have more possible points possible.  UMHS did particularly well on Facebook and YouTube, but didn’t rank very well on LinkedIn.

Using social media can be an important tools for hospitals that until recently were widely underutilized.  For example, hospitals can use social media to gather feedback from patients or market their organizations.

To illustrate this trend, MediaBistro created an inforgraphic on how hospitals are using social media. Check it out for a visual representation of the current trends!

Resources: Affordable Care Act in Michigan

Michigan map from The Century Company's 1897 atlas, digitized by the Stephen S. Clark Library, University of Michigan. Public domain.

Michigan map from The Century Company’s 1897 atlas, digitized by the Stephen S. Clark Library, University of Michigan. Public domain.

Michigan representative John Dingell has created a locally relevant guidebook on the Affordable Care Act (also known as Obamacare) and how it relates to Michigan residents. We’ve previously covered resources from the federal government, but Dingell’s efforts focus on questions and information specifically tailored to Michigan residents.

You can see the full list of questions here and access a PDF of Representative Dingell’s guidebook here.

The Myth of Supplements

Via The Atlantic’s The Vitamin Myth: Why We Think We Need Supplements :

"Vitamin" by James Keuning 2012 for The Noun Project, CC0

Vitamin” by James Keuning 2012 for The Noun Project, CC0

Nutrition experts contend that all we need is what’s typically found in a routine diet. Industry representatives, backed by a fascinating history, argue that foods don’t contain enough, and we need supplements. Fortunately, many excellent studies have now resolved the issue.

A bevy of recent research studies have actually shown detrimental effects of supplement usage (including cancer risk, heart disease, and shortened lifespan ) – and yet we continue to purchase supplements in droves. The frenzy can be largely attributed to one man, Linus Pauling, “a man who was so spectacularly right that he won two Nobel Prizes and so spectacularly wrong that he was arguably the world’s greatest quack.

Vitamins have been billed as essential in the battle against free radicals, and “although it’s clear that free radicals can damage DNA and disrupt cell membranes, that’s not always a bad thing. People need free radicals to kill bacteria and eliminate new cancer cells. But when people take large doses of antioxidants, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state in which the immune system is less able to kill harmful invaders. Researchers have called this ‘the antioxidant paradox.’ Whatever the reason, the data are clear: high doses of vitamins and supplements increase the risk of heart disease and cancer; for this reason, not a single national or international organization responsible for the public’s health recommends them.

Read the full article here.

Now, I take vitamin supplements regularly, and I don’t believe that this article or the studies mentioned in it are wholesale indictments of the entire  process – but I do think they signal important points that consumers and patients should be aware of: that vitamins should not be viewed as a panacea of variety of conditions, and that we need to be cognizant of dosage levels.

New Report: The Global Burden of Disease & the State of US Health

The Institute for Health Metrics and Evaluation (IHME) at the University of Washington has recently released a new report, The State of US Health: Innovations, Insights, and Recommendations from the Global Burden of Disease Study

Significant changes in life expectancy by county, The State of US Health: Innovations, Insights, and Recommendations from the Global Burden of Disease Study page 40, CC BY NC ND 3.0

Significant changes in life expectancy by county, from The State of US Health: Innovations, Insights, and Recommendations from the Global Burden of Disease Study page 40, CC BY NC ND 3.0

“The Global Burden of Disease (GBD) approach…is a systematic, scientific effort to quantify the comparative magnitude of health loss due to diseases, injuries, and risk factors by age, sex, and geography.” The IHME report is based on seven papers from the Global Burden of Diseases, Injuries, and Risk Factors study (2010) that appeared in The Lancet and American results from the July 2013 issue of the Journal of the American Medical Association.

IHME also has a complementary report on GBD evidence to guide policy.


A tip of the hat to Patricia, for telling me about this publication.

HealthCare.Gov: The New Guide to Marketplace Health Insurance

This week the federal government launched a new consumer-focused website and 24 hour call center to provide information on the coming Healthcare Insurance Marketplace, which will help people buy private insurance or locate free or low cost government options under the Affordable Care Act (or, Obamacare).


Right now HealthCare.Gov has fairly general information, but is a good start for consumers who want to learn more about the Health Insurance Marketplace before the open enrollment coverage period begins in the fall. Website functionality will continue to expand through the summer, and 24 hour help is also available through a variety of mediums. You can chat online with a representative, or you can use the 24 hour call center at:

  • 1-800-318-2596
  • Or 1-855-889-4325 for hearing impaired users with TTY/TDD technology

Important Dates:

  • October 1, 2013: Open enrollment begins
  • January 1, 2014: Coverage begins
  • March 31, 2014: Open enrollment ends

You can keep up with the conversation by following @HealthCareGov. The New York Times also has coverage on the new HealthCare.gov and its interaction with the Affordable Care Act.

Nationwide Hospital Charges

On the heels of yesterday’s post on U-M’s analysis of its visualization activities, today’s post also touches on the impacts of visualization, although on a much broader scale. The New York Times recently released an interactive data visualization map that tells you how much hospitals charge per procedure. You can search by location (state & zip code) and see how the charges compare to national averages. Visualization is based on 2011 data collected from 3,300 hospitals and includes the top 100 common procedures (including hip replacement, heart operations, and gallbladder removal).  Naturally, there is an accompanying article.
The pricepoints that the NYT used to build its interactive map comes from the Centers for Medicare & Medicaid Services, and the full (warning: massive) dataset can be found here.
UMHS reported costs slightly above the national average, but AnnArbor.com points out that it:
doesn’t mean patients or their insurance companies are paying those charges…Patients then pay whatever’s left after the insurance or Medicare payments.
UMHS Medicare reimbursement was also high, to which UMHS Headlines responded:

The payment we receive for treating Medicare patients is set by the federal government, not us, and takes into account how sick the patient is. Since we care for some of the most acutely ill patients in the country, including transfers from other hospitals and patients with underlying conditions that complicate their care, it is not surprising that we should be reimbursed at a higher rate.

Our Medicare reimbursement also includes payments that offset some of our costs for caring for a disproportionate share of uninsured patients, and for paying for the salaries, training and supervision of more than 1,100 resident physicians.

Read the full UMHS response here, and the AnnArbor.com article here.

Shopping for Health Insurance

I heard e-Patient Dave speak at a conference last year.  Great story, great message.

In this blog post, he talks about shopping for health insurance, a story which is sadly familiar to myself and many others, I am sure.

I keep hearing disparaging things about what lousy consumers patients are – unable to understand how things work, unable to understand the options. Well, as I often say in my speeches, in any other industry you go out of business if consumers don’t understand you – because customers ditch you. But in medicine we consumers can’t easily do that. Heck, we can hardly get our hands on information in the first place.

Case in point: when I shopped for health insurance in 2011, I found out just how slanted the table is when companies offer insurance and consumers buy it.


Which one would you choose? Your answer may be different from mine: do you anticipate lots of bills or little? That’s always the choice with insurance – and you can’t answer it if you don’t understand how each option plays out.

Said differently: You can’t be an informed consumer if you don’t have information you understand.

Read the full blog post (and others) here.