Category Archives: Society

Aside

I am no expert in health care policy but I do know what it cost to be fat and sick. I know that if I did not have health insurance it would cost a lot more and I would be in much worse shape than I am now.  I think that healthcare policy requires a more comprehensive common sense approach only made complicated by the lobbyist for this industry.

I also know that in this country there is less emphasis on  preventative care and a major emphasis on medicinal maintenance when someone becomes ill.  There is a pill (and profit) connected to every conceivable condition – conditions that by and large can be avoided if we had a different relationship to food and health.  In 2009, health care accounted for 16% of America’s Gross Domestic Product (GDP) with the expectation that this will increase by nearly 10% by 2025.  We have a population that is living longer with chronic conditions driving up overall costs associated with health care.  Overall, we have a more obese and less healthy overall population in this country.  And the health care lobbying efforts have ensured that our leaders continue health care policy to place emphasis on maintenance rather than prevention.  

Prevention advocates argue that using such an approach in the context of healthcare policy would result in reigning in increasing healthcare costs and creating a more healthy society.  “The Trust for America’s Health reported that prevention programs could save the country more than $16 billion annually within five years, a return of $5.60 per dollar invested.  The Commonwealth Fund estimated that reduced tobacco use and decline in obesity would lower national health expenditures by $474 billion over ten years.” At a time where we are talking about reducing deficits and spending, this is an opportune time to really focus on this issue.


Unfortunately, though many Americans are indoctrinated to eat and drink to excess the wrong things, the real problem is that our policies and national leaders protect the very companies that benefit financially from our illnesses; this means the capacity to advocate for a sensible approach to health care policy against these powerful corporations is more than difficult.  For example, according to the Center for Responsive Politics, in 2005 there were 535 members of Congress compared to 2,084 health care lobbyist; this means for every member of Congress, there was approximately 3.8 lobbyist lobbying them on behalf of various drug and health insurance companies.  Further, according to OurFuture.org, in 2004 the health industry was credited with giving approximately $14M to 11 members of Congress who were created with negotiating the Bush Medicare Plan

So what are the costs associated with chronic disease in America?  Let’s take my personal favorite chronic illness, diabetes.

Diabetes

There are a total of 25.8 million children and adults in the United States which means that 8.3% of the population has diabetes with approximately 7 million undiagnosed.  As of 2010,  1.9 million new cases of diabetes were diagnosed in people 20 and over.  This is part of the reason why there has been a substantive increase in the number of diabetes related advertising and why we’ve begun to experience a sense of “normalcy” relative to diabetes.  Rather than focus on preventing Type 2 which is largely tied to weight, we are being socialized to learn to live with it.  There are approximately 79 million pre-diabetics in the United States; for diabetes drug companies and companies that produce lancets, blood glucose readers, and diabetes related products, that’s a lot of potential customers and money.

 After adjusting for population age differences, a 2007-2009 national survey data for people diagnosed with diabetes, age 20 years or older showed that 7.1% were non-Hispanic Whites, 8.4% were Asian Americans, while non-Hispanic Blacks and Hispanics made up 12.6% and 11.8% respectively of those diagnosed.

There are a host of other related conditions associated with diabetes including:

Heart disease and stroke

  • In 2004, heart disease was noted on 68% of diabetes-related death certificates among people 65 years or older.
  • In 2004, stroke was noted on 16% of diabetes-related death certificates among people 65 years or older.
  • Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
  • The risk for stroke is 2 to 4 times higher among people with diabetes.

High Blood Pressure

  • In 2005-2008, of adults aged 20 years or older with self-reported diabetes, 67% had blood pressure greater than or equal to 140/90 mmHg or used prescription medications for hypertension.

Blindness

  • Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years.
  • In 2005-2008, 4.2 million (28.5%) people with diabetes 40 years or older had diabetic retinopathy, and of these, almost 7 million (4.4% of those with diabetes) had advanced diabetic retinopathy that could lead to severe vision loss.

Kidney Disease

  • Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2008.
  • In 2008, 48,374 people with diabetes began treatment for end-stage kidney disease in the United States.
  • In 2008, a total of 202,290 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States.

Neuropathy

  • About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.

Amputation

  • More than 60% of nontraumatic lower-limb amputations occur in people with diabetes.
  • In 2006, about 65,700 nontraumatic lower-limb amputations were performed in people with diabetes.

Morbidity and Mortality associated with diabetes:

In 2007, diabetes was listed as the underlying cause on 71,382 death certificates and was listed as a contributing factor on an additional 160,022 death certificates. This means that diabetes contributed to a total of 231,404 deaths.

Cost of Diabetes

The total cost of diagnosed diabetes in the United States in 2007 was $174 billion, with $116 billion for direct medical costs, and $58 billion for indirect costs (disability, work loss, premature mortality). After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes.  Does anyone see the economic benefit for prevention here?

The American Diabetes Association created a Diabetes Cost Calculator that takes the national cost of diabetes data and provides estimates at the state and congressional district level.  Factoring in the additional costs of undiagnosed diabetes, prediabetes, and gestational diabetes brings the total cost of diabetes in the United States in 2007 to $218 billion.  In my lovely borough of Brooklyn, in the 11th Congressional district where I live, the total cost of diabetes for people in Congressional District 11 in 2006 is estimated at $551,100,000. This estimate includes excess medical costs of $376,200,000 attributed to diabetes, and lost productivity valued at $174,900,000.  For the entire state of New York in 2006, the cost is estimated at $12,860,000,000. This estimate includes excess medical costs of $8,676,000,000 attributed to diabetes, and lost productivity valued at $4,188,000,000.  So clearly, this is a chronic disease that can wreck havoc on someone physically if they aren’t maintaining it, but the costs associated with this disease is astronomical.

I could have used cancer, heart disease, or some other chronic diseases in the same vein to prove what should be obvious to everyone.  It cost so much more to our government and our society to be chronically ill than to take a comprehensive policy approach to preventative healthcare in this country.  The Obamas have worked hard to create an awareness of this through Mrs. Obama’s “Let’s Move” initiative, but we have to do more as leaders.  As Americans we need to change our mindset and relationship to food and we need to demand that our leaders on both sides of the aisle engage in real leadership by reforming how health care policy is done in America.

2013: Prevention as a Healthcare Policy in America

The Politics of Sexual Identity

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Last week, Politker, published a story about the wife of  NYC Public Advocate (and Mayoral candidate) Bill De Blasio’s wife, Chirlane McCray and her past as a lesbian.  McCray’s response to the report, “In the 1970s, I identified as a lesbian, and wrote about it.  In 1991, I met the love of my life, married him, and together we’ve raised two amazing kids. I’m reminded every day how lucky I am to have met my soulmate.”

My initial reaction to this was the same one I had when De Blasio first began showcasing his wife African American wife and biracial children more prominently in campaign literature.  Eh,  ok, but so what? So what because this is clearly (in my opinion) a personal matter between a husband and wife and not necessarily for public discourse.

Is this really a scandal? Among younger people, something like this really is not news or overly scandalous based on the (incorrect) assumption that the majority women have had a same sex “college experience”.  While many females I know like to boast that they’ve kissed a girl, most women in my generation have gone no further or are out the closet and open about their sexual preferences.

According to a 2002 study done by the Center for Disease Control’s (CDC)  and the National Center for Health Statistics (NCFHS) based on 12,571 in-person interviews:

  • 4% of females reported having had a sexual experience with another female in the past 12 months.
  • 11% of women admitted to a same-sex sexual experience in their lifetime (vs. 4.1% of women ten years prior who admitted to having had oral sex with another woman).
  • 3% of women admitted to having had sex with both males and females in the last 12 months.

Additionally, women have been more open about exploring their sexual identity.  For example, in the same study cited, among those who had sexual relations with another woman, nearly two-thirds (65%) ultimately considered themselves heterosexual.

According to a May, 2011 Gallup Poll, roughly 25% of adults in the US are estimated to be gay or lesbian.  If that is the case, one could argue that as a society we are increasingly open to those who aren’t considered “straight” and not every woman who identified as “straight” has always engaged in “straight” sex.

So not every bisexual female or lesbian who has always identified accordingly may have ended up with a partner, mate, or spouse that fit neatly into their own concept of their sexuality.  So De Blasio is hardly the first guy to marry a not-so-straight woman, other women have married not-so-straight men…  It’s all become fluid and we know that in this time and age of sexual experimentation, some of us won’t be completely straight at the end of the day but we all seek to find an honest and loving connection to another human being.

I don’t think (or care if) Chirlane McCray is straight, I think she happens to be in a relationship with her soulmate, who happens to be a guy (gasp!).  I don’t think McCray is confused or has moved away from her core principles regarding civil and human rights by virtue of the fact that she has maintained an active role as an outspoken advocate of civil rights for the GLBT community (as has her husband). I don’t think McCray has been “cured” nor has she ever claimed such foolishness as indicated by Andrea Peyser.

I think this is less about McCray and more about the fact that generally, people like others to be categorized. Some of us like to categorize folks nice and neatly as Black, White, Latino, fat, skinny, rich, poor, etc… We like to see the world in black/white, either/or terms because the grey area tends to make us uncomfortable.  We like to push our notion of right and wrong on others because of our own discomfort with fluidity.

Here are some facts in black and white.

1. McCray wrote an article about her experience and growth as a Black woman who identified as a lesbian at that time.  It was groundbreaking to do so coming from her ethnic background and was brave.

2. The article she wrote for Essence magazine was written over 30 years ago.  It was only a mere 20 years ago that Madonna was taking nude photos with Big Daddy Kane… Put it in perspective…

3. McCray later met an interesting (and handsome) Italian guy by the last name of De Blasio who piqued and shared her interest.  The two later got married and had kids  – does it really matter what she was doing sexually before she got married? Are we asking him about his past relationships? No? Moving on.

4. If McCray was looking to experiment with men, she could and would have done it a lot differently.  If her relationship with  De Blasio was a front, it would not be where it is today, 18 years later.

5. Anyone that has been around Mr. De Blasio and his wife can see clearly they love each other and have a very good dynamic based on mutual respect, friendship, and a deep knowledge of one another (most of us WISH we could have that).

6. McCray and De Blasio are loving and caring parents who have set a good example for their kids about relationships and humanity whether they be multicultural, multiracial, multiethnic, multisexual, multi-whatever.  And the end of the day, that’s all that matters.

De Blasio’s desire to become mayor should lead us to pick apart and research his political history.  Using that as a measurement of his capacity to lead this City should be the emphasis.

Finally, at the end of the day, McCray and De Blasio did not issue anyone of us an invitation into their bedroom, so perhaps we should stay out of it.

America Nears El Tipping Pointo – With Ignorance

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In a recent articles in both the Huffington Post and  Latina magazine online, Ann Coulter is highlighted as attacking hispanics.  You can read her entire musings here.  As always, Coulter  serves as the conservative right’s “in your face “attack dog”.   The fact that she’s considered pretty perhaps makes it easier (and more scary) for some to sit there and listen to her ignorant pronouncements; pronouncements that serve to stir the emotions of many on both sides.  We’ve all heard snippets likes “Our Blacks are so much better than their Blacks.”  Snippets meant to incite, meant to gain publicity, divide, and meant to get her paid.

Coulter does not care about this country.  She may argue differently, but ultimately, her words and rhetoric speak far louder.  She is paid to be hateful, something that she seems to enjoy doing when you watch her on conservative news programs. The sad part in all of this is that Coulter will often mix in “facts” without citing the sources; this means that more often than not, her facts are pure fiction. I continue to submit to those who bother to pay attention to her diatribes that rather than have an emotional reaction to her statements, it’s important to understand the purpose of the statements and dissect them appropriately.

I refer back to my November 17th blog where I critiqued and discussed the need for the Republican party to evolve and become more inclusive.  Marco Rubio and Bobby Jindal have both moved forward in publicly decreeing the need for Republicans to move past this election cycle. These men along with the McCain women have noted that the party must diffuse  the perception that it cannot move past this election loss with grace and dignity.  The party itself has to take the long view to ensure its sustainability by no longer pandering to extremist. In fact, this notion was bolstered more so by Speaker of the House John Boehner’s decision to remove Tea Party Republicans from key financial committees in the House.

In fact, in spite of Coulter stating clearly on the Sean Hannity Show  that the Republicans should cave to Obama on the issue of taxes because “We lost the election“, she and the most conservative among the GOP can’t seem to let this election go.  So they write what they write without any real logic or reasoning…  just emotion.

And while that is good for rallying up the crazy crew, it provides no value or service to the citizens of this great union.  In fact, Coulter’s recent musings about Latinos is straight out of Lee Atwater’s 1981 Southern Strategy play book with respect to using her scribes to speak to her constituency in code.  The underlying message is that by 2024 “you” (Whites) will be the minority and that is a scary thing.  Why? Could it be because connected to that message is the subliminal and irrational fear that “they” may treat “us” like “we’ve” treated “them”?

Let’s take a moment and really look at what Ann Coulter is saying.  After all, she is no Rachel Maddow, when she talks, it’s more like verbal vomit and not necessarily factually based.

“What the youth vote shows is not that young people are nitwits who deserve lives of misery and joblessness, as I had previously believed, but that America is hitting the tipping point on our immigration policy.  The youth vote is a snapshot of elections to come if nothing is done to reverse the deluge of unskilled immigrants pouring into the country as a result of Ted Kennedy’s 1965 immigration act.  Eighty-five percent of legal immigrants since 1968 have come from the Third World. A majority of them are in need of government assistance.”

  • Ok, let’s look at this. The 1965 Immigration and Nationality Act was passed and we saw it’s implementation in effect by 1968.  This means in a 44 year period (1968-2012)  Coulter can’t speak to which ethnic groups have come here during that time?  Ms. Coulter said a majority of them are in need of government assistance but there are no facts as to how many received any assistance.  There is no data to support how many received assistance in 1968, 1978, 1988, 1998, or even 2008.    This matters because while Mexicans were Latin America’s largest immigrant group after the passage of the Immigration and Nationality Act of 1965, there was also an influx of Asian, African, and Middle Eastern immigrant groups as well.  However, Coulter speaks of no other immigrant group.  Why is that?
  • Further, according to data provided by the Center on Budget & Policy Priorities, over 9/10 of “subsidies” go to the elderly, disabled, and working households. “Federal budget and Census data show that, in 2010, 91 percentof the benefit dollars from entitlement and other mandatory programs went to the elderly (people 65 and over), the seriously disabled, and members of working households.  People who are neither elderly nor disabled — and do not live in a working household — received only 9 percent of the benefits.” (Source: CBPP) So how much actually goes to immigrants?
  • Additionally, according to a 2008 article in Bloomberg Businessweek entitled, “Immigrants Are More Likely to Be Entrepreneurs”, there is conclusive evidence based on a survey of 2.054 companies, that immigrants are more likely to be entrepreneurs by establishing a small business niche in local communities.  50% of Silicon Valley engineers and tech startups were founded by immigrants in comparison to 25% nationally. “Now, a November 2008 study by Robert W. Fairlie, a professor at the University of California at Santa Cruz, gives the strongest evidence to date that critics of open-immigration policies have misjudged the impact of immigrants on the U.S. economy.” (Source: Bloomberg Business Small Business, Immigrants are More Likely to Be Entrepreneurs-  on November 25, 2008)
  •  Coulter completely fails to define “third world”.  Are we talking third world in terms of political and civil rights? Or in terms of economics and the country’s Gross National Product (GNP)?  Or perhaps she defines third world in the context of human development, poverty, or freedom of the press.

This distinction matters.  It matters because  when you attack an ethnic group and set them up to essentially have to defend itself against lies and distortions, you need to be prepared to support your lies with facts.  While snippets and sound bites sell books and get you a place on television, the truth always comes to light. However, I suppose the ignorant and extremist will cling onto the mistaken notion that Hispanics and Latinos are the same. Immigrants from another country of origin who speak the same language, have babies out of wedlock, lacking in formal education or civility… Except we aren’t.  That’s like suggesting all eastern Europeans are essentially one in the same, especially if they share a common language.  Except, they aren’t.

“That profile has nothing to do with recent Hispanic immigrants, who — because of phony “family reunification” rules — are the poorest of the world’s poor.  More than half of all babies born to Hispanic women today are illegitimate. As Heather MacDonald has shown, the birthrate of Hispanic women is twice that of the rest of the population, and their unwed birthrate is one and a half times that of blacks.”

  • Again, facts are skewed and distorted.  Heather MacDonald’s 2006 article can be found here .  The fact is that she focuses on the Mexican population and uses the term “hispanic” interchangeably with Mexicans.  Additionally, the reasoning (fear) behind the MacDonald report is in part a concern for family values and structure but more importantly to bring home the notion of fear with respect to a White minority in America. “The dimensions of the Hispanic baby boom are startling. The Hispanic birthrate is twice as high as that of the rest of the American population. That high fertility rate—even more than unbounded levels of immigration—will fuel the rapid Hispanic population boom in the coming decades. By 2050, the Latino population will have tripled, the Census Bureau projects. One in four Americans will be Hispanic by mid-century, twice the current ratio. In states such as California and Texas, Hispanics will be in the clear majority. Nationally, whites will drop from near 70 percent of the total population in 2000 to just half by 2050. Hispanics will account for 46 percent of the nation’s added population over the next two decades, the Pew Hispanic Center reports.” (Source: Heather MacDonald – “Hispanic Family Values”, City Journal, Autumn 2006)

The reality is there are disparities among Latinos related to class, culture, politics, policy, and socioeconomic status. and immigration reform.  Similar to that of other immigrant groups who came here, including Germans, Polish, Jews, the Irish, the English, Italians, etc.  Things change with the passing of each generation.  For example, contrary to the claims of Coulter and MacDonald, a November 30, 2012 Pew Research Center study has shown that birth rates among Americans have in fact dropped with Latinas showing the largest decline.

Coulter claims that by 2024, America will have a white minority.  It is inevitable.  And not something to fear.  The factors that will bring about this reality aren’t just a growing Latino population, but an increase in multi-cultural, multi-ethnic, and multi-racial relationships that have produced non-White babies, including Barack Obama and my own child.  By in large, many of these households consider themselves progressive households because at their core, their relationships have been considered “progressive” in a society that so long been seeped in institutionalizing racism.

Ms. Coulter, in your article, you skew your facts in order to form a more perfect distortion that Obama won because the majority of our fellow Americans voted for him.  Now it is time for you and your extreme right to consider working with the party moderates to determine how to better at engage the party and diversify the membership. Again, as you acknowledged on Sean Hannity’s show, “We lost the election, Sean.” So get over it and move on with it.

Until then, this married with one child American born legal Latina with a Master’s degree thanks you for the amusing chuckles you provide and the opportunity to respond with data to your insidious claims.

Respectfully,

Akilah Rosado-McQueen

The dirty “F” word – Feminism

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So, when did the “F” word (Feminist) become bad? And why? I was reading a very interesting piece at Salon about female “celebrities” increasingly denouncing any claim to being feminist.  This has been an increasingly discussed topic for a number of reasons.  First, when someone like Katie Perry claims female empowerment but denounces the label of feminist, it carries weight with young girls across the globe.  The message is to not be labeled feminist.

But here’s the rub.  By its own definition, that IS what feminism is.  So either Katie Perry is setting a clear example of public ignorance or she has no clue about what feminism is (which is the same thing and thus is she proven to be ignorant).  Feminism, according to Merriam-Webster is “the theory of the political, economic, and social equality of the sexes” or “organized activity on behalf of women’s rights and interests”.   So the Spice Girls were feminist, Madonna is a feminist,  P!nk (who is THE absolute coolest feminist to my mind) is a feminist… ANY human being who believes in equality between the genders and female empowerment IS a feminist.

There can be no argument that the work of the women’s suffrage movement, Gloria Steinem, Ntozake Shange, Madonna, Hillary Clinton, and many others broke the barriers that has allowed these idiots to cast off the title of feminism as though its a dirty word.  But the reality is that these women who are in their 20’s, famous, and role models, now, more than ever need to embrace the strengths and empowerment of this mind set because of their influence.  And because, at it’s core, women need to be reminded of how much it took for us to get where we are.  The old Virginia Slims commercials had a tag line “You’ve come a long way, baby.” (Yes, I am dating myself, so what!)  And this tag line spoke to many of us who felt strong and empowered enough to kill ourselves slowly on cancer sticks.  But more importantly, it reminded us, that through it all, adolescence, adulthood, motherhood… we come from a sisterhood and that sisterhood has come at a price.  We have to accept a collective history of rising from inequalities to empowerment, from social pariahs to independent women (thank you Destiny’s Child).

Why we would choose to dismiss feminism and the title of feminist as a relic of the past when we have many other barriers to our progress ahead is ignorant and borders on mental dysfunction.  We have to know our collective past to be on the correct future path.  We must not ever take for granted that every time we vote, go to work, and choose to be a single mother meant that someone fought for and in some cases died for our collective right to do so.  Some also fought and died for our collective rights to do whatever the hell we wanted to our bodies, whether it was establishing safe ways to ensure termination of unwanted pregnancies, dress as we wished without ridicule or judgment, and speak out against the many abuses our sisters still suffer in African and Middle Eastern countries.

Fuck that, I am a 40 year old FEMINIST of Caribbean descent living right here in Brooklyn.  I want my 10 year old to be a feminist or whatever she wants to be  as a result of my struggles and those that came before me.  Just as long she as she understands her history and avoids being as ignorant as a Katie Perry or Carla Bruni-Sarkozy or any female that has decided being so is somehow negative.  You have the right to say you aren’t a feminist, but DO NOT stand on the side lines and pronounce that you aren’t a feminist but yet you believe in the very principles feminism extols.  What is that?

Now, it is worth noting that feminism in 2012 is not what it was in 1960, 1970, 1980, or what came out in the ’90’s.  But we evolve based on the situation and conditions we face in our society.  Why do you think there was an uproar over Rush Limbaugh’s dumb comment about Sandra Fluke?  That was feminism people.  A bully of a man trying to intimidate a woman through words and actions and not applying the same standard to himself.

I own my past, my sisterhood, my strengths, and I rise up to advocate as a woman, an empowered woman.  I don’t smoke Virginia Slims (anymore) but I have come a long way, baby.

The Death of the G.O.P… And the Rise of the Dems…

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So we’ve survived this last round of presidential elections and I managed to only discuss it in the Twitterverse.  Then Romney and Ryan and the other annoying “r” guy… Rove, began their assault on the voting public due to their failure to acquire a win.  There are some significant lessons to be learned here for Democrats and Republicans alike.

But first, a little history… In 1991, at the tender age of 18, I registered as a Republican for my first election.  Why? Well, it was contrary to my parents political views and I did believe it to be the original party of Lincoln.  Parenthetically, based on the cheesy films I was exposed to in the ’80’s, I also thought it was the party of rich people and by being one, I’d somehow be rich.  That never happened.  Ultimately, William Jefferson Clinton happened to me and I was wooed over to declare my status as a Democrat where I have remained since, firmly aligned with core democratic values and principles.  But I digress.

It is worth noting that Ronald Reagan began his career as a Democrat and later switched to the Republican party. (Under the Republican party he served as Governor of California and ultimately succeeded Jimmy Carter as President of the United States.) While I began as a Republican, I associated myself as a Republican with liberal leanings, who was very concerned with social issues and ensuring that all people had basic needs met, without necessarily having big government.  In short, I was and continue to be at heart, a Lincoln Republican. This context is relevant because as a voter who is (1) female, (2) a child of social and political activist, (3) Caribbean descent (specifically Puerto Rican and Barbadian), and (4) politically astute, I am not your typical run of the mill voted down the ticket voter.  I vote and have voted across party lines.  I stay informed on current and historical trends.  I live and love politics and believe in our government and leadership.  I’ve read the constitution, the bill of rights.  In short, I am a true Lincoln Republican/moderate Democrat.

But the reality is that party of Lincoln no longer exists.  And Reagan Republicans have been forced out of the Republican party because they are too moderate and/or liberal in their leanings to be accepted.  Even Senator John McCain’s daughter and wife have advised Republicans to evolve or die.  And while many liberals  and conservative, extreme leftist and right wingers don’t care if the Republicans evolve or not, I do.  I care about those who have been left out of the political process because they don’t fit an either/or category.  I care that it is in the interest of the citizens of this country to have at minimum a two-party system (if not a multi-party system) which, focuses more on policies than rhetoric.  Americans should have a real opportunity to choose the best leaders to represent us, not least bad of two.  And more importantly, I care where those votes will go over the next four years, in 2016, and beyond.

So, where does that leave us?

With a Democratic party that was against the ropes in 2010 and rebounded thanks to a sect of extreme right-wing social conservatives that managed to hold hostage the Republican party.  And with GOPers became weak-kneed and scared that folks like the Tea Party Movement (note movement, not party) had somehow created a large and concentrated base that required pandering to.  Everyone jumped on that fascist band wagon and Republicans moved from the middle to the far right in order to show an essentially racist coalition, that they were on their side.  In 2010, the Dems were reeling from a butt kicking, the GOP is now in the same boat.

2008 brought back the Lee Atwater Southern Republican strategy (a la Karl Rove per Reagan) to scare the crap out of White Americans regarding African Americans.  They increased their efforts around utilizing  “code words” to speak to those fears publicly and institutionally in the hallowed halls of government.  And it was this particular strategy, the Atwater strategy, that Romney and Ryan employed in this election.  Only we saw it.  We knew.  And, as Americans (with a slim majority 50.6% vs 47.8%) we did not find it acceptable.  This election was a fight about the soul of America; who we are and what we represent.

Let me be clear (and I say this as an Obama supporter) I agree with my good friend, Obama would not have won had Romney stayed true to his core moderate Republican roots and base.  Had Romney remained centered and not pandered to the racist and extremist base as he did, women, liberals, Latinos (who are a diverse and disparate voting bloc), independents, and those who were disappointed in his performance would not have voted for Obama.  But instead, Romney’s inconsistencies, his rhetoric, along with those of Fox News idiots, and the Rush Limbaugh’s of the world ensured an Obama win through their Atwater-ish stupidity. And even now they continue.

The GOP need to realize, people by in large did not vote for Obama per se. They voted to reject the GOP’s message and proposed policies.  They voted to send a message to the party that while they were pissed off at Obama in 2010, they are thoroughly disgusted with the direction that the party has gone in 2012.  Marco Rubio is changing his stance (passively), Bobby Jindal is back to opening his mouth after being silenced by his party,  and other prominent Republican leaders are suggesting that the party reflect and regroup (via a proctology exam).

The GOP as is should die.  The level of hate and racism emitting from the party’s leadership and its pundits is divisive and horrible for this country.  As Meghan McCain stated in her Tweet, it must evolve, it must reflect the growing diversity that is America, it must embrace its roots as the party of Lincoln, it must review in great detail, it’s decision to move so far to the right and those implications. OR it should embrace it’s current extreme configuration with aplomb.  And if they do, those with any basic sense and love for this country, should create a nationally recognized 3rd party that holds true the core principles of the Republicans while ensuring its evolution.

And my fellow Dems should take heed. We should not pat ourselves on our collective backs or rest on our laurels.  People, throughout this nation, are pissed off and disenfranchised with their political leadership.  From local state races to major national races, the people are getting tired of the bullshit.  And they should.  With social media being utilized to share information and call out mis-information, we have a more sophisticated constituency who seeks results and accountability of its leadership.  Obama won by 2.8%.  That isn’t much and it is a message for those in either party willing to listen.  While the GOP is licking it’s wounds, now is the time to batten down the hatches, take a good look at ourselves, and make sure that the next election (when the campaign begins in roughly 2.5) we can give the voting public a clear reason why they should continue to let us represent them. Because the jury on that is still out.  And there is enough time to rebuild a  party or create a New Republican Party…

Weight Loss Surgery and Diet Plans – Not a fan… Here’s why…

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I have sat on this blog for at least a month.  Why? Because while I happily opine on a daily basis about many a thing, I am accutely aware of the fact that weight loss is deeply personal and emotional.  The process is deeply personal and emotional.  And coming out on the other side of it is deeply personal and emotional.  And while I am still in the process (phase two if you will) I’ve had to deal with the mental stuff that accompanies the journey.  But because I see how easy it has become for us to slice and dice ourselves into weight loss and some of the related complications associated with slicing and dicing, I do feel the need to opine (to an extent).

Some argue that it is necessary for them to have surgery as a means of jump starting their weight loss process. This may be especially true for those who have attempted to lose weight but have not had much success for a number of reasons. I think about the video of that 600 pound 22 year old guy on YouTube and I say to myself, yes, I get it, he may need surgery to start his process.  It will be incredibly hard for him to get to a place where he can walk around the block without wheezing (though he could do it with effort).  So I am not referring to those who honestly fall into the morbidly obese category. He could also start juicing and possibly jumpstart the same process as effectively.

That said – 

I’ve had a couple of recent debates on the subject and at the end of the day, I’ll concur that it IS a very peronsal and individual decision, like many things in life. And extreme cases aside, I still stand by the opinion (MY OPINON)  that it’s a bad decision.  Mind you, this is merely my opinion but here are my reasons  why:

It’s invasive.  In most cases, unless someone is seriously morbidly obese (and there is debate as to what that is), there is no reason in the world why anyone should opt to cut themselves open in order to create an internal discipline relative to their consumption of food.  As these procedures have become the norm in a surgery happy society, there are increased cases of fatalities, infections, and other issues arising from these types of procedures.  Additionally, this is not a great starting point with respect to the mindset one needs to have and own for successful weight loss.  Now there are always exceptions to the rule, but by and large, it has become such a regular thing to do when one is overweight. 

It’s dangerous. When you are in bad health generally with heart conditions, high blood pressure, diabetes, high cholesterol, asthma, etc. that is directly connected to your weight, there is an increased likelihood of complications from surgery.  In 2004, 140,000 people in the U.S had weight loss surgery (this number does not include those who left the country to have the procedure done), by 2005 that number had increased to 171,000.

In 2010, there were 210,000 weight loss surgeries performed in the United States.  While one can argue that there are increased numbers of those having the surgery so the death rate related to such surgeries would increase as well… the fact of the matter is this is an industry that is not necessarily highly regulated in the United States and there are a number of “spas” outside of the United States that are cheap and quick and cater to the desperate.  The fact of the matter is, bad health is always problematic for those getting any surgery because of the complications associated with surgery.

It’s not always in the patient’s best interest. The criteria for eligibility has changed.  Due to heavy lobbying by heavily financed interest groups last year,  the FDA changed it’s eligibility criteria for those seeking bypass or lap band surgery. Previously, the requirements dictated that only those with a Body Mass Index 30 (which is obese) and at least one significant weight-related health problem like diabetes or heart disease could have the surgery.  This means that a person who was  5’10, weighing between 235 and 245 with either high blood pressure or diabetes could qualify for the lap band procedure. Now,that patient could weigh between 200- 210 with if they had the same health risks to be eligible.  These are two completely different body types we are talking about.  This FDA ruling made it so the eligibility of Americans who would qualify for this procedure jumped from an estimated 15-18 million to 26 million.  

In plain english, after losing 56 lbs sans surgery and at my current weight and height, I would be eligible for the surgery… why? because my BMI calculates me as being obese and my weight… yeah, puts it in perspective.

Who actually benefits the most from these surgeries? 

“There are an estimated 2,400 doctors in America who are authorized to perform Bariatric surgery procedures although it is hard to fix the actual number since there are no requirements for Bariatric surgeons registering with a medical agency in order to perform the operation. Still, more than 90% of surgeons are expected to be affiliated with the American Society for Bariatric Surgery.” 

It is worth noting is even after weight loss surgery, the weight can come back.  There is no real permanent solution if you aren’t changing your approach to food, your mindset around food, and establishing healthy habits.  So what does this lack of permanency buy you? See below…

 What is the costs of weight loss. In 2006, the  average cost of the Bariatric surgery procedure was $30k.  In 2010 that number has increased to around $42,000 (a 40% increase in the cost over a 4 year period).  If you spent $200 a month for a year at a gym, it would only cost you $2400.  A classic Bow Flex will run you $650 and a tricked out upgraded version of that machine  will run you about $3k – still less than surgery, no recovery time, and no danger. 

Worth noting, in the last year alone, Americans spent approximately $40 billion on diet plans ALONE – that is a lot of Jenny Craig.

And related weight loss products?

According to a 2006 study reported in The New England Journal of Medicine, most people who participate in weight-loss programs “regain about one-third of the weight lost during the next year and are typically back to baseline in three to five years.”  Why?

The short answer is because we over eat. Those who engage in weight loss tend to look for quick fixes given that we are a country that enjoys immediate gratification without the capacity to look long term.  Many of us know this.  For some reason, we still continue to engage in behavior that is bad for us.

Changing one’s lifestyle is the only and most natural way to achieve a healthier life  and the weight will follow.  Weight loss surgery and pre-packaged meals are not a magic bullet. Janet, Mariah, and Jennifer Hudson look like that because they brought the pre-packaged food and meals plans, but they also have trainersmake up artists, and stylists that help them out – not to mention for the working celebrity moms, nannies and house keepers allow them time to work out.

However, there is in many cases a struggle to establish the self discipline required to exercise, eat right, engage in portion control, etc… all the things one has to do anyway in orger to reach a desired goal and maintain both health and weight…  So… if you have to go through all of that to ultimately end up where many of us get to, why do it?

The truth about Diabetes (and Weight)

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As some of you know, in my ongoing effort to manage my Type 2 diabetes, I am reading, researching, juicing, experimenting, and devouring kernals of knowledge that will make me healthier and keep me on course with respect to my own regiment.  I know I probably sound like a baby bitching about taking pills when there are people (a close friend included) shooting straight insulin daily, sometimes several times a day…  And I know how that feels from my bout with gestational diabetes…  However, I also feel strongly that  this doesn’t have to be my reality and I want to affect change within my body.  So with enough elbow grease, maybe I can “defeat” this condition…

That said, today is one of those days when I feel like my diabetes is here for the long haul and isn’t going to go away… that maybe its the universe’s way of keeping me honest and in check for life (I don’t like that notion because I hate being regulated by anyone).  The truth is diabetes drives my desire to lose weight.  But there are some real consequences with respect to just having diabetes… there are day-to-day realities, when in spite of my best efforts, my numbers SUCK moose ca-ca.  There are days when I am too high because I did cheat and eat some tortilla chips (which I LOVE with guacamole or salsa) or when subtle hormone fluctuations cause my pancreas to be even more insulin resistant than it’s been…  There are days when I feel lazy due to high/low numbers and don’t want to work out and in not working out, my BGNs are crappy.  There are days when I am so wound up at work and forget to eat that I go low and don’t realize it until I am woozy and feel like a run down battery… The fact is diabetes has a tremendous impact on my life and I wish it would go away.  However, it is directly connected to my weight and activity… so, while it’s not going away (as quickly as I’d like)… my goal is to make it go away.

My sister, who is a nurse, is one of my biggest supporters and sources of information.  She regularly reminds me that  me I am doing great and have made tremendous strides in the last 12 months and I should be proud and stop pushing myself so hard.  But me pushing has gotten me to where I am… further, here is why I think I should push.

Type 2 diabetes (adult onset diabetes) is typically tied to weight, being overweight or obese.  Why? Because, according to the Journal of the American Medical Association, the definition of diabetes is the result of the body having difficulty controlling sugar levels in the bloodstream. In a normal functioning body, the pancreas (located in the abdomen)  produces insulin, which is the the hormone that regulates our blood sugar levels.  The location of the pancreas is important and I’ll get to that in a minute – read on.

For those with type 1 diabetes (which usually starts by the early teen years), the body does not make enough insulin to control blood sugar, so they must receive insulin injections.  Essentially, in the case of type 1, the pancreas does not function in a normally and weight isn’t necessarily a factor here.

HOWEVER, for those type 2 diabetes, the body has become resistant to the effects of insulin.  Remember, Type 2 diabetes usually develops in adulthood but can also occur in overweight children which I’ve written about  in a previous blog.  While a family history of diabetes can be a major consideration for type 2 diabetes, excess weight,especially weight carried around the middle, are strong risk factors for developing type 2 diabetes.

Why is that last sentance important? Go up a bit and read the part where the pancreas is located in the abdomen.  If we are carrying a bunch of fat around our abdomen and it interferes with our external body, what kind of impact do you think those juicy little fat cells are posing to our internal organs?  We know that fat deposits that build up in arteries can cause a heart attack or stroke, we know that fat build up in the eyes can cause blindness, we know that fat built up in any part of the body (organs, veins, etc) can create a problem.  What does that tell you? (obvious question inserted here)

There IS a direct correlation between fat/fat deposits and it’s capacity to screw up our body’s functions.  This is why losing weight around the middle greatly reduces your chances for type 2 diabetes and can help bring your blood sugar under control if you already have type 2 diabetes.

Why is this important? (another obvious question)  I am getting to that.  Because diet and exercise have been shown in clinical research to significantly improve the health conditions of patients with type 2 diabetes.  I am going to use myself as an example to further show a correlation – when I dropped from a size 20 to a 16, my metformin was cut in half by my doctor because my A1C had vastly improved from nearly 11 to 7.  My belly fat had been significantly reduced and the result for my pancreas was better function.  Now, I am a size 14 (working goal is 10/12).

Here’s something else:

On February 7 and 8 2011 my BGNs were as follows:

2/7/11  Fasting: 292   Midday: 287  Pre-bed: 198  – 2/7/12 Fasting: 83  Midday: 99   Pre-bed: 87

2/8/11 Fasting: 196    Midday: 252  Pre-bed: 200 – 2/8/12  Fasting: 91  Midday: 90   Pre-bed: 86

A1C: 10.8    A1C: 5.7

This tells me that while I am still currently stuck on that damn metformin pill once a day (for the moment), my body is functioning significantly better with 1/2 the dose than it did a year ago.  I’ve also further decreased my dress size which again decreases the belly fat taking some of the pressure off of organs and promoting healthy functions among my organs, especially those located around the middle like say, the pancreas.

That said, what else do you need to know about diabetes?  (Source: American Diabetes Association)

Total prevalence of diabetes

Total: 25.8 million children and adults in the United States—8.3% of the population—have diabetes.

Diagnosed: 18.8 million people

Undiagnosed: 7.0 million people

Prediabetes: 79 million people*

New Cases: 1.9 million new cases of diabetes are diagnosed in people aged 20 years and older in 2010.

* In contrast to the 2007 National Diabetes Fact Sheet, which used fasting glucose data to estimate undiagnosed diabetes and prediabetes, the 2011 National Diabetes Fact Sheet uses both fasting glucose and A1C levels to derive estimates for undiagnosed diabetes and prediabetes. These tests were chosen because they are most frequently used in clinical practice.

Race and ethnic differences in prevalence of diagnosed diabetes

After adjusting for population age differences, 2007-2009 national survey data for people diagnosed with diabetes, aged 20 years or older include the following prevalence by race/ethnicity:

  • 7.1% of non-Hispanic whites
  • 8.4% of Asian Americans
  • 12.6% of non-Hispanic blacks
  • 11.8% of Hispanics

Among Hispanics rates were:

  • 7.6% for Cubans
  • 13.3% for Mexican Americans
  • 13.8% for Puerto Ricans (Me encanta mi gente but we have to get healthier!)

Morbidity and Mortality

  • In 2007, diabetes was listed as the underlying cause on 71,382 death certificates and was listed as a contributing factor on an additional 160,022 death certificates. This means that diabetes contributed to a total of 231,404 deaths.

Complications

Heart disease and stroke

  • In 2004, heart disease was noted on 68% of diabetes-related death certificates among people aged 65 years or older.
  • In 2004, stroke was noted on 16% of diabetes-related death certificates among people aged 65 years or older.
  • Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
  • The risk for stroke is 2 to 4 times higher among people with diabetes.

High blood pressure

  • In 2005-2008, of adults aged 20 years or older with self-reported diabetes, 67% had blood pressure greater than or equal to 140/90 mmHg or used prescription medications for hypertension.

Blindness

  • Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years.
  • In 2005-2008, 4.2 million (28.5%) people with diabetes aged 40 years or older had diabetic retinopathy, and of these, almost 0.7 million (4.4% of those with diabetes) had advanced diabetic retinopathy that could lead to severe vision loss.

Kidney disease

  • Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2008.
  • In 2008, 48,374 people with diabetes began treatment for end-stage kidney disease in the United States.
  • In 2008, a total of 202,290 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States.

Nervous system disease (Neuropathy)

  • About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.

Amputation

  • More than 60% of nontraumatic lower-limb amputations occur in people with diabetes.
  • In 2006, about 65,700 nontraumatic lower-limb amputations were performed in people with diabetes.

Cost of Diabetes

  • $174 billion: Total costs of diagnosed diabetes in the United States in 2007
  • $116 billion for direct medical costs
  • $58 billion for indirect costs (disability, work loss, premature mortality)

After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes.

The American Diabetes Association has created a Diabetes Cost Calculator that takes the national cost of diabetes data and provides estimates at the state and congressional district level.  Factoring in the additional costs of undiagnosed diabetes, prediabetes, and gestational diabetes brings the total cost of diabetes in the United States in 2007 to $218 billion.

  • $18 billion for people with undiagnosed diabetes
  • $25 billion for American adults with prediabetes
  • $623 million for gestational diabetes

So knowing all of this and seeing how much it cost to have diabetes, doesn’t it make way more sense to take a sensible approach to this disease? Sure, it’s not a “sexy” disease like breast cancer (and I don’t think breast cancer is sexy) so therefore the support for and funding sources aren’t the same as say Komen (never mind!!!!).  We don’t have a mass group of people talking about it relative to taking a comprehensive approach in fighting it.  Diabetes is typically that throw away word that gets wrapped into and under other health conditions and complications… but as a stand alone disease, diabetes has the capacity to cause serious complications and problems.  And type 2 diabetes doesn’t have to claim as many people as it does in this country if we just became a bit more aware of its relationship to fat.

Type 2 diabetes is what I call my fat disease.  When I get fat, I get it.  When I hit 230 during pregnancy, I got gestational diabetes.  When I hit 243 from laziness and food, I got type 2 diabetes…  At 185 and size 14, it hasn’t really gone away… yet.  But I have some more fat to get rid of… stay tuned.