Ariel Beresniak MD, MPH, PhD’s Post

Important summary of human toll, global prevalence and financial burden of long COVID. Global political and public health leaders have to recognize that long COVID is not going away and the human and financial toll will only increase over time, likely for decades without effective treatment. Please also see the second article below for some hope. Full disclosure I am a co-author of the second paper. https://lnkd.in/gcqu2_M8 https://lnkd.in/g46gj8DN

Population Health Versus Precision Medicine More people can live longer, happier, and healthier lives if as a nation we focus on our environment, socio-economic status, ethnic variations, persistent gender discrimination, and other self-induced non-medical risks—rather than personalized medicine or precision medicine.   This thought was well developed in a New England Journal of Medicine “Perspective.” https://lnkd.in/eHxnS3uh   No doubt clinical medicine has changed the way we live for the better. However, the greatest change for the better in overall life expectancy in the history of civilization has been an effective sewer system combined with a safe drinking water supply.   There is great enthusiasm for precision medicine or any scientific medical research to move society forward, and this enthusiasm derives from the assumption that sophisticated and rapidly evolving science will contribute to clinical practice. The argument that research helps lower morbidity and mortality has already been proven many times. One noteworthy example in our lifetime is the prevention of polio worldwide, except for three countries that are unaccepting of modern public health measures (Afghanistan, Nigeria, and Pakistan).   “There is now broad consensus that health differences between groups and within groups are not driven by clinical care but by social-structural factors that shape our lives,” according to the Center for the History and Ethics of Public Health, Mailman School of Public Health of Columbia University.   We struggle with limited resources to care for our population and the world’s population by concentrating on prevention. But healthy eating, purposeful movement, work-life balance, and many of the nine principles of the Blue Zones Project would yield greater dividends than the vast spending on precision medicine. Realistically we as a nation and as a world civilization may get more “bang for our buck,” by preventing illness rather than developing new technologies for repair purposes.   Nonetheless, public investments in our nation’s public health versus precision medicine will continue to be debated—much the same way that funding pure science versus applied science has been debated for decades. There probably is no “right” answer, but looking at cost benefit with the focus on how many people will be helped by adding years of quality life is a reasonable metric. This measure is called a “quality-adjusted life-year” (QALY). It is a measure of both the quality and the quantity of life lived.   The United States spends about 18% on health care but ranks 37th out of developed nations for quality of healthcare according to the World Health Organization. Most other developed nations spend only high single digits of GNP, with longer and healthier life spans.   As a nation, we have opportunities we have always responded to. I’m optimistic we can both develop precision medicine and improve population health.

"In addition to social determinants of health, such as economic resources, education, access to care and various environmental factors, there is growing evidence that political polarization poses a substantial risk to individual and collective well-being. Here we review the impact of political polarization on public health. We describe the different forms of polarization and how they are connected to health outcomes, highlighting the COVID-19 pandemic as a case study of the health risks of polarization. We then offer strategies for mitigating potential harms associated with polarization, with an emphasis on building social trust. Finally, we propose future research directions on this topic, underscore the need for more work in a global context and encourage greater collaboration between social scientists and medical scientists. We conclude that polarization is a serious—if largely overlooked—determinant of health, whose impacts must be more thoroughly understood and mitigated." Tiago Fioravanti Zibecchi Rym Ayadi Agustin Ibanez Alexander Hudson Seema Shah https://lnkd.in/gc7CXUzH

News to share! I recently published a new article in JAMA Network Opening, highlighting the burden of obesity among single-race and multiracial Asian and Pacific Islander people. The study uses electronic health record data combined with survey data and finds that multiracial Asian and Pacific Islander individuals (e.g., "Asian, Pacific Islander, & White", "Pacific Islander & White") experience greater obesity than Non-Hispanic White individuals and many single-race Asin groups. The prevalence of obesity is as high as 52% among people who identify as "Asian, Pacific Islander, & White". https://lnkd.in/gRaWRrje I'd also like to highlight the accompany commentary, led by Alexander Adia, emphasizing the utility of using electronic health record data to better capture and disaggregate Asian American and Pacific Islander groups: https://lnkd.in/gxYRfA9G These papers come at a very important time, especially given the new modifications to asking about race and ethnicity in the U.S. Census and efforts by researchers to better understand the health and needs of Asian American and Pacific Islander communities: https://lnkd.in/gavdYcBs Special thanks to Stanford Center for Asian Health Research and Education, my collaborators, and my mentor, Latha Palaniappan for the opportunity to conduct this important work. Onward!

Dr. Adrian Bacong, PhD, MPH, a postdoctoral research scholar at Stanford CARE, has recently published a new study titled “Obesity Disparities Among Adult Single-Race and Multiracial Asian and Pacific Islander Populations” in the Journal of the American Medical Association Network Open. The study examines disparities in obesity among single-race and multiracial Asian and Pacific Islander adults using the Cardiovascular Disease Among Asians and Pacific Islanders dataset, of which Dr. Latha Palaniappan is a co-principal investigator. The study found that 52% of people who identify as "Asian, Pacific Islander, & White" and 45% of people who identify as "Pacific Islander & White" have obesity, which is higher than Non-Hispanic White individuals (26% with obesity) and all single-race Asian groups. The high prevalence of obesity among multiracial Asian and Pacific Islanders remained after accounting for underlying differences in demographic, socioeconomic, and health behavior factors. This higher burden of obesity and potential cardiometabolic disease among multiracial groups is important to track in the future as the population continues to grow. To read more about it, please visit: https://lnkd.in/gHx8aEuq To learn more about the research that CARE is spearheading, make sure to visit Stanford CARE at Asianhealth.stanford.edu #Asianamericanhealth #asianhealth #stanford #medicine #cardiovascular #obesity #healthdisparities #healthequity #healthcaresolutions #research #education

Viewpoint discusses highlights from the National Academy of Medicine 2023 Annual Meeting Scientific Symposium that are representative of key gaps, trends, and opportunities in women’s health. https://ja.ma/3JP9Zob

Our NIHR Newcastle BRC research themes benefit from patient and public involvement, but so does the wider health and research landscape. In this case study ⬇, our Ageing, Sarcopenia and Multimorbidity theme (ASM) share insights into how to design a public engagement event for an underserved group of older study participants. 🔗 https://lnkd.in/d_5iQEAh #BRCresearch #ageing #casestudy #METPREVENT #researchstudy #ppie

Study Compares EQ-5D-5L and PROMIS Measures in Longitudinal Analysis A study compared two health preference measures, EQ-5D-5L and PROMIS preference

The Interconnected Self ( and health). In the ever-evolving landscape of medical science, rarely spoken of are leaders in their fields that connect parts of people together and see us as whole beings rather than disparate systems which have no impact on eachother. Amongst the few whom have made as profound an impact, is Dr. Esther Sternberg. Her groundbreaking research illuminated the intricate relationship between the central nervous system and the immune system, a connection that has reshaped our understanding of what it means to be human came at a time where the research continued to support the emerging field of psychoneuroimmunology. Ancient Greek and Roman Medicine spoke of the 'Four Humors'. And whilst they are based in different frameworks some thematic connections with psychoneuroimmunology (PNI) can be noted. In a broad sense, both the four humors and PNI reflect an understanding that physical health and emotional or psychological states are interconnected. Somewhere along the way we forgot about these connections and with this came the crisis we currently face with the number so chronic diseases people contend with. Dr. Sternberg’s work revealed that the immune molecules circulating in our blood are not mere bystanders—they actively influence brain function, which in turn shaped our emotions and overall health. Their contributions cemented the foundations for the burgeoning field of psychoneuroimmunology, which explores the deep interconnections between our psychological state, nervous system, and immune responses. This field has opened our eyes to the complex and dynamic interplay between our brain, gut, and inflammatory processes. We now understand that inflammation is not just a local response to injury or infection—it is a key player in a vast network that includes the gut and the brain, profoundly influencing both mental and physical health. As we continue to build on this framework of the causes of health and illness, the movement towards integrative medicine becomes ever more essential. An equitable, root cause approach—one that is participatory, preventative, proactive, and personalized—holds the potential to revolutionize healthcare. By embracing the interconnectedness of all body systems, we can move towards a future where health is not merely the absence of disease, but a balanced and harmonious state of being. In following the path paved by folks like Dr. Sternberg, Dr Ader et al we can forge a more holistic and human-centered approach to medicine, one that honors the intricate and inseparable links between our bodies, minds, and emotions.

The economic and practical challenges of optimizing functioning across the life course. Aging, Functioning and Rehabilitation