Editorials
Reversing the Slide in US Health Outcomes and Deteriorating Health Care Economics
The foreword of a 2013 National Research Council and Institute of Medicine (IOM) report on international comparisons of health could not be more frank: The United States spends much more money on health care than any other country. Yet Americans die sooner and experience more illness than residents in many other countries. While the length of life has improved in the United States, other countries have gained life years even faster, and our relative standing in the world has fallen over the past half century.Medicine Is a Social Science in Its Very Bone and Marrow
Rudolf Virchow is perhaps most widely remembered in medical circles as the father of cellular pathology,1 and researchers at Mayo Clinic are perhaps most widely renowned for their outstanding ability to translate cellular and subcellular science into practice. Readers of this editorial may be surprised to learn that Rudolph Virchow was an anthropologist. Readers may also be surprised that an anthropological study, directed by Mayo Clinic researchers, appears in this issue of Mayo Clinic Proceedings.Overcoming the Barriers to Cancer Screening
In this issue of the Mayo Clinic Proceedings (pages 301 to 308), Lobell and colleagues report on the association between knowledge about cancer and anxiety in a group of 188 Mexican-American women. The investigators used sophisticated statistical modeling techniques to demonstrate that knowledge of cancer did not directly predict screening behavior and that screening behavior did not directly predict anxiety. With access to health care statistically controlled, communication skills and anxiety were predictive of screening behavior in the directions hypothesized (a higher level of communication skills was associated with increased screening, and increased anxiety was associated with decreased screening).Is It Not Time to Make Smoking a Vital Sign?
More than 30 years ago, Dr. Luther L. Terry, as surgeon general, concluded that smoking was a risk to health,1 and investigators have since substantiated that advice and assistance to quit smoking increase cessation rates.2 Although few physicians now smoke, they continue to fail to advise their patients to stop smoking.3,4 In 1991, Fiore5 proposed making smoking a “vital sign” as a way to remind clinicians to address smoking, and in this issue of the Mayo Clinic Proceedings (pages 209 to 213), he and his coworkers provide an evaluation of this innovation.Clinical Preventive Services: How Should We Define the Indications?
In fact, prevention and prophylaxis more and more will become medicine's primary approach to challenging diseases…. Victory can come only when preventative measures eliminate the need for aggressive action.1
