We could do a lot to improve public health and reduce runaway medical expenses if we focussed more on preventing disease and less on medical fixes, says Gary Bennett. 

Bennett is a professor of psychology and neuroscience at Duke University. 

Transcript:

From Duke University, this is “Glad You Asked,” where we consider the question, “What should we be talking about this election season?”

"I’m Gary Bennett. I’m a professor of psychology and neuroscience at Duke. I think we should be talking about the idea that good policy is better than medicine. The problem that we have in the U.S. right now is that we have healthcare costs that are just spiraling completely out of control. And this is really unsustainable. 

And if you look at what we’re dying of, there are things like cardiovascular disease, cancer, diabetes. These are all mostly preventable conditions. And then the burden of those conditions falls disproportionately on the poor. And if you can’t get behind the moral imperative to fix that problem, then I think you have to get behind the economic one, which is, we just can’t afford it. 

The good news here is that if you look at these leading killers, you can seriously mitigate your risk by doing some extremely common sense, very simple things. Things like never smoking, losing weight, eating a healthy diet and being physically active. For those four conditions, we have good treatments. But they all require high levels of motivation. And we know that a lot of the American population just is not motivated to improve their obesity and their diet and their physical activity and their smoking rates. 

And that’s where good policy comes in. Because good policy can help to structure environments in a way that the default choice is always a healthy choice. So we really need to be thinking about the kinds of policies that can make our world a place where it’s easier to be healthier. In the area of physical activity, what would really help is for us to create neighborhoods that had greater street connectivity, to increase the number of sidewalks, to increase our bike lanes, to really make our physical environments conducive to physical activity. And that requires good public policy. It requires investments in our physical infrastructure.

In the area of obesity, we have good examples here in North Carolina of policies that are designed to make it easier for corner store operators to offer healthy fruits and vegetables. These are really important policies that can add meaningfully to the health of Americans."

You’ve been listening to “Glad You Asked.” To subscribe, visit bitly.com/gladyouaskeditunes. Again, that’s bitly.com/gladyouaskeditunes. 




Sidewalks Versus Surgery {Glad You Asked, Episode 23}

Our society gives the mentally ill short shrift, so much so that "we'll look back on it in 100 years' time as absolutely appalling," says Jane Costello. 

Severe mental illness burdens families, taxes the criminal justice and shortens lives. And we'll continue to pay those heavy prices until we take the issue seriously, Costello says. 

Costello is a professor in the psychiatry department at the Duke University School of Medicine and the Duke department of psychology and neuroscience an associate director of the Duke Center for Child and Family Policy.

Turning Our Backs on Mental Illness {Glad You Asked, Episode 30}

The United States has long been a magnet for scientists from all over the world. With both science and immigration under attack, Raphael Valdivia wonders if that legacy is at risk. 

"Glad You Asked" is a series of short commentaries by Duke experts on issues that deserve public attention. In Season 2, Duke experts share a question they would like to pose to our nation's new president -- and describe why that question matters.   

Valdivia is a professor of molecular genetics and microbiology in the Duke University School of Medicine and vice dean for basic science at Duke University.

Photo of the Noor lab at Duke University by Duke Photograpy.

Transcript:

From Duke University, this is “Glad You Asked.” A new administration in the White House means new issues on the table. So we wondered, if you could ask our new President one question, what would it be?

“My name is Raphael Valdivia. I’m a professor of molecular genetics and microbiology at the School of Medicine. I’m also the vice dean of basic sciences at Duke University. 

“President Trump, I am a scientist and an immigrant. And my question for you is, ‘Am I welcome here?’ 

“I was born and raised in Lima, Peru. I left there to attend college here. Once I got here, that’s when I discovered a passion for the sciences, for discovery, for knowledge. And it was very much a sense here in the United States that that was valued. To be curious, to be creative, to be an intellectual was never a dirty word. 

“And it is really in the last decade or so where that has become a problem. So the support for sciences, I’ve seen it erode at the beginning in the context of climate science. And certainly funding of the NIH, of NSF, of the EPA, of the USDA, of all these different government agencies
-- the erosion of that foundation just percolates to the entire system. 

“So there’s me as a scientist, but there’s also me as an immigrant. Many of the scientists in the United States actually were born abroad, and they came here really looking for opportunities and to tap onto this excitement about discovery and knowledge. The U.S. is the magnet, you know, we come here because we know the possibilities. We bought into the dream. 

“And I had never really felt until the last couple of years, especially after the election, that I would be judged by how I would look as opposed to what I can bring to the table. Now that I suddenly feel that I may not be welcome, for the first time in 30 years that I’ve been here, I have second guessed whether I made the right decision or not when I decided to come here to work, live and have a career in science.”

This is Glad You Asked. To subscribe, visit bitly.com/gladyouaskeditunes. That’s bitly.com/gladyouaskeditunes.

Is America Still a Beacon for Immigrant Scientists? {Glad You Asked, Season 2, Episode 3}

Infectious disease expert Greg Gray, MD, PhD, FIDSA, discusses why COVID-19 spread so quickly, why it’s so deadly compared to other viruses, and what we should be doing to prevent another pandemic. 

Transcript:
Lindsay Key: Welcome to HeadScratchers, a minicast from the Duke University School of Medicine. We ask Duke experts to help us understand the questions in science that have us scratching our heads. Today we're speaking with Dr. Greg Gray, an expert in infectious disease. 

Dr. Gray, the coronavirus has spread quickly around the globe. What makes this virus so special? Why did it catch us so off guard? 

Dr. Gray: Well, this virus is unique in that 100% of people, essentially, are susceptible to infection. And it is highly infectious. And it has a long incubation period. It's a real super challenge, if you will. It's difficult to control.

LK: As an infectious disease researcher, is this epidemic that we're experiencing? Is it something that you thought might happen one day or were you really surprised by it?

GG:  Yeah, I think those of us in infectious disease epidemiology recognize that in the last 25 years, we've had seven or so of these events. This is not the first one. And it's a repetitive issue: we see the emergence of a virus that causes an epidemic in man, we try to understand it, we mitigate it. And we do the best that we can to put out the fire. 

So what can we do when the next virus surfaces? We need to do a better job. What we need to really be doing is looking at the human-animal interface and monitoring for novel viruses that might emerge from that interface. Looking at people who have close contact with animals and seeing when they have evidence in their respiratory tract of a new virus that's emerged from the animals, and then making preparations way before the virus cycles over and over and becomes highly infectious to man. And we can do that -- and the way to do it is through something called One Health. Working together with human health, veterinary health, environmental health on specific problem areas like these, to get ahead of this, so we're not always responding to the latest threat. Often we've been to that in partnership with the animal industries, animal production industries. You might not know it, but there have been three emerging coronaviruses that really had a big negative impact on the swine industry, they've not affected humans. But we could help, and at the same time we're looking for novel viruses that would have an impact on humans, we could help them get a handle on the viruses that are going to only cause deaths in their animals. 

We talk about zoonosis as a pathogen that causes disease. And usually we talk about a pathogen that moves from animals to man. But we can also see zoonosis, sometimes called reverse zoonosis, where a pathogen that is normally affecting man moves to the animals. And that's another reason to do One Health -- because understanding zoonosis, we can help not only human health, but animal health and the animal industries. 

So, Duke has been a great place to do the research we do, because Duke is very forward thinking and we're very connected to the Global Health Institute. And we have studies right now in about 14 countries and many of these studies are looking for zoonosis. Right now we're doing big studies and northern Vietnam. We just wrapped up a study in Yangon, Myanmar. We're wrapping up a study that was conducted in South Africa. And over the last several years, we've done studies in many different places. 

Yeah, we’ve found some pretty unusual things right now that we're still working them up -- some viruses that shouldn't be in humans, and unless you look for them, you can't easily find them. But we're able with some of the technologies that we've adapted or developed here at Duke to do so.
. . .visit https://medschool.duke.edu/about-us/news-and-communications/podcasts/headscratchers/coronavirus-why-did-it-catch-us-guard for closing.

Headscratchers: Coronavirus,  Why Did It Catch Us Off Guard?

Duke University School of Medicine is one of the nation’s top medical schools.

Headscratchers: Coronavirus, Why Did It Catch Us Off Guard?

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