Heart disease and February. What relationship could be more cozy?
From the scary risks of shoveling snow (yep, you could DIE, so be sure to lift a little at a time!), Mercedes-sponsored red dress parades and government-sponsored National Wear Red Day®, to tips for identifying heart attacks in women (men, you need a different month I guess), February has all the important stories to improve your "awareness."
Such a polite term, "awareness."
But I wonder, now that the internet is upon us and people are seeing their insurance rates and co-pays skyrocket if maybe we're shooting ourselves in the foot with all this heart month marketing hype. People are sick and tired of testing "just to be sure." It's starting to directly cost them a fortune, and people are pissed at having to pay a fortune for health care, let alone heart care.
I know, I know, I should be at the forefront of working with patients to stomp out heart disease. And goodness, people DO need to be attuned to diet, exercise, and weight loss. But the reality is, if we're giving you the ten latest tips on how to detect a heart attack, we're probably a bit too late.
That's the problem with all these press releases: while there's a need to raise "awareness" of heart health, there's also a very real need for people to take us, heart disease professionals, seriously to help cut costs in health care here. The last thing our health care system needs is more frivolous testing. Yet this is exactly what all this marketing does for our health care system: and it helps those with the largest PR budgets most of all.
Of course, there are researchers who depend on a portion of the funds raised to continue their work. After all, research is ridiculously expensive. There really is a need to raise funds for these scientists if we're going to continue our tradition of creative innovations in cardiovascular health care.
Maybe that should be the story line.
Maybe it would be nice to highlight these researchers' work and what that work hopes to bring to people rather than splashing a big feel-good red dress parade all over the media. Maybe we could focus on real life stories and less on the hyperbole. Maybe we could focus on the challenges, rather than the accolades and perfection.
Maybe then we'd have people take us seriously.
-Wes
They've obviously learned the lesson of the pinkification of breast cancer, which has become an enormous, year-round marketing campaign for yogurt, cosmetics, candy, T-shirts, teddy bears, and a host of other products large and small, some of which don't even claim to donate a cent to research; they're labeled "breast cancer awareness" just because they're pink.
ReplyDeleteWes,
ReplyDeleteMaybe as a cardiologist, your perspective is skewed because you're thinking about cardiology all the time, and your patients are there presumably because they're already worried about possible heart disease.
I wish some of my friends and family were more conscious of their risks for heart disease, not necessarily to get tested, but to lower their salt intake, exercise more, and maybe get their blood pressured checked once every year or two, etc.
Really I think there's a lot of good in the awareness campaigns, as long as they're not overblown.
Dr. Wes, you are, sadly, missing the point, big-time.
ReplyDeleteAwareness of women's heart attack symptoms, as beautifully illustrated in the new U.S. government campaign called "Make the Call - Don't Miss a Beat" - http://www.womenshealth.gov/heartattack/ is what may well convince women to pick up the phone to call 911 if they believe they may be having a heart attack. Over half of women surveyed before this campaign said that they would NOT be likely to call 911 if they thought they were having a heart attack.
And here's what happens now: too many women still believe that heart disease is a man's problem. And they are not alone - awareness campaigns may serve to educate our docs as well: a 2006 AHA study on physicians found that only 8% of family docs were aware of this fact, but (even more shocking!) just 17% of cardiologists were aware of it.
A 2008 Canadian study of women over 40 called the LIPSTICK Survey reported that women spend more time thinking about their weight than they do about their hearts. For example, only 10% of women surveyed knew their LDL cholesterol levels, versus the 64% of women who know how much they weighed back in high school!
When I was having a heart attack, I believed it couldn't possibly actually be happening to me because I wasn't experiencing the "Hollywood Heart Attack" that I knew men had: crushing chest pain, fall down, unconscious, CPR, call 911, paddles, sudden cardiac arrest, blahblahblah...
To me, THAT was a heart attack - and my experience was completely different, so how could I really be having one?
Like most women, I remained conscious, I could walk and talk and get myself to the E.R. Where, by the way, like many women, I was then misdiagnosed with GERD and sent home with a pat on the head, feeling terribly embarrassed because I had just made a fuss over nothing.
As long as women mistakenly believe that heart disease is something that happens to other (old, male) people, awareness campaigns are the very least we MUST do to help inform them.
By the time these women see you or another cardiologist, it's already too late and the damage has been done.
And women have to get past the E.R. gatekeepers, a problematic roadblock for many. Research out of Oregon, for example, showed that women under the age of 55 are seven times more likely to be misdiagnosed in mid-heart attack compared to men, and the outcomes of being sent home can prove deadly.
While pervasive "pinkwashing" around Breast Cancer Awareness Month is quite another story (pink-handled Smith & Wesson handguns?) we know that heart disease kills six times more women than breast cancer does, yet most women still believe that breast cancer is our biggest health threat - a potentially deadly mistake.
So I'd ask you, Dr. Wes, what YOU are personally doing, besides ridiculing red dress campaigns, to help educate your female patients long before they even become your patients?
Wes, excellent post! I am in complete agreement with you that all this hype about cancer and heart attacks is too little too late. If we were really serious about mitigating these problems, we would be much more serious about prevention -- environmental triggers of cancer and behavioral interventions for CAD. Both Elaine and Carolyn are correct to an extent that we do need education on how to detect these diseases. Yet I have never been convinced (nor have I seen any evidence) that these color-coded campaigns accomplish anything other that alarm the public and raise money and reputation for the sponsors.
ReplyDelete