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}

Sleep expert Jade Wu, PhD, discusses the causes of insomnia and what to do—or not do—about it.  Dr. Jade Wu is a clinical psychologist at Duke University School of Medicine and her current research focuses on treating sleep disorders in those with chronic illness.

Transcript:

Lindsay Key:
Welcome to Headscratchers, a mini-cast 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. Jade Wu, a clinical psychologist and sleep expert. 

Dr. Wu, I’ve been sleeping well my whole life. Then, five years ago I developed insomnia. What’s keeping me up at night? And how can I get out of this rut?

Dr. Wu  
I would say it almost doesn't matter why you got insomnia in the first place. Many people have different reasons for why they get insomnia. Maybe you moved, got a new job, had a baby, went through menopause. But what keeps you in the insomnia rut? What gives you chronic insomnia, is probably the same reason as everybody else. It's like insomnia lit a spark five years ago, but, over time, you've been putting on logs and keeping the fire going. So let's talk about how you can take those logs off.

If you have chronic insomnia, you're probably spending too much time in bed. So I know there's this magic number eight floating around in the ether, where we feel like we need to get eight hours of sleep, and you're just doomed if you don't, but that's actually not true. Not everyone needs eight hours. However, what happens when insomnia becomes chronic is that people are trying really hard to get those eight hours. So they spend a lot of time in bed, they cancel their evening activities to really “protect” their sleep (air quotes); they try to sleep in.

So if you spend too much time being sleepless, and awake, and frustrated, and angsty in bed, then your brain starts to learn that bed and being angsty go together. So every time you go to bed, it's almost as if a light switch flips on, because your brain is like, “Oh, I know what this place is; this is the place where we get angsty and, you know, very frustrated!” So then, of course, you’re not gonna fall asleep if you’re feeling that way.
 
The first thing I would do is set a really consistent wake-up time. So, instead of trying really hard to establish a regular sleep pattern by trying to calculate in your head how many hours you need, and when should you go to bed, I would just say get up at the same time every day, and be really strict about it -- like, boots on the ground when your alarm clock goes off. And what will happen is, even if you didn't get a good night's sleep last night, if you only got a few hours, that's okay because then you'll just be sleepier the next day, and, you know, eventually your body will regulate itself. Just remember that sleep is really resilient. Your body really, really knows how to do it, just like a knows how to breathe without you trying really hard. So, I wouldn't try really hard. I would just let your body figure itself out -- and go to bed only when you're sleepy, and not before that.

Lindsay Key:
Thanks for listening. This podcast was produced by the Duke University School of Medicine. Music by BenSound. Visit us online at headscratcherspodcast.duke.edu
Medical Disclaimer & Terms of use at https://bit.ly/2LrjWdh

HeadScratchers: What’s Keeping You Up at Night?

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

HeadScratchers: What’s Keeping You Up at Night?

DukeMedSchool

Related tracks