HEART OF THE MATTER"
a special program of the National Emergency Medicine Association (NEMA)
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Week: 593.6 Pt.2
Guest: Martha Hill, PhD. Professor of Nursing, Johns Hopkins Med. School, New President of the American Heart Association.
Topic: Mass media health informations
Host/Producer: Steve Girard
SPOT: 15 years in the prevention of heart disease, stroke and trauma - The National Emergency Medicine Association. This show is just part of what NEMA does. We send out millions of pieces of prevention information to people around the country, give grants to organizations in research, public information and emergency services, and have been instrumental in the creation and expansion of the Chest Pain Emergency Room movement. To play a role, call 800-332-6362.
NEMA: Our second segment today is with the new president of the American Heart Association, Martha Hill...a professor at the Johns Hopkins School of Nursing in Baltimore, and the first non-physician to head the AHA. Were talking about the kinds of health information in the mass media...such an increase in the amount of health publications, TV and radio programs...that can be confusing to people who are looking for real information to help them stay healthy...
HILL: I think its quite exciting that theres been such an increase in the amount of information about health and prevention thats available to people. I understand that the health section, when newspapers run their weekly health section, that they get a big jump in sales. And there certainly is a great deal of information available through bookstores and the world wide web and other sources. And in general I think the quality of it is quite high. What can be confusing to people is two things: one is were constantly discovering new findings, and new factors that may be relating to treatment...like the latest one to get a lot of attention is homosysteine. And many people who are interested in maximizing their health will have questions like, "well, should I start taking B vitamins, or should I do this or do I need to stop that...how much of this is good for me, and how much of it is going to be unnecessary"? And so people have many, many questions...and many times, scientists dont really have the answers to those questions. And thats why, I think, some of the statements...some of the information thats available may be a bit wishy washy. It sounds kind of like its equivocating, or hedging...so many times the information is not yet ready or available. And the other point is that as new studies are done, we may find that we have to modify previous understanding, because the new information provides us with new insights, and we develop a greater appreciation of the real benefits or value of certain prevention strategies.
Also let me add....whats going to be helpful for men may be different for women...and certainly there are differences at different ages of life. So, it may be imprecise to make some recommendations for everybody. And very often youll find a statement like...the Heart Association will say, "In general, its not bad for people if they cut down on salt in the diet, its not going to hurt you, and some of you are going to be helped by it".
The challenge is you dont know who the individuals are that are most at risk...and thats where it shifts from being a public health message to more of a medical message. Where the patient is in care, and then the physician and the other health professionals that work with the physician, make a more individualized recommendation, because they know what the family history is, and know what the individuals risk factors are.
NEMA: Then there are the authors and publishers who blast off with endorsements and recommendations for something like melatonin, or fen-phen...and are making a lot of money on these products before there is real, complete evidence of efficacy and benefit...
HILL: One of the points there is that the American Heart Association is extremely cautious, and some people would even say very conservative in how we formulate out scientific statements and recommendations. And because of that, we are very credible. And we have not had to withdraw statements. Some other organizations have sort of gotten out ahead of the data, occasionally...and that causes problems. And then the other thing is that occasionally a reporter will arouse interest and where the argument theyre making exceeds what the data will support, and it gets more into speculation.
HILL: Theres one thing in raising the publics awareness, that there either are new medications or new research data that tell us...for example, in the homosysteine, this looks very, very promising...it certainly is extremely interesting and compelling in the laboratory data and some of the research data. We now need to do the studies that will say that if people take B vitamins over time, compared to people who dont...does this have a beneficial effect, and can we document what the actual mechanism of action is? What literally is happening in the body, because we have to be watching to make sure the benefits exceed the risks. For some of these things, it does take time.
NEMA: Thats Martha Hill...a professor of nursing at Johns Hopkins School of Nursing, and the new president of the American Heart Association. Many thanks for appearing on our show.