Envisioning 2.0

Early last month, PLoS Medicine published a disturbing, but very important study that sheds new into the vast gaps in life expectancy rates between people of different racial backgrounds and socioeconomic status. This study has significant implications for people involved in health promotion, social marketing and other efforts to improve the health of diverse communities.

Authors of the study found that (when measured by life expectancy) we live in eight different Americas. See images below for definitions and gaps in mortality (click images to view larger versions).

What’s interesting about the data is that the differences in life expectancy cannot be explained by “race, income, basic healthcare access or utilization alone.” According to the authors of the study: “The causes of death that were mainly responsible for . . . [variations in life expectancy] were various chronic diseases and injury.” In addition, the in mortality rates were between middle-aged Americans of different races and socioeconomic status, not the elderly or children.

In sum, people are dying earlier due to illnesses like high blood pressure, abnormal cholesterol, smoking, obesity, diabetes and pre-diabetes. All of these conditions are highly treatable and preventable.

The study authors note that “expanding health insurance coverage alone will not reduce disparities.” Instead, we need improved disease prevention strategies, especially in the area of cardiovascular disease.

These data indicate that we need to increase efforts to educate diverse populations about risk factors that contribute to early death, including high cholesterol and high blood pressure. Intensive communication, social marketing and behavioral modification programs are needed now more than ever.

This post also appeared on HealthCareVox.

A few weeks ago, I announced that I published an e-book, “From Command & Control To Engage & Encourage” designed to help players in the healthcare industry get a handle on social media. I’ve been very happy with the response to the e-book and honored that people like Nedra Weinreich, Toby Bloomberg, Neville Hobson, Lee Hopkins and Dmitriy Kruglyak have found it helpful and recommended it to others.

After reading the e-book, a friend of mine suggested that I submit a proposal to a Website called “ChangeThis” to expose it to a wider audience. ChangeThis is a non-profit organization dedicated to helping ideas about business, technology and other topics spread. Seth Godin thought-up ChangeThis, which is now part of 800-CEO-READ.

Over the past few years, lots of people I respect, including David Maister, Debbie Weil, Mark Cuban and Guy Kawasaki have produced so-called “manifestos” (sometimes based on previously existing material). I’m happy to announce that my proposal was accepted by ChangeThis for potential development into a manifesto.

Here’s where I need your help. The editors of ChangeThis select proposals for further development based on the number of votes they receive. It’s a bit of a popularity contest, but I can see how ChangeThis is using the “wisdom of crowds” to foreground good ideas. So, if you would like to see my e-book become a ChangeThis manifesto, please visit my proposal and cast your vote. Voting closes on November 2.

While you are there, I encourage you to visit a few other proposals I think are worth noting:

- The Natural Advantages Of Small Business: John Jantsch, author of the award-winning blog Duct Tape Marketing has developed a proposal focusing on the benefits of small business for organizations of all sizes.

- Creativity & The Chaotic Edge: Ernie Schenk asks companies interested in innovation to “reside in a creative space that yields ideas that are neither too radical and therefore useless or too conservative and therefore inconsequential . . . [and] balance themselves at their own edge of chaos.”

I’d like to thank everyone for reading and commenting on this blog and for your continued support. Once again, to cast your vote, please click here.

. . . at Managed Care Matters. Read the best of the health policy wonk-o-sphere.

With all of the talk about the potential of blogs, podcasts, wikis and other social media technologies to transform healthcare, the fact is these tools are not yet in the mainstream. They take a lot of time and effort to produce properly and many physicians do not understand social media and are unwilling to devote the time to exploring it.

Those seeking reasons for this, should look no further than more mature online communications tools like e-mail. According to a new Center for Studying Health System Change study, only about 25% of physicians use e-mail to communicate with patients. Dr. Bob Centor, author of the blog DB’s Medrants, explains why:

“Many physicians . . . avoid email communication as another cost of time. . . Most insurers do not pay for email. Physician avoidance is mostly about money.”

If a September Wall Street Journal/Harris Interactive poll is any indication, patients want physicians to adopt e-mail, electronic medical records and other technologies much more aggressively. 74 percent of respondents want to communicate with physicians by e-mail. 67 percent want to receive the results of diagnostic tests via this method. People crave fast, efficient communication with their doctors and the medical profession is not responding.

Let’s compare the numbers one more time. Barely 25% of physicians use e-mail for patient communication, but 74% of patients want to interact with doctors via it. That’s quite a gulf between demand and supply. Are any savvy entrepreneurs looking at this data and putting together a business plan to meet this need?

When it comes to communication, e-mail is a no-brainer. It’s fast, easy, secure and cheap. However, as with podcasting and blogging, physicians will have to be provided with incentives (financial, business, personal) before they will be persuaded to take full advantage of these technologies.

A couple of weeks ago, the Centers for Disease Control (CDC) released new guidelines suggesting that all Americans between ages 13 and 64 should be tested for HIV. The new recommendations would not require doctors to ask patients’ permission to test them. According to the Associated Press, the CDC wants the test to become “as common as a cholesterol check.” Advocates for routine testing say that it is needed to prevent those with AIDs from infecting others with the disease.

Some AIDs advocates have praised the CDC’s move calling it brave and saying that it could help reduce the stigma associated with the disease. However, opposition to the testing is fierce in New York City, which some call the epicenter of the AIDs epidemic.

I’m not going to debate the pros and cons of a law. However, I will ask and answer a few questions about the policy from a communications perspective.

Read the rest of this entry »