Over the three months that my TedMed talk on geomedicine video has been available, many interesting comments have been generated -- not just in response to this Huffington Post blog but to the many viewers of my video presentation circulating on the Internet.
A recent interview on Microsoft's Health Tech Today also generated interest and comments on this subject. I thought my readers here would appreciate hearing what I thought about their as well as others' comments on the importance of the environment to our personal health. I did, however, respond directly to some of the comments, many of which focused on the relative strength or weakness of the known scientific relationships between our environment and human health.
Some felt evidence was marginal, at best, while others stressed its importance. One reader mentioned the vastness of the "evidence" in the scientific literature about the harmful effects of environmental contamination on human health while others took issue with the notion that our environments are as important as lifestyles or genetics. Several comments warned that knowing more about the potential hazards of environmental impacts on health would only promote more lawsuits.
One comment in particular that caused me to flinch was a suggestion that people with limited economic opportunities and less access to medical care tend to live in less healthy places. This, if it is really true, would have huge societal implications. Which comes first? Bad health or unhealthy communities? Do you think that the "poor" are naturally drawn to "less" healthy places?
An entry from a physician commented that my personal story over-reached the environmental impacts on my health, suggesting however that the idea of creating a place history had merit. Some readers wished for solid evidence (correlations and causation) in what I had to say. Even the comments that were critical of the strength of environmental evidence were supportive of the idea that society should get busy cleaning up known compromised environments! Much to my surprise, there were many comments that reflected people's concern over government's role in "watching" society too closely -- and the potential abuse of this type of information or its analysis by health insurance companies and governments to deny coverage or otherwise limit our economic opportunities.
It was also suggested that, if your physician thinks your symptoms reflect an environmental cause, then he/she would certainly ask you more about your personal geographic "place" history. Many commentators agreed with me on the value of creating a personal place history and many others shared stories where they believed overlooked environmental factors could potentially explain a personal health event or condition. One commentary, from a physician, said that this idea is "an incredibly common sense approach [that] could help to unveil risk factors from your past and potential health issues to look out for."
That doctor suggested that patients should tell their doctor if they think they have been exposed to a toxic substance. While I certainly agree with that advice, it is often what we don't know and see in and around our environments that is the most harmful to our health! In general, comments reflected a growing awareness of the potential impact of environmental factors and most felt it was "smart" to try to use all the available information when it comes to understanding what makes them sick.
The recent news stories of the identification of long-term pediatric cancer cluster in Florida by the US CDC and of the contaminated well water and soil from the long term disposal of hexavalent chromium in a rural Pennsylvania community by the US EPA have people worried. One thing that both of these events have in common is the need to discover the many people that lived near this contamination long before it was identified as a potential threat - thus the compelling need for an accurate personal place history linked to our electronic medical record.
In my opinion, those who are building electronic health records, supposedly for the benefit of patients and health seeking consumers, need to make sure we have a reliable way to link our personal place history to the sophisticated electronic health records they are building now. As always, I appreciate second opinions.