Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

25 Sivan 5765 - June 21, 2006 | Mordecai Plaut, director Published Weekly









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Shema Yisrael Torah Network












Observations: Are We Healthier If We Know That We Are Sick?
by M. Plaut

Americans are probably not sicker than the rest of the world - - they are just more knowledgeable about their sickness. With advances in medical technology making more sensitive detection of abnormalities in the body possible at increasingly lower cost, a lot of minor problems are being found — and treated — that would probably have gone unnoticed — and without any ill consequences.

According to a recent article in the New York Times ("If You've Got a Pulse, You're Sick," May 21, 2006), Americans look much harder than anyone else to find out whether they are sick — and they detect many problems. However sometimes those problems could have literally been lived with.

In a paper in the Journal of the American Medical Association, Dr. H. Gilbert Welch of Dartmouth University reported that the incidence of thyroid cancer in the United States had increased by 250 percent over the last two decades. But the death rate from it remained the same. This is a tipoff that a lot of thyroid cancer that has been newly discovered was not life-threatening. The serious cases, from which people died, were discovered more than twenty years ago. What changed is that a lot more non-threatening cases came to light with better detection technology.

Another example that seems to be indicative of the same phenomenon is another paper that was published in the Journal of the American Medical Association comparing the health of Americans and the health of Britons. They found that "Americans are much sicker than the English." Almost all specific diseases were more prevalent among Americans than among the British.

However, the New York Times pointed out that most of these results come from the reports of the respective people. However there is one objective statistic that is considered reliable, and that is life expectancy at birth. These are very close in the United States and Britain: 77.6 years in Britain; 77.1 in the United States. Despite this, more than twice the proportion of Americans say they have cancer as Brits, and 50 percent more say they have heart disease.

Some researchers say that this just reflects the American interest in testing. People are very eager to have all the latest tests done, and then once they find something, they demand that the doctor do something about it. But often the conditions are subclinical and never pose any danger. Massive public screening programs turn up conditions at early stages that would be much harder to treat if found later, but they also find small problems that might never have otherwise turned up. Autopsies have found that people often have such diseases without being aware of them.

One medical expert said that if everyone had all the recommended tests for blood cholesterol, blood sugar, body mass index and diabetes, maybe 75 percent of the adults in the United States would be diagnosed as diseased.

For example, more Americans say they have high blood pressure than British, but when researchers compared actual measurements of blood pressure in British and American populations ages 40 to 70, there was no difference.

What is the bottom line?

With all our modern technology and increased knowledge and understanding of how things work, the scientific approach has its limits.

"Everything is miraculous and there is no "nature" or "way" of the world, . . . rather if one does the mitzvos their reward will bring him success" (Ramban at the end of parshas Bo).


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