The Way to Better World Health
Using
Knowledge to Balance Territoriality and Compassion
Table of Contents
Introduction to The Way
Section I Need 2 Know/Hide
Chapter 1 Visions of Health Knowledge/Ignorance:
Smallpox Scenarios page3
Chapter 2 Chose the Best Balance of Territory and
Compassion page 5
Section II Knowledge to Balance Compassion and
Territory in Health
Chapter 4 Sweets, Vitamin C, Obesity, Diabetes, and
Scurvy page 22
Chapter 5 Tobacco: A Stimulus to the Modern Economy
with Bad Side Effects page 27
Chapter 7 Sexually Transmitted Infections: Taboo for Two page 33
Chapter 8 Preventing Injuries: Searching for Our Best Niche page 36
Chapter 9 Mental Health: Dealing With Our
Subconscious and Social Heritage page 39
Chapter 11 Fat Wars: DHA and Vitamin D versus Trans
Saturated Fats with Sugar page
61
Chapter 12 Genes: A Natural Information System page 63
The Discussion Continues
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This is a book to help individuals and groups to feel better in a sustainable way. By using knowledge from the past and present we will help ourselves, help others and thereby help our species and its home, our planet. Since the origins of vertebrates territory has been used as a way to divide resources among individuals and families in a species. Humans have homes and yards often still. Since the origins of vertebrates compassion has been used to protect the immature and frail members of a species. Humans still tend to be attracted to and give to children and the ill. These feelings touch deep powerful emotions that may be used to motivate us to help our species or may be used to manipulate us to divert resources to harming our species. Since the origins of primates and before, species have developed social groups with their own leaders ruling over territories and providing for the immature and helpless. With symbols, language and ideas territory and compassion have become abstract often. We have resources in banks in our virtual territory of an account or in corporations in shares. We show our compassion by bank or stock transfers to charitable institutions. We even claim ideas as territory with copyrights and patents. Nations and international organizations identify with territories of demarcated lands or the whole planet. Groups may claim the ideal of territory or compassion as their own territory. Nations and/or regional organizations often combine their traditional geographic territory and their compassion for their residents or group members to be especially powerful at motivating their members. This may help our species adapt to our local, regional and global environment or this may just satisfy some of our primitive emotions to the short term benefit of some greedy territorial leader. With knowledge of our history, our psychology, our biology, our sociology and our economics in the past and in real time in the present we are better able to determine what is best for our species and ourselves. In the past we depended on bureaucrats and academics to guide us. Now information in corporations and on the Internet is more up to date and accurate than the 19th century built infrastructures of knowledge. Corporations may use this information to their advantage in lobbying and marketing. The public and its government must use it to benefit our society and species.
In a capitalistic materialistic society compassion is often sought as a spiritual oasis. Helping the immature, the sick and the needy does help us feel good about ourselves and help our species by promoting its survival with diverse individuals with their own special skills. Religions, political groups and nations that strive for this alone ultimately become victim to extremes of territory. Only groups that recognize the need for resources and know how to accumulate them will continue to exist. The protective cover of altruism or compassion then allows the leaders and bureaucracy to accumulate immense wealth to the sole benefit of the hierarchy. Similarly in a socialistic communistic society territory is often sought as a practical oasis. Rewarding creative and productive workers and developers helps us all improve our physical lives. Individuals, corporations, and multinational corporations that recognize only the material world may accumulate much wealth while harming the environment and social structures. If we recognize the territorial and compassionate needs and accept them in our organization and ourselves then we will better control them and use them to help others while keeping our organization and ourselves self-sustaining and helpful to our species and ourselves.
Now in our political, energy, environmental and health crisis we have one solution to help the species and its members. Knowledge of our past and present will guide us to the way to live. For most of us in most areas this means using non-violence to work with others with limited force for self defense as needed. We must use our own muscle power for energy and exercise primarily with renewable energy sources for supplements and non-renewable sources only as an investment in a self-sustaining future when necessary. Vegetables and fruits should our main sources of food to help decrease our energy, land, and health needs. With less energy use, less disease and less pollution our political problems will be easier to solve. Using vegetables and fruits for our main food source will decrease our main problems of heart disease and cancer. With less waste on wars and animal protein production we will be able to give more resources to the poor and needy of our nation and the world. This will make the world safer from extremism, infectious disease and violence while giving a better social and health environment to all.
Section I
Need 2 Know/Hide
Chapter
1 Visions of Health
Knowledge/Ignorance: Smallpox Scenarios
Smallpox Scenarios
#1 The Present or Recent Past-
The
United States of America (USA) is just starting to vaccinate military and
medical frontline responders to smallpox. Many people with fever and a hard
white rash on their arms and legs start appearing in the
(http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp). The diagnosis is made within 24 hours. All known
contacts are vaccinated within the next 2 days. Overseas reports of smallpox
cases start to come in. Simultaneously a massive attack on the Internet by
computer viruses shuts down the Internet for a few hours and slows down
communication for days. Cases continue in contacts that were not vaccinated and
containment of new cases is again done with immunization with smallpox vaccine
of contacts of the new cases. In communities with many cases smallpox vaccine
is offered to everyone. About 30% of the smallpox patients and about 1% of
vaccinated contacts that also have poor immune systems or severe eczema die.
Many are severely ill and some become disabled with brain and eye damage.
Overseas the disease spreads in the poorly developed countries of the world
where the health care resources are limited. The World Health Organization
(WHO) begins to mount an effort to contain and eliminate smallpox once again as
in the 1970's.
#2 The Future with Improved Knowledge and
Security Systems -
The
United States of America (USA) has finished its final phase of voluntary
smallpox vaccination. A few people with fever and a hard white rash on their
arms and legs start appearing in the
With
the use of the HaSN the untreated people that died with smallpox at home were
found to be a group of people that often associated. People that sometimes
dealt with them noted that had an extreme admiration for living things
including viruses. A new computer virus is unleashed shutting down the
non-secure Internet for days. The HaSN easily copes with the computer virus
using traps and limited access to its registered computers. With the HaSN
records members of the group who traveled overseas were tracked and the
information given to the WHO (World Health Organization) and the health
agencies of the countries of travel. Immunization of contacts is begun
immediately and members of this group promoting the smallpox virus are isolated
to prevent further spread of the smallpox. The group members that volunteered
to carry the smallpox used veils, scarves, hoods and winter masks to avoid
people noting their typical smallpox rash.
#3 The Future with a Comprehensive Knowledge
and Security Integrated System -
The
At the same time the group has used the
identities of their the unsuspecting others to make
phone and letter contacts. All phone calls at this time require an electronic
user identification number and a matching PIN. Letters require a unique barcode
for the sender along with an encoded PIN. Receiver addresses are also
bar-coded. Postal computers record and track all mail and parcels. Receivers
may block letters from some addresses, and for security may only accept mail or
parcels from senders who also know their special receiver PIN and have it
encoded on the letter or parcel.
The VLM plans to release smallpox back into
the environment. This will help let the virus reach its full potential. They
also plan to release large number of computer viruses into the electronic
environment. These will be blocked from all registered computers on the state
protected International Health and Security Network by anti-virus traps and
programs within the network. The Virus Liberation Movement hopes to attack the
wild old Internet remnants and the unvaccinated of the world to let the viruses
live. The VLM gained access to registered and secure computers of unsuspecting
friends and acquaintances. By the time the VLM has found one rogue organization
to give them the smallpox virus, Interpol has tracked them down and arrested
them with the virus shipment. The smallpox release is prevented. Some at large
members of the VLM upset at their failure with real viruses release the
computer viruses into unregulated parts of the Internet causing damage to
computer networks in developing countries without the latest computer virus
protection. New secure identities to prevent further breaches in their
Internet, phone and postal security are given to the unsuspecting associates of
the VLM with stolen security access. Developed countries work to improve
security in the developing world to help maintain international communication,
health and commerce.
Chapter 2
Chose the Best Balance of Territory and Compassion
Which
scenario would you like? Throughout the centuries of our existence there has
been benefits to knowledge and to secrecy. There have also been many abuses of
both. In this book I would like to review the history of knowledge and secrecy.
To discuss past and present choices and make recommendations for future choices
that may help our species and environment survive in the best possible state.
Our species now must make major decisions regarding information processing. Our
information technology revolution is forcing us to chose between an efficient
and powerful integrated information network with tremendous potential for
benefits and abuses, or to continue with fragmented, disintegrated, redundant
systems which will be hard to use and abuse. Both choices have benefits and
dangers. How the choices are implemented will be very important. The integrated
system must be strictly controlled and protected to prevent abuse by the
powerful controllers of the system or from any possible intruders. With the
integrated data system automated and high security review of data by a select
few with explicit directives and limits determined by a legislative directive
subject to judicial review would be best. With the continuation of our separate
data systems trusted observers and regulators must constantly review the
fragmented systems to make them useful at all for health and security. Our
inability to use these separate data systems to prevent the 9/11 2001 terrorist
attack bodes poorly for continuing this system in its present state. First I
will briefly discuss the smallpox scenarios.
In
the first scenario taking place in the present/ recent past people with smallpox
that present to physicians will be detected at about the time the smallpox
virus becomes infective. At the end of 2002 experts believe that the virus will
unlikely spread to other casual contacts until the typical smallpox rash
becomes easily visible during a routine examination by a physician or other
well-trained health care provider. In the NBC TV show ER broadcast at
the end of the spring 2002 season the smallpox virus was shown to spread to ER
staff when the smallpox infected patient first got a fever 2 to 4 days before
the typical rash appears. This sometimes occurs if the infected person shares
food or drink or kisses another person (http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp). Most experts believe that smallpox infected
patients with fever but without the rash would rarely transmit the smallpox
virus to ER staff, healthcare workers, casual acquaintances or passersby. This
is consistent with the ability to contain natural smallpox in the 1970's with
programs that just vaccinated known contacts of the smallpox infected.
Vaccinating contacts within 3 to 4 days of contact with the virus is able to
prevent severe smallpox. The sooner the vaccination is done after contact the
better. Vaccinating within 72 hours (3 days) of contact is most effective, but
even up to 96 hours (4 days) still prevents most of the severe disease
( http://www.bt.cdc.gov/agent/smallpox/basics/index.asp ). Even with this limited period of contagion
tracking the path of infectious person and finding all the contacts is very
daunting in our mobile society. Especially of the person was contagious while
in a school, concert, church, subway, train station, bus terminal or airport.
If the person knowingly concealed the illness and tried to expose the maximum
number of mobile people before dropping from the illness the task to vaccinate
all exposed within 3 to 4 days of exposure would be nearly impossible. Our data
systems on travel and contacts is insufficient to quickly document and find
these contacts. We could only hope that the number of concealed ill was small
and we soon discovered all the non-concealed cases and their contacts. At
present we must plan on about 30% of the unvaccinated smallpox infected dying.
This is the rational for the current plan of President Bush to offer smallpox
vaccination to the general public in the year 2004. This would cause 1/3 of the
vaccinated to get ill enough to miss work in 7-10 days from the smallpox
vaccine, 1 in 1000 people to become severely ill with hospitalization, and 1 in
a million to die, but would protect the survivors for 10 years from a concealed
exposure to smallpox.
Unless we know the future chance of smallpox
exposure we are unable to accurately tell whether the risk of the vaccine is
more or less than the risk of disease or death from smallpox. Only by gathering
more information on smallpox, terrorists external/internal, travel,
communications and resource or money flows will we better able to plan and
prepare. To better survive and use our resources we must decrease the number of
unknown variables. For a discussion of a proposed National Health Information
Infrastructure [NHII] see the work of the National Committee on Vital and
Health Statistics [NCVHS] web page (http://ncvhs.hhs.gov ) and its report on the NHII (http://ncvhs.hhs.gov/nhiilayo.pdf ). At the same time we must decrease the number
variables known to the terrorists to make their actions and planning less
successful. When we gather information it should just be available on a need to
know basis with the high level information systems protected by identification
that is linked to unique body markers. These systems will take time and money
but they will guard the health of the community and the privacy of the
individuals. As at present for sensitive information on sexually transmitted
diseases, inherited genetic tendencies, and behavior problems; security to
prevent disclosure must be strong. Penalties for wrongful disclosure must be
severe and enforced. When we spend time entering our identification codes,
using our smart cards, swiping through bar codes, and then entering our PIN
(personal identification code) and/or placing our fingerprints on a machine
reader we must feel the information is used only for the good of ourselves and
the community. When we need to enter a high security area or have a large money
or property transfer we may need further levels of verification with perhaps
pattern analysis of our face or iris (the biologic shutter around the pupils of
our eyes). For the highest levels of security pattern analysis of our retina
(the back of our eye seen through our pupil) or DNA analysis may be necessary.
Machines that communicate through the Internet, phone networks, and radio
networks should be uniquely registered with identifiers hardwired into their
silicone chips. Intel tried to do this with computers a few years before
At present we are ill prepared for another
internal attack as the Oklahoma City Bombing by Tim McVeigh in April 1995 (http://www.cnn.com/US/OKC/bombing.html ). Our only improvement in surveillance is the
temporary legislation known as the USA Patriot Act of 2002 allowing the FBI to
examine credit card records. This may easily be circumvented by using credit
cards that are stolen or with false identities. The recent credit card theft
ring in
The
developing countries of the world without our health care and information
infrastructure will be hard hit if smallpox escapes to their populations. The
resources of WHO (The World Health Organization) and the developing countries
will be severely challenged. Smallpox might smolder for years in the these
countries with large disruptions occurring in health, culture, travel,
transportation, and commerce which are all now global in many ways. To cope
with these challenges developing countries with foreign aid as needed might
develop simple efficient integrated data systems based on affordable technology
that would best direct limited resources and help development. As hardware and
wireless technology costs fall developing countries without wires may use open
source software such as Linux to fill the information void with public systems
that are easily usable, secure, and affordable. International agreements would
be needed to share information on a need to know basis. Data would be kept
within each country and only given to computers in other countries when the
person travels. Contagious disease or criminal history may then preclude
certain activities or travel but only officials who must be involved in risk
reduction would be informed of the nature of the problem.
In
the second scenario we have implemented better tracking of people traveling on
public transportation and using health services. Public health organizations
are then better able to find contacts of infectious disease and prevent further
spread of the disease. Police organizations are then better able to find the
criminals spreading the disease and limit their criminal impact. The second
scenario however lacks the means to effectively prevent disease and crime.
In the second scenario criminals, terrorists,
pranksters, and hooligans are still allowed to use electronic and mail
communications to perpetrate their damage to our society. We would likely
continue to have bomb threats causing disruptions to businesses and schools. In
NY State laws have been passed with severe penalties for such behavior with
little help. The present mail system that continues to use much of the same
security that Ben Franklin gave it in the 1700's, lends itself to spreading
disease and dangerous materials. Computer viruses, fraud, pornography, Internet
attacks and electronic junk mail or spam clog the Internet making it more
difficult and expensive to use for legitimate individuals and businesses. Our
electronic world is like the Wild West where people must defend themselves. The
Bush Administration in October 2002 says that private corporations and
individuals must provide for their own security (http://www.landfield.com/isn/mail-archive/2002/Sep/0083.html , http://www.whitehouse.gov/pcipb ).
This is a necessity at present, but lacks
efficiency and effectiveness. Even the most conservative and liberal agree that
government has an essential role in police protection. Since our future is in electronic
information and commerce, government must police and regulate this environment.
We accept the rules of the road and traffic regulations for our cars and
trucks. Why fight them for our Internet communications and commerce? We accept
being taxed to pay for our streets, roads, and superhighways. Why fight them
for our information byways and superhighways that will make our country and
world safer and more efficient? We accept the need to register cars, trucks,
and buses. Why fight the registration of connected electronic devices such as
phones and computers that might bring schools, businesses, or the defense
department to disaster? We license and regulate professional and businesses
that are located in our state. Why fail to provide secure identification and
licensing for them when they operate electronically in our homes, businesses,
and public networks? We prevent pollution of world with contagious disease and
toxic substances. Why allow our machines for knowledge and business to be
infected and damaged thereby threatening our health and economics? Just as we
have set up infrastructures in the earth environment for communication, travel,
transportation, economics and health we must also set up infrastructures in the
electronic environment. Few of us would accept phones, train, airlines, or mail
systems that fail to interact. Why do we accept failures in accounting systems,
medical record systems, immigration and criminal justice systems that then fail
to protect us from fraud, contagious disease, and crime because of their
inability to communicate to the public servants that need to know?
Bill Gates in Business @ the Speed of
Thought (http://www.microsoft.com/billgates/speedofthought ) and Alvin Toffler in POWERSHIFT
http://www.amazon.com/exec/obidos/ASIN/0553292153/ref=ase_thewhythingsdont/104-0213690-2499931#product-details believe that easy access to
knowledge at anytime and anyplace is a key to our future well being. Bill Gates
simply sees knowledge as essential to good management and business practices.
Alvin Toffler sees knowledge as the key at present to controlling society.
Knowledge as communicated will influence social choices and also makes the
other means of social control: violence and wealth, more effective. Both see
that we must progress beyond the period of mass production, mass religion, and
bureaucracy to more flexible organizations through which information flows
freely to where it is needed. Bill Gates sees within organization e-mail as
helping out. He accepts e-mails from anyone in Microsoft and uses the
information to make his organization better. From the anti-trust trouble he got
into by writing down in his e-mail his ideas on eliminating Microsoft's
competition, he probably needs to appreciate more the need to conceal. The
e-mail archives were used against him and Microsoft in the government's
anti-trust case involving the Windows operating system. This illustrates the
need to hide. Alvin Toffler notes that informal social contacts and structures
as among Japanese executives that start training in their corporation in the
same year also help. The failure of the
To
change our private and public sectors to be more adaptive with the use of new
information and knowledge systems will take much time, money and political
will. Bill Gates discusses at length the conflicts between the financial and
information technology (IT) people within private organizations. Financial
experts with like to see the IT departments make money or at least minimize
their expenses. The IT people are usually a support service which contributes
parts of functions to money making parts of the organizations. Often it is
difficult to account for how much income they produce for the corporation.
Other departments that use them often wish to underestimate the value of IT to
avoid sharing income with the IT department. As a society we are poor at
dealing with the value of ideas or intellectual property. Our Gross National
Product (GNP) and our International Trade Deficit often fail to adequately
account for income that we make on movies, music, and entertainment. Bill Gates
notes that even his huge corporation must avoid over reaching. Data and
information systems should start with limited achievable goals. Alvin Toffler
notes that bureaucrats in old businesses of the mass production era and in old
government departments often control through limiting access to information in
their departments to others. Information and analysis from these private or
public departments is usually provided after a time delay, sometimes with special
payments to the department, and often with view or opinions of the chief
bureaucrat being built into the report. Accessible data and analysis systems
available to other employees, stockholders or concerned citizens threaten the
control of these bureaucrats.
Much of our evolution from vertebrates on to
mammals and primates has involved territoriality. This allows for the
allocation of resources for survival such as food and shelter. The territories
serve to distribute species member individually or as in mammals in groups to
certain areas that may support their growth and reproduction. Some of the
bureaucratic and political behavior may be explained by this tradition. Often
shame and pride mediate the protection of territories both physical and intellectual.
Donald Nathanson in Shame and Pride
explores in depth how we frequently use these affects and associated emotions
subconsciously but fail to recognize them consciously
(http://www.behavior.net/column/nathanson/bio.html ). We know from infancy to have shame if we are
unable to do some task. Often parents and/or teachers use this to control us as
we grow. When shame becomes associated with guilt or emphasized in our early
childhood we suffer pain whenever we experience shame. This often keeps us out
of areas that bureaucrats would like to control. Those who are shame sensitive
tend to stay within their own territory where they will make few errors, feel
competent, are comfortable and have pride - our home. Unfortunately our world
is changing rapidly and we now must often venture into new intellectual
territory. Only those who may tolerate failure and are willing to explore the
unknown may go gladly into the future and adapt willingly. Much of our fear of
computers and data systems is due to the shame we get when the machine or
system fails to work as we expect it to. When systems become useful, stable,
and easy to use then even the faint of heart will take advantage of the new
knowledge.
In
the third scenario we have implemented the security in communication gaining
the ability to prevent an attack on the public. Our danger now is in allowing
the control over communications to protect those in power from the scrutiny of
the public. Free speech must continue to be protected to give the public the
ability to react to and correct the misuses of power. If electronic
communications are properly used free speech may be increased. Computers may
know who posts information but only if there is a clear and present danger or
definite intent to cause harm would the information be given to those with the
highest security clearance. Cases that are uncertain or unclear would have be
disclosed on court order. On going surveillance would only be done with a
warrant. Records of who has seen such private documents would be unalterable
and maintained along with the documents. To facilitate this copies of such
records might be kept in the highest security areas in the administrative and
judicial branches of government. With secure and accurate tamper proof records
rogue elements both within and outside the government may be monitored and
regulated by high security administrators and judiciary with legislative
direction.
Another
danger with knowing so much is in being forced to implement laws that many
people are unable to obey. Our economy now depends on about 5 to 10 million
illegal immigrants or aliens who do work that citizens of the
Development
of a secure health information system may help in solving the financial and
quality crisis in health care and business. It also may provide for the key to
providing quality health care for the uninsured. With a national health
information system containing basic information on health care costs and health
problems state governments may better analyze health problems and find health
care that lacks cost effectiveness. Basically if we pay more for health care
than its benefits are worth we will have a net loss on health care. If we pay
for health care that saves us money by decreasing future expenses for
complications or preventable diseases we will all gain. Government may then
mandate cost effective care for all residents of our country with coverage
through employment and/or taxes. With a secure national health information
system the responsible person will know before getting care what services or
drugs will be covered. People or employers may opt for insurance or other
coverage for health care services that lack proven cost effectiveness. A
national board will continually review the art and science of medicine to make
change coverage for health care new services are shown to be cost effective or
old services are show to lack cost effectiveness in the new environment or as
diseases change. At one time routine chest x-rays were cost effective when we
had many people with tuberculosis in our country but as the number of people
with the disease decreased the benefit of doing chest x-rays also decreased. At
present it is hard for businesses or insurance companies to manage such a
program since many businesses change insurance companies year to year and many
prevention programs only have a benefit over 5 to 10 years. For instance paying
to help a 30 year olds to stop smoking costs money now but will give most
benefits for decreasing heart disease risk over 1 year or more, and lung cancer
risk over 5 years or more from the start of the program. A good health data
system should also help decrease claim and administrative costs by helping to
automate information processing and data exchange. Current insurance companies
would be able to use the one state regulated system making it easier for health
care providers to contact and communicate with the many insurance companies
throughout the country. Just as in the other information sectors privacy must
be protected. Health care providers and payers would be limited to get patient
information on a strict need to know basis. Patients or there responsible
caretaker would have to authorize patient information access to the health care
provider. Providers would be protected from liability if only given incomplete
information. Patients would have a secure identity (perhaps with a smart card)
with a PIN and/or fingerprint confirmation for record access to be regulated by
them and/or their caretaker.
Once
basic public data systems in health, education, finance, government and
security are working then information and knowledge may be used to improve our
society. In health computers may be used to reduce errors in medications and
diagnoses. The Institute of Medicine (IOM) and the Agency for Health Care
Research and Quality (AHRQ) have written extensively on how this might be done
(http://www.ahcpr.gov/qual/errorsix.htm ). Education achievement may be evaluated continually
and resources directed as needed. Financial markets will be more trustworthy
with open and transparent accounting systems viewable by all, and protection
from identity fraud. Government may measure citizen needs and resources in real
time with improved responsiveness to the needs of individuals and communities.
Security systems may adjust according to strategic importance of intellectual
resources, geographic locations, or sectors of the economy.