Tuesday, March 26, 2013

Why Measure Healthiness? What can we learn?

Is your health half full? or half empty?  Is your health three quarters full? or one quarter empty?

No one is perfectly healthy. Healthiness is about balance - thousands of balances, constantly changing, shifting, adjusting, re-balancing.

Healthiness is a measure of your health. When individual measurements of healthiness are mapped to a percentage scale - the inverse is the level of unhealthiness. If your heart is 80 percent healthy, it follows that it is 20 percent unhealthy.

In this view, unhealthiness is not 'bad' any more than 'darkness' is bad.  It is simply the inverse of healthiness, as darkness is the inverse of light.

I often write that we don't measure healthiness, and I am sometimes challenged by people in the medical profession who believe we do.  I wrote a blog post on Healthicine.org about Alice and Zizi to illustrate the fact that we do not, and presently cannot, measure healthiness.

In summary:

Alice and Zizi are two women, of similar age, height and weight. One is a bit taller. The other a bit stouter.  Neither has any illness detectable by our medical systems.  The question:  who is healthier, Alice or Zizi.  The initial post grew into  a series of blog posts exploring different aspects of healthiness.

Our medical systems and medical sciences have no standard recognized way to measure the healthiness of Alice vs Zizi.  We can measure their sickness - or their tendencies towards sickness, but we cannot measure their healthiness.

We do have some measurements that might be used to determine healthiness, but those are very weak.  We might measure height and weight - and calculate BMI.  We might measure the vital signs: resting pulse, respiration rate, and temperature - although these may provide useful measurements of healthiness, we normally use them to measure sickness. The so called 'fifth vital sign' is not actually a sign of healthiness - it is simply a measurement of illness.

When we measure the vital signs, however, we don't typically measure them for health - we measure them to detect illness. If the pulse is very low, or very high, or very erratic - it indicates a serious medical condition.  But if a pulse is in the 'normal range' - no further investigation is done.  If we want to use a measurement of pulse to measure healthiness, we need to determine the theoretical 'optimal resting pulse' for the individual - and then see how the current pulse compares. That measure as a percentage is the level of healthiness - and the inverse is the level of unhealthiness.  Of course if we are using pulse to measure some aspects of healthiness, our measurements will be much more accurate and useful as we add data: resting pulse, pulse during exertion, recovery time to resting pulse, pulse regularity, etc.  Even simple measurements of healthiness are complex.

Today, we have no useful way to bring these or any other health measurements together into a useful overall measurement of healthiness.

Is it important to measure healthiness?  Why should we learn to measure healthiness?

Let's look beyond Alice and Zizi.

Let's take 100 random people, adults, children, seniors, males and females (and others) who are not sick.  We can easily determine who is taller, who is heavier.  We can calculate the BMI for each person and place every one of them on a scale.

But we cannot say a word about which of them is the least, or most, healthy. Not with any scientific basis.  Isn't that strange - or is it just tragic?

Although our current model of medicine is often referred to as 'health care', we measure sickness.  Then we provide a treatment - and measure sickness again.  This is a valuable technique to find effective treatments. It does not measure healthiness.

I believe we can do better.

I believe we need to measure not just sickness, but also healthiness. If we are testing a treatment, measuring sickness gives us information about the effectiveness of the treatment.  And typically - it also causes 'side effects'. What are side effects?  They are some of the unhealthinesses created by the treatment.

Imagine the day when you go to a doctor for a 'health checkup' instead of a medical checkup.  A standard annual medical checkup is a test for illness, or tendencies towards illness.  There is a long way between a 'medical checkup' and a measure of overall healthiness. A medical checkup simply reports 'normal' or 'a medical condition', like the mythical Star Trek doctor, which reports: "I’m not picking up anything on my tricorder scan. He seems perfectly healthy." We can find many useful measurements of healthiness - but we need to learn to look for them, and make effective use of them.

When we can measure healthiness - we might measure the healthiness, as well as the illness, of someone who is to be treated.  Then the treatment proceeds, and as it progresses, we measure healthiness, and also illness on a periodic basis.

Medical science wants to be precise and efficient. These are valuable goals.  But we know that medical science often ignores the big picture - of healthicine, in order to focus on the illness.

There are many illnesses that confound medical science.  The most well known is cancer.  Medicine declared war on cancer over 40 years ago - but today reports more cancers and more deaths from cancer.  Clearly something is wrong with the medical approach in this case.

Many other illnesses confound our medical systems - the easiest way to find them is to look for medical conditions that cannot be cured, or conditions that are considered 'degenerative'.  Those that progress slowly and cannot be cured. Parkinson's Disease, Alzheimer's disease, arthritis, Multiple Sclerosis, and macular degeneration, are but a few. There are many medicines for these illnesses - but none of them provide a 'cure'. Most of the top selling medicines of today do not 'cure' the disease - they simply attempt to address some of the symptoms. The Medicines Myth is the myth that our best selling medicines actually cure illness.

None of the top selling medicines have been tested for their effects on healthiness.  We only measure their effect on illness.  But, virtually all of the top selling medicines don't 'cure' the illness, they provide 'long term treatments'.  Health is 'long term', and if we are taking any medicines over the long term, we need to measure the health effects.

Imagine a day when all treatments are tested for their effects on healthiness?  Today's clinical studies are very limited in scope and duration.  Medical scientists test new drugs on a small group of patients over a short time period.

When we can measure healthiness - we can measure the healthiness of all people who take a medicine or alternative treatment, whether they are in clinical trials or not.  We will learn many relationships between healthiness and illness that are invisible to today's techniques.

I believe we will learn to cure many of today's 'incurable diseases'.  What is the difference between an illness and an unhealthiness?  Today, we have no useful distinction.  We need one.

There are many illnesses that might actually be simple, or complex unhealthinesses. Because unhealthiness is the inverse of healthiness - when we learn to measure healthiness effectively, we will understand these illnesses.  Today, because we don't measure healthiness - we can't measure unhealthiness - and thus we cannot tell the difference between unhealthiness and illness.

We cannot truly seek health until we can recognize it.  We cannot truly recognize it until we can measure it.  Until then, our search for health, and health freedom will remain, like some aspects of our medical systems, in the dark ages.

to your health, tracy
founder: Healthicine.org
ps. If you want to know if your health is half full, or half empty - you'll find the answer here:
Is the glass half full, or half empty? Is your health half full or half empty?
Tracy is the author of two book about healthicine: