Physicians who personally engage in an active lifestyle are likely to encourage their patients to become active. During my 27 years of practicing medicine, the most common advice given to patients that they fail to follow is to exercise on a regular basis to improve the quality and longevity of life. We know that physical activity, other than work, is a major factor in decreasing the risk for developing diabetes, cancer, hypertension, heart disease, obesity, and rheumatoid arthritis. Exercise, such as walking, is a major treatment for back pain and new studies reveal that patients who involve themselves in the recommended exercise protocol can tolerate chemotherapy, if needed. Adherence to an exercise program continues to be difficult for most patients.
A telephone survey conducted by the CDC verifies what I have experienced in my practice. Only 20%, one out of five adults, of the American public adheres to the guidelines of aerobic and resistant exercise recommendations for optimal health. Men seem to adhere better than women. Adherence to recommendations decreases as one becomes older and this is when exercise is most needed.
I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
A common dilemma that I experience as an African American physician is giving advice and getting patients to follow the advice about weight reduction. People have a tendency to hear what they want to hear and do what they want to do when it comes to following the doctor’s advice.
Recent information has revealed the best way for patients to lose weight and maintain the loss. The study included people who were 45 years and older, had a poor diet, and were inactive. Many of those reading this tip fall into this category. The people participating in the study were divided into four groups. The first group exercised and dieted, the second group only exercised, the third group only dieted, and the last group
exercised and dieted a few months later. The final outcome showed that patients who combined exercise and a healthy diet fared better than the others. In order to shed pounds and keep it off, you must combine exercise and a healthy diet for a lifetime.
I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
Over the past several months, some of my former patients have returned for medical care after making the decision to discontinue their care years ago. The reasons for leaving were dissatisfaction with my style of practice and failure to believe the diagnosis.
Some patients attempted to return after being admitted to the hospital for end stage heart disease, end stage renal failure, debilitating stroke, prostate cancer, and diabetic complications. Some patients were readmitted to my practice while others were not. The sad thing is none of this had to occur. My style of practice is unique, but is always in the best interest of the patients' health.
I want you to be aware that on the horizon of patient care reimbursement is the principle of "pay for performance.” It means that physicians are reimbursed based on the medical care provided to their patients. Your chances of getting the doctor you want may be based on the type of patient you have been in the past and your compliance to the medical advice given. Do you make it easy for your physician to provide medical care?
I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
We’ve known for some time now that the United States has a weight problem and African Americans, poor people, and other underserved populations are most affected. Obesity is a major health problem for African American Men and Women.
Magazines and infomercials often claim to have the answer to this epidemic, but this serious health issue is very complex. Lately, politicians have weighed-in by suggesting a ban on sodas and limiting what foods can be purchased with public aid, both welcomed but limited solutions in my opinion. Getting politicians to have open dialogue on this health issue is a step in the right direction. Years ago when I was the Chairman of the Governor’s Council on Physical Fitness, physical education was deleted from the school’s curriculum by our politicians. This move greatly contributed to South Carolina’s current obesity dilemma.
Greenville Health System will host its seventh annual Minority Health Summit on Saturday at the BI-LO Center from 11 a.m. to 2 p.m. The event will focus on obesity and include Dr. Benjamin Carson, a renowned pediatric neurosurgeon; Cullen Jones, an Olympic gold medalist swimmer; and Dr. Ann Kulze, a wellness and nutrition expert. I am also excited about participating in the summit again. I will be discussing myths and truths about weight problems.
The Minority Health Summit has proven to be a good venue to share information with the Upstate’s minority community and it is critical that we discuss the causes and effects of obesity.
The National Medical Association, which is the organization made up of primarily of Black physicians, will be discussing all aspects of Obesity in the Black community at its national conference in July.
Our country’s obesity epidemic is multifaceted.
Simply telling people to reduce calories and exercise is not enough.
Obesity is a problem affecting the entire population, but African Americans and Hispanics are diagnosed at even higher rates. Nationally, 35.7 percent of adults are obese. Nearly 50 percent of African Americans and 39 percent of Hispanics are obese. Four out of five African-American women in the United States are overweight or obese.
Recently, the term “food desert” has surfaced to describe low-income neighborhoods where it is difficult to find fresh fruits and vegetables. People living in these neighborhoods are disproportionately overweight. Sidewalks and bike lanes are also scarce in these neighborhoods, and this missing infrastructure discourages exercise. It is encouraging that these important topics have become part of our conversation on obesity. Also, keep in mind what we drink is just as important as what we eat. Sodas and other sweet drinks contribute significantly to obesity in the Black community. A serious look at what I call the “Church Diet” and “Repast Diet” must take place and changes must occur.
We also must acknowledge that physicians and patients need to have better conversations about obesity. Some physicians shy away from talking to patients about their weight to avoid offending the patient, while other physicians assume the patient has accepted being overweight and doesn’t want to change. I also must admit that physicians should use more tact when discussing weight, but patients also make it difficult to have these much-needed conversations. Patients, particularly Black women, have left my office and never returned after I’ve suggested they lose weight. Since then, I’ve had to change my approach to having this discussion.
In 2011, I gave what I called a “beauty shop talk” at an African American Church in Greenville, SC sponsored by the hospital system entitled So You Think You are Fine? I humorously addressed the barriers that Black women and physicians have experienced during the obesity discussion. It was very well received by 300+ Black women who attended. I opened the discussion by asking permission to have the obesity conversation and introduced the term “Diabesity,” that showed the relationship between diabetes and obesity.
People must understand what a healthy weight is
and the dangers of being overweight.
Obesity is leading to increased rates of cancer, hypertension, diabetes, heart disease and osteoarthritis. As a result of early onset of obesity the above mentioned health disparities are being seen at an earlier age. Fast food nutrition and the sedentary lifestyle of adults are being passed on to our children, and as a result we are seeing record numbers of adolescents and young adults diagnosed with chronic diseases much earlier in life.
Unfortunately, many African Americans have skewed views on what a healthy weight is and have begun to accept obesity as a cultural trend. We must have a major change in mindset and recognize that being “big boned” or “thick” has never been a part of the African American culture, as many younger African Americans are lead to believe. Research shows that Black men and women have different views of obesity. This is a major problem that not enough attention has been given. Studies have found that some think overweight infants look healthier than babies at suggested weights. This distorted view sometimes carries over into adulthood. I have had some Black women say they feel more attractive when carrying extra weight and this is reinforced by friends, relatives and lovers. We also tend to accept the idea that it is acceptable to gain weight as we age and too many people do not appreciate physical activity and think exercise is only for athletes.
I remember being in the best shape of my life at age 43 while competing internationally in master’s track and field events for people older than 40. I was 185 pounds and my mother asked, “Are you sick?” This was years after I was a 225lb medical school graduate and realized that I needed to make a change.
We can only win our fight with obesity if we recognize its many culprits ranging from poor health literacy and lack of obesity health policies, to individuals accepting personal responsibility and making difficult, yet appropriate lifestyle changes.
African American men often receive a plethora of information, often from non health care professionals, about the prostate gland. We often hear many commercials encouraging Black men to purchase products to improve prostate health, but none of these commercials encourage them to talk to their health care provider.
The prostate gland is subject to develop problems as one gets older. It can become enlarged, resulting in problems with urination; infected, resulting in pain; or develop cancer.
Current studies suggest that exercise, like walking at a moderate pace 3-4 times a week, can improve prostate health and even prevent prostate problems. Studies have also shown that frequent exercise can decrease the spread rate of prostate cancer in some men.
I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
Several weeks ago, I spoke at a patient’s 70th birthday party. She asked her other lady friends, also age 70, to stand and take a bow with her and at that age, these ladies were absolutely beautiful.
As I sat observing, I thought about the obvious. Everyone gets older but can it be done with grace, sophistication, and in good health? Yes, it can.
Recently, my Aunt Rachel, a young, 88 year old lady, made a very thought provoking statement to me. She said, “I just want to be the best 88 year old that I can be.” She is so right and certainly we know that our seasons change and we should appreciate the past, present, and future. Aging is life.
I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
Do you remember when it was a common notion among many people that a desk job would be the ultimate job? I often wonder why our parents lived longer and took fewer medications than many Black people today.
We now know that people who sit for many hours during the day are more prone to become sick. Those who have desk jobs, are truck drivers, or have positions that require sitting for long periods of time should take notice. New research reports that prolonged sitting, on a daily basis, leads to chronic medical issues such as diabetes, cancer, and heart disease. We know, with a high level of confidence, that being more physically active decreases chronic medical problems and increases mental capacity and energy levels.
This concept continues to be difficult for some members of the underserved population to understand, but a job that encourages prolonged sitting is hazardous to your health.
Get up and move regularly during the day to improve your health.
I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
My grandson, Edmund James Alston, was born March 2, 2013 at 6:26 pm in Presbyterian Hospital in Charlotte, North Carolina. He weighed five pounds and 5 ounces and is in apparent good health. He is my third grandchild, joining Julia Marie Alston (4) and Kaidyn Thaddeus Snipe (3). They are my three diamonds and I am truly blessed that my life has been spared to not only see them be born, but to spend quality time with each of them.
You may be asking what this has to do with Closing the Gap in Health Care. It is all about thinking of these moments when you are young and in good health. Many African American men and women lead poor lifestyles that may place them at risk for early death or major illnesses. This deprives them of the opportunity to see the birth of their grandchildren or living long enough to be involved their lives. It is not uncommon for some Black people to say that they don't care about living a relative, long life, but based on the aforementioned, they may want to rethink their train of thought.
I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
Recent health news has focused on the weight of Governor Chris Christie of New Jersey who, by all medical standards, is obese. He became very angry with the former physician of President Bill Clinton who made a comment on national TV about his potential of having a heart attack and dying in office if he were to become President. I do not know anything about the governor’s health history and it is unfortunate that this debate was aired on TV, however the doctor’s concern about the governor's health outcome is correct if he remains significantly obese. Outcomes that are very well documented in obese patients include: - Increased risk for heart attack and stroke
- Hypertension
- Diabetes
- Increased risk for several types of cancer
- Increased risk for osteoarthritis
It is not uncommon for people to get angry with physicians when dealing with the facts. The governor should get serious about losing weight because it does not get easier as time progresses. I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
You should be aware that heart disease is the number one cause of death in the United States. Heart attack symptoms in men and women are different and women should know their symptoms. Common heart attack symptoms for women are an acute onset of fatigue and shortness of breath (SOB). Risk factors for heart disease include uncontrolled diabetes, uncontrolled hypertension, a family history of heart disease, and lack of daily exercise.
It has been reported that three daily servings of strawberries, blueberries, or other berries which contain antioxidants are very beneficial in
decreasing the risk for heart attack in women. Studies have not been conducted among men to determine if berries are beneficial, but it is thought the same results apply.
I am Dr. Thaddeus John Bell closing the gap in health disparities for African Americans and the underserved.
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