When population health and personal health maintenance become very relevant

March 30, 2020

By Dennis Archambault

I recall a strange comment made by my primary care provider when it became evident that I needed to lose weight. He said I needed to lose weight, but that “a little extra weight” is good should I become sick. As in seriously sick. I have come to know that was his simplistic way of saying that like all creatures preparing for difficult times, we need to build our reserves to carry us through.

Why is that cities like Detroit, Chicago, and New Orleans are becoming hot spots in the numbers of those infected and died from the virus? New York is still the focal point, but predictions are that the numbers of those infected in three cities will rise significantly this week, along with the death rate. What do Detroit, Chicago, and New Orleans have in common that might relevant to this situation? One thing is high numbers of impoverished African American and other minority populations living with multiple chronic diseases and poor health determinants.

We have known about the long-term impact of obesity on diabetes and hypertension. We’ve known about the impact of social determinants on longevity of life, as well as quality of life. Now we’re seeing that people with pre-existing health conditions and those with weakened immune systems are particularly vulnerable to COVID-19. Age certainly factors in, as the body overall is more susceptible to disease and less able to fight it – unless you are in good physical condition.

China noted that 40 percent of people infected by the coronavirus requiring critical care had pre-existing conditions. Of those who died, heart disease, diabetes, or chronic lung disease were common pre-existing conditions. In Italy, half of the people who died with COVID-19 had three or more underlying conditions.

Dr. Trish Perl, an infectious disease physician at UT Southwestern Medical Center noted in a recent article https://www.detroitnews.com/story/news/nation/coronavirus/2020/03/29/coronavirus-risk-age-not-only-factor/111489666/?utm_source=native&utm_medium=capi_retrofit&utm_content=inapp&build=native-web_i_p  that risks in the less healthy may have something to do with how they hold up if their immune systems overreact to the virus. Patients who die often seemed to have been improving after a week, only to suddenly deteriorate, experiencing organ-damaging inflammation. That is especially true for people with lung disease confronting this virus, which hits the respiratory system.

The benefits of health maintenance are well known. Nutrition and exercise fortify body organs and efficiency. Improved natural environment – less pollution in air, water, and soil – is an important social determinant, especially considering lung function in places with poor air quality. Certainly, proper handwashing and social distancing is the order of the day. But boosting the immune system through good nutrition (minimizing comfort food), staying physically active, meditating, practicing stress management, and getting adequate sleep can help for the moment – as it helps build stronger resistance to disease over time.

An article published recently by CNN https://www.cnn.com/2020/03/25/health/immunity-diet-food-coronavirus-drayer-wellness/index.html  offers recommendations for fruits and vegetables to consider in boosting your nutrition:

  • Carrots, kale, sweet potatoes, broccoli, and apricots for beta carotene, which is converted to vitamin A;
  • Oranges, strawberries, Brussels sprouts, red and green peppers, and broccoli for vitamin C;
  • Eggs, cheese, tofu, and mushrooms for vitamin D;
  • Beans (also chickpeas, lentils), nuts, cereal and seafood for zinc, which may shorten the duration of the common cold;
  • Milk, eggs, nuts and more for protein, a key building block for immune cells and antibodies
  • Bananas, beans and more for prebiotics, which help boost the health of the microbiome.

Remember to exercise with the time and favorable weather that we have, maintaining your flexibility and aerobic well-being.

While we are seeing the dire consequences of late-stage chronic disease, we are also realizing that there is great wisdom in eating well, exercising, and finding a path of therapeutic restoration, be it mindfulness, spirituality, and interpersonal connectivity.

Or, as my physician suggests, a little extra helps, when we must fight disease.

 

Dennis Archambault is vice president of Public Affairs for Authority Health.