On Health, Wellness and Better Quality of Life
By Charles Martin
Living a healthy lifestyle might include factors such as healthy self-esteem, age, environment, and even economic status. The same can be said for relationships between low-income levels and growing health disparities in small pockets of our communities across the country.
A recent Kaiser Family Foundation report on health disparities revealed 30 percent of direct medical costs for Blacks and Hispanics were excess costs due to health inequities (Disparities Policy, 2012) – people of color oftentimes experience poor quality care, as well as inadequate access to care, resulting in meager health outcomes. But it is not just an issue of higher health risks and mortality – the economy loses more than $300 billion a year because of these direct and indirect costs associated with poor health. Poor health impacts us all.
With healthcare costs skyrocketing, I wanted to learn first-hand how we as a nation, and as a community, might reverse this disparaging trend; how we might reduce our chances of strokes, high blood pressure, obesity, diabetes and respiratory illnesses – the more common epidemics.
I spoke with Dr. Soenda Padmore-Norman, a family Primary Care Physician at Duke Primary in Briar Creek in Raleigh. Dr. Norman’s compassion and personal discipline are fueled by her parents who fled a bloody military coup in Liberia more than three decades ago, in a quest for a better life for their children. More than three decades later, she has provided preventive health care to underserved patients in and around Maryland, and today is a practicing Primary Care Physician with Duke Medicine.
Charles Martin: What are some health concerns that you feel require immediate public awareness?
Dr. Soenda Padmore-Norman: There are so many things, and in primary care we see everything. There are however are a few things that come to mind that I think require awareness, particularly in minority communities, and that is our mental health; depression, anxiety, and severe stress reaction.
Much of what we see in primary care is linked to extreme and emotional stress, and I think patients do not seek help because of a stigma associated with mental health. We feel that we are weak if we are suffering from depression, anxiety, or severe stress reaction; we may feel we will be labeled as “crazy” and that it might affect our personal and professional lives. Many of our patients come in with a number of physical ailments but when we run tests and everything comes back fine, we realize that a lot of the symptoms they are experiencing have more to do with untreated stress. There has been a new push in the medical community, specifically at Duke, to provide depression screenings, from adolescent all the way to the geriatric patients. We want to affect the mental health status of our patients and not only focus on physical health because the two are so tightly linked.
The second thing, which I don’t feel we are doing enough to fight the epidemic, is obesity. It is a crisis in our country and getting astronomically worse every year. It is a crisis among the pediatric and adult populations.
Charles Martin: When we talk about obesity we must talk about poor nutrition. Would you relate the problem to socio-economic status along with other factors?
Dr. Soenda Padmore-Norman: The obesity epidemic is really complex and multi-faceted. Number one, there is way too much chemically, genetically produced products on the market; the cheaper foods tend to be the more highly processed foods, and there are sugar and other unhealthy additives put in so many of our foods, I think are very addictive.
Food is marketed in this country to the extent the portions have gotten larger. When we were young for example, a meal at McDonalds was completely different than what we are getting now. Portions given to us in restaurants are out-of-control. So going back to mental health and stress factors that some of our patients are dealing with, they may choose food as a form of self-treatment. In certain cultures, there are more fatty foods, like fried foods and pork products that are a challenge to overcome. In addition, our nation has become more sedentary. People don’t walk or ride bikes anymore, and often we live in suburbs where people have to drive their cars to go places. So are there ways to overcome this, even on a budget? Yes. You don’t necessarily have to buy fresh vegetables, you can purchase frozen vegetables. Canned vegetables are not optimal but they’re still vegetables. There are ways around this but unfortunately, you don’t see many produce stores in certain communities, and you don’t see restaurants that serve healthy foods – all you see are the fast food restaurants. So depending on your community, you may have to venture out to get healthier foods.
Charles Martin: Heart Disease, Cancer, Stroke, and Respiratory Diseases are primary health concerns in our country. Can you offer any solutions that might help people curtail some of these more common illnesses?
Dr. Soenda Padmore-Norman: Well, the number one thing to do is if you smoke, quit. This will drastically reduce a patient’s risk for developing heart and respiratory disease. Number two, make sure you consume a heart-healthy diet; avoid fried foods, eat healthy proteins like poultry, and make sure you are getting enough fiber in your diet. Eat more vegetables, beans, whole grains, like brown rice – also, get rid of the white flour from your home. All of these things contribute to a low-fat, heart-healthy and high fiber diet while preventing cholesterol elevation, hypertension, and diabetes.
Lastly, get moving. I talk to patients frequently about exercise. A lot of people will throw up road blocks like, “I can’t afford a gym”, or “I’m too busy”. Physical activity doesn’t always require going to a gym. You can do something as simple as take the stairs at work instead of an elevator. I tell my patients to break it down into a 10-minute exercise in the morning, and then a 10-minute exercise at night until you build your stamina. Even a simple walk is a cardiovascular activity, and a good starting point; just find ways to keep moving.
But I want to emphasize, go to your primary care doctor. Get your annual physical. Preventive care is at the cornerstone of medicine. Too many of us wait until we have a symptom or problem.
I had a patient who had not seen a doctor in three years and she has hypertension. By not seeing a doctor, her blood pressure caused some damage to her heart. Had she been coming in regularly, we could have monitored and treated the pressure, so that it’s not causing damage to the heart, kidneys and eyes. We can prevent so much when a patient receives a health screening annually. We can increase your quality of life and actually prolong your life.
Charles Martin: We see the cost of health care increasing for families, and for some the cost of healthcare may be more burdensome now than ever before. Have you seen a decrease in the number of patients who come through your doors?
Dr. Soenda Padmore-Norman: What I will say is that preventive healthcare is free. For a physical examination, which includes blood work, is covered. There is no co-pay.
This is across the board for Medicaid, Medicare, and private insurance. So wellness visits are free visits, and of course, if you require a follow-up visit there would be a co-pay. I will add that some patients don’t always understand their insurance product and how it works. I have to remind patients all the time that wellness exams are covered. But in all fairness healthcare is expensive and there are patients who simply cannot afford it, or obtain insurance. There are still patients, particularly in our state, who are not meeting the Medicaid eligibility requirements, so there is still that population of people out there who don’t have access to the proper care they deserve.
Charles Martin: What does it take to cultivate in young people the interest to pursue STEM fields such as medicine?
Dr. Soenda Padmore-Norman: Children really don’t know their full potential, so having a role model, a parent, grandparent or even a teacher, is important. Having someone who has faith in you is critical – for me, it was my parents.
I think also, being an African immigrant is different too by virtue of the fact that we have lived a life where all of our leaders in the country look like us. The idea that you can’t do something doesn’t often occur. I mean, when we came here — we really struggled, so at a young age, I was able to link education, hard work and quality of life. It’s important we have more programs where young people see themselves achieving in STEM fields. People need to see others who look like them, achieve.