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able of Contents Nutrition
04 Locavore Movement 06 Myth of Processed Food 07 Vitamyth? 08 Navigating a Cornell Dining Hall 10 Iodine Deficiency
exercise and Dieting
11 Exercise Your Stress Away 12 Exploring Cornell Fitness Center Classes 14 The Risk of the Female Triad 16 Evolution’s Most Unwanted Trait 18 The Collapse in the Fat Hypothesis
Healthcare and Disease
19 Trapped in a Plateau: Infant Mortality in the U.S. 20 A Call to Arms in the Battle for Mental Health 22 Infectious Disease in the U.S. 23 Oxygen: Couriers of the Future 24 Why You Should Care about Obamacare Cover and Table of Contents photography by Elizabeth West [1-2]
Locavore Movement By Janhawi Kelkar
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Consider the banana you selected from an abundant pile at the dining hall after lunch today...
lthough the fruit does not grow anywhere close to upstate New York, your banana had that classic fresh fruit glow, yellow and ripened to perfection. That banana most likely came from a large plantation somewhere in Central America. It was packed onto a ship, where it was kept cool and unripe, until it reached a distribution center. There, it was ripened with ethylene, and then sent off in our direction. The fact that we residents of Ithaca, New York are able to enjoy such quantities of this tropical fruit should raise concern. There is an environmental and ethical cost to shipping fruit from overseas, one that conscientious consumers are increasingly unwilling to pay. These consumers, so-called locavores, have shifted to eating locally grown produce. The coining of the term “locavore” is the consummation of a national trend towards natural and organic foods. Starting in the 1960s, the public grew increasingly aware of the inconvenient truths of the food industry, beginning with the use of pesticides, and expanding with time to the use of GMOs, or Genetically Modified Organisms and the exploitation of immigrant labor on large corporate farms. The 21st century has given
rise to a generation that is invested, more than ever, in the sources of the foods it puts on the dinner table. Between 1994 and 2006, the number of farmers markets more than doubled. In 2007, America’s obsession with high-quality food was made official when “locavore” was named “Word of the Year” by the Oxford American Dictionary. The locavore movement has gained momentum for a variety of reasons. Local eating increases dialogue about food production, closing the knowledge gap that exists between indiscrete corporate-owned farms and the grocery store. At farmers’ markets, consumers can speak with the farmers who grew the produce they are about to buy, and ask about its cultivation. When consumers know where their food is coming from and the chemicals used to grow it, they can make informed decisions about the foods they purchase. Local eating also supports local farmers, benefiting the entire community. Buying local preserves farmland, and keeps space undeveloped in and around cities. Most rewarding, however, is the quality of the produce. Locally grown produce is harvested at the height of its ripeness, unlike bananas, which are picked while
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© The Student Body 2013
Nutrition • 5
Ithaca Farmers’ Market Reproduced from [4]
they are green and tough in order to prevent them from overripening during transportation. These flavorful fruits and vegetables also provide incentive to eat seasonally. It is much more environmentally sound to eat berries in the fall rather than in the winter when they must be exported from elsewhere.
from Central America. Finally, we cannot ignore that the world depends on the global trade of agriculture to compensate for low crop yields elsewhere and to prevent famines. There are certain benefits to industrialized agriculture that outweigh the benefits of local produce.
As with most cultural trends, the locavore movement has drawn much criticism. The greatest argument against the movement is that it is impractical. The entire world cannot be fed by small, independent local farmers, because their systems are not as efficient as those of industrial farms. As a result, local produce is also more expensive than produce at the grocery store. Some also argue that the cost of transporting food only accounts for about 4% of the energy expenditure in the agriculture industry. Cargo transport by trains, especially, is so efficient that the environmental impact is nearly negligible. Powering greenhouses to grow, say, bananas in New York is more inefficient than simply shipping them
Despite the criticisms of the locavore movement, there are benefits to eating local. The produce quality is superior, and the local markets facilitate a more informed consumer experience. The act itself of buying local and supporting the community is undeniably rewarding. However, when you choose to buy local, it is important to choose produce that is in season and compatible with the climate. If these aspects are ignored, there is no environmental benefit to the local foods. In our world of globalized trade, nearly every variety of fresh fruits and vegetables is readily available. It is up to you, the consumer, to strike the perfect balance between buying seasonally at markets and shopping practically at the grocery store.
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5
Myth of
By Olivia Lee
PROCESSED FOOD W
hen I interned at a community clinic last summer, I was given an assignment to create a guideline to healthy and cheap processed food. As a health-conscious college student, I was confident suggesting some of the packaged foods that I consume myself on a busy day running from Baker Lab to the Mann Library. Nature Valley granola bars were at top of my list and the rest of the list included items like Baked Lays, Quaker oatmeal, and dried fruit. However, the results I got back from the clinic doctor were quite disturbing. As college students, we occasionally munch on Hot Cheetos, brownies, or Chex Mix at midnight in the stressful times of prelims, but we at least understand that these snacks should not be consumed on a daily basis if we wish to live for as long as we can. What happens when we find out that something we relied on for a quick breakfast is as unhealthy as a bag of Hot Cheetos? Can you trust labels like “nature,” “organic,” or “healthy” on a package? The reality is that our understanding of “healthy” food cannot come from the labels we see on advertisements or package boxes. Nature Valley granola bars and Quaker oatmeal are perceived as healthy alternatives to chips and cookies, but the grams of sugar each serving has will hit you when you least expect it. One serving of granola bars and instant oatmeal takes up third of the suggested daily amount of sugar which is 30 grams. Additionally, most processed food items such as Nature Valley granola bars and the Sun Chips that contain grains or carbohydrates are made out of genetically modified (GM) ingredients. In the recent years, there has been a lot of controversy over the safety and effect of consuming genetically modified food. The ongoing debate on the issue cannot be easily settled due to strong opposing forces, but the consumers should at least be aware of what they are digesting. Unfortunately, ways to check for GM ingredients are not easily accessible, and it’s not safe to assume that you’re eating healthy ingredients based on marketing scheme that uses words like “organic” and “natural.” If you are a fan of dried fruits, you should be cautious of how much you consume. Although the dried fruits look harmless and nutritious, these snacks actually contain a considerable amount
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of sugar and preservatives that can accumulate in your body. The dried fruit packages that are shelved on major supermarkets contain sulfur dioxide, which has been listed as a toxic reagent by the state departments. According to the Environmental Protection Agency, sulfur dioxide may cause damage to reproductive or respiratory systems. In defense, the food companies self-reportedly have used a legally acceptable amount of sulfur dioxide; nevertheless, the consumers would not be able to find out the exact amount contained in each bag. The outer appearance of these healthy-looking snacks can fool a lot of consumers who may think they are eating healthy. Thankfully, many of dried fruit packages list sulfur dioxide in the nutrition labels. Developing a habit to read the nutrition labels is critical in order to truly maintain a healthy diet and be well-aware of what we eat. In the last decade, the topic of healthy food and well-being received a lot of attention, and the demand for organic products has increased. However, food industries have also gotten smarter and created new marketing strategies that are not easily discernible to regular consumers. For example, FritoLay introduced a healthier version of their famous potato chips, Baked Chips. It has been successful for creating an illusion that Baked Chips have less oil, thus healthier. Although Baked Lays contains less amount of oil in one serving, it is made out of processed corn starch, high fructose corn syrup, and lecithin, a food additive. On the surface, choosing Baked Chips may look smart, but in the end, you may be consuming ingredients that you may not expect. As many of you already know, ingredients like high fructose corn syrup are heavily used in processed food, and these artificial additives are associated with obesity. According to Huffington Post, contaminants such as mercury have been found in testing of high fructose corn syrup. The ingredients and contaminants together can create harmful effects in the long run if consumed regularly over a large period of time. We cannot continue to rely on the food industry to tell us what is healthy or not. We need to develop skills to discern the good from the ones that only look good. Next time you pick up a granola bar or cookie, check the nutrition label and see what you’re really consuming. © The Student Body 2013
Nutrition • 7 Reproduced from [8]
VItamyth? By Dayle LaPolla
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t’s hard to go a day without seeing advertisements for supplements that promise to beat stress, increase mental or physical performance, or reduce the effects of aging. It seems that there is no human ailment (or inconvenience) that can’t be alleviated by popping a pill, chewing a gummy, or enhancing your water with vitamins and minerals. It is true that there are some vitamins and supplements that can enhance health. Unfortunately, there are large numbers of supplements that have no effect on health or can even cause harm. While there’s a lot of hype surrounding “super” supplements, there are actually some vitamins and that are worth taking. Here are a few supplements and vitamins that, when taken under the supervision of a doctor, can actually improve your health:
Vitamin D: This powerful vitamin can improve calcium absorption and therefore improve bone health, especially in women. There is also preliminary research suggesting that it may help prevent cancer.
Omega-3:
While there are a few supplements that may be worth your money, there is an abundance of supplements that don’t live up to their reputation and may even be harmful. Here are a few of them:
Vitamin A (and beta-carotene):
It has been claimed that vitamin A can boost your immune system by keeping mucous membranes healthy. Unfortunately, recent research has found that taking vitamin A supplements may increase your risk of dying prematurely!
Vitamin E:
This vitamin has long been considered one of the best antioxidants because of its supposed ability to fight free radicals and prevent heart disease. But research has found that taking vitamin E supplements may actually increase your chance of developing heart disease and other cancers.
“It’s easy to get caught up in the hype of “super” vitamins and supplements that claim to make you smarter, more fit or reduce the effects of aging. Unfortunately, most of this hype is actually myth.”
Most commonly found in cold-water fish, has been found to alleviate the symptoms of depression, ADHD and asthma. These benefits occur because omega-3 helps reduce inflammation and improves cognitive function.
Multivitamins:
daily requirements of certain vitamins and minerals, there are other negative consequences to having a poor diet.
Now this is a tricky one. Many multivitamins claim to prevent fatigue, boost your immune system and even stave of cancer. Unfortunately these are claims that multivitamins can’t really live up to. It is true that multivitamins can be a good way to supplement your diet if you tend to eat poorly and have been avoiding your fruits and veggies. However, it is important to remember that just because a multivitamin is taking care of your
Vitamin
B-6:
Vitamin B-6 has often been credited with promoting healthy brain, nervous function, and immune system. However, taking B-6 in the doses usually contained in supplement pills can actually lead to nerve damage in the long run. It is easy to get caught up in the hype of “super” vitamins and supplements that claim to increase intelligence and fitness or slow aging. Unfortunately, most of this hype are actually myths. A small number of vitamins and supplements, such as vitamin D, omega-3 and multivitamins, have been proven to have health benefits. But there are dozens of vitamins and supplements, such as vitamin A, E and B-6, which may actually be harmful despite its claim to boost health benefits.
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8 • Nutrition
Navigating a Cornell Dining Hall
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By Jessi Silverman
nyone who eats in dining halls knows how tempting everything can be at a school that offers foods as delicious as Cornell does. The problem is that most of the options have the potential to be detrimental to your health, especially when consumed in excess amounts. You may not be realizing that something you’ve been eating regularly is unhealthy. In this little guide, I will attempt to impart some advice to help you make healthy choices with your meal swipe. Seek out items that bear the “Eat Well with Cornell Dining” symbol and try to eat these more often than items that do not. According to the Cornell Dining website, this logo is helpfully assigned to dishes that are • 100% whole grain • 100% trans fat free • Made with only fresh ingredients • Lower in fat, sugar, and salt.” Remember to consume everything in moderation. If you read below to avoid your favorite dish, don’t feel you have to always avoid it or feel guilty about eating it. Eating a small portion (key word “small”) of a less-than-healthy food every now and then isn’t going to have any lasting effects on your health.
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On a similar note, you will notice that I categorize cheese into “beware” section. This is not because cheese is always bad for you, but because it contains a significant amount of saturated fat and can be harmful to your figure and your health in excess quantities.
“Asian” Station
“Traditional” Station
Beware of
Beware of
• Fried rice and noodle dishes, which are very calorie dense because of excess oil and refined carbs. • Stir-fry meals made with oil and sugary, sodiumridden sauces. You can ask for light on the oil and/or sauce for a much healthier meal. • Egg rolls, which are also fried. • Red bean paste items, which sound kind of healthy but are full of sugar. • Dim sum buns (i.e. chicken buns or pork buns), which are surrounded by nutrient-devoid white bread.
Take advantage of
• • • •
Take advantage of
• • Steamed dumplings, a tasty and healthier way to cook meat. • Vegetables, though be aware that they can be cooked using less healthy oils and sauces too. •
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Creamy or sugary sauces (i.e. Chicken and Biscuits). They drown potentially healthy items in empty calories. Fried items (i.e. Beer-Battered Fish), which are coated with oil and breading. Casserole-type items (i.e. Lasagna, Vegetarian Moussaka), which are usually stuffed with an excess of cheese. Biscuits, garlic bread, etc, which are laden with unhealthy saturated fat from butter and refined carbohydrates from white flour. The abundance of non-fried vegetable dishes. Luckily there are many dishes offered where vegetables are cooked in an unhealthy way; look for words like “roasted” and “sauté”. Anything with the “Eat Well with Cornell Dining” symbol, as I explained above. © The Student Body 2013
Nutrition • 9
The Soup Station Beware of •
Anything that says “Cream of” or is cream-based (i.e. New England Clam Chowder), which is laden with excess calories saturated fat.
Take advantage of •
•
Pretty much anything else. A cup of broth-based soup is a great way to start a meal, especially when it gets cold around here. The hot water fills you up so you’re less likely to overeat with the rest of your meal! Chili, a reasonable bowl of which can make a healthy meal.
Salad Bar
Beware of • •
Most dressings, which are full of oil or cream and can add a lot of empty calories to an otherwise healthy salad; use only 1-2 tablespoons. Cheese; just don’t overdo it.
Take advantage of • • • •
Veggies, veggies, veggies, which are low calorie and nutrient dense. Beans, which are full of fiber and protein without any saturated fat. “Light” dressings. Prepared grain or bean salads (i.e. Chickpea and Artichoke Salad, Pomegranate Bulgur Salad).
Pizza/pasta Station
Desserts Station
Beware of
Beware of everything.
• • •
Pizza, which has an oily crust of refined carbs and • is piled with cheese. Pasta that is not whole grain. Creamy sauces, like alfredo, which are caloriedense and full of saturated fat.
Take advantage of • • • •
• Whole grain pasta offered at Risley Dining • Tomato sauce, which is low calorie and full of nutritious lycopene, the antioxidant that gives tomatoes their red color. Meat sauce, which, in moderation, is more nutri- • tious than creamy sauce, calorie for calorie. Pesto, which is calorie dense but has super healthy monounsaturated fats from olive oil and pine nuts.
This is where it gets tricky. You know desserts aren’t good for you, and if you eat them often in excess of your daily calorie needs, they can easily lead to weight gain. But as I am a huge fan of dessert myself, I would never tell you to swear off dessert; enjoy in moderation. Follow some general rules before indulging. There are often plates of squares (i.e. cake, brownies, any sort of dessert with “bar” in the title). If you really want a dessert, pick one thing that is worth the indulgence and have half a square. Save the ice cream sundae bar for a really special treat. Some of the dining halls offer low fat, low sugar frozen yogurt, which is a much healthier alternative.
Take advantage of
Breakfast Station
•
Fruit, which is naturally sweet and very nutritious.
Beware of • • • • • •
Scrambled eggs, which are very easy to overeat when served in gigantic mounds. Sausage and bacon, which are high in saturated fat. Pancakes, French toast, and waffles, which are calorie dense and low on nutrients. Hash browns, which take the mostly healthy potato, fry it in fattening oil, and encourage you to consume it in large portions. Bagels, which are very calorie dense and contain no nutrients besides refined carbs. Pastries (i.e. muffins and danishes). Do I have to explain why baked goods aren’t healthy?
Take advantage of • • • • • •
Oatmeal, which is a whole grain with filling and beneficial fiber. Hard-boiled eggs, which are a great source of protein but be aware of the calorie dense yolks. Omelets, especially made with egg whites. Ask for all the veggies you want, but be sparing with cheese, bacon, and ham. Whole grain bread. Whole grain cereal (i.e. Kashi GoLean). Fruits.
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10 • Nutrition
iodine deficiency a salty situation
By Matthew Engel
“P
ut your hands in the air and move away from the salt shaker.” You’ve been caught by the dietary police! Sure enough, the National Institutes of Health (NIH) recommend limiting salt consumption to 1500-2300 mg/ day, depending on one’s health status.1 With the tremendous success of DASH and other low-salt diets in reducing the risk of cardiovascular disease, a low-salt craze may be upon us.2 Other popular diets, such as the paleolithic or “paleo” diet, include limiting dairy and grain consumption. But wait! These diets may result in inadequate iodine intake. Iodine deficiency continues to affect billions of people worldwide, including a significant percentage of Americans. Don’t put your salt shaker down just yet.
Health-conscious Cornellians may want to watch their iodine intake. Though iodine deficiency only affects a small subset of the U.S. population, several diets restrict foods that provide this essential micronutrient. If you have eliminated iodized salt from your diet, a ¼ teaspoon of which can provide almost 50% of your daily value for iodine, you should explore alternative sources of iodine.7 Seaweed packs a serious punch, often containing over 1000% of your daily iodine requirements per serving. Dairy products can also be an excellent source, due to the feeding of iodine supplements to cows. Grains and some fruits, like strawberries, can also provide about 9% of your daily needs.8
Feeling fatigued? A lack of iodine in your diet may be to blame. Iodine is an essential nutrient for proper thyroid function, contributing to the structure of T3 and T4, thyroid hormones which maintain metabolic rate. Deficiency results in an accumulation of thyroid-stimulating hormone (TSH), which cannot stimulate the production of T3 and T4 in the absence of iodine.3 This accumulation is responsible for goiter, an enlarged thyroid gland. Severe iodine deficiency can even result in hypothyroidism, causing mental sluggishness, exhaustion, and depression.
In addition to eating plenty of iodine-rich foods, Cornell students would be wise not to overload on goitrogens, foods which block iodine uptake. Soy and soy-based products can interfere with iodine absorption, as can cruciferous vegetables like broccoli and cauliflower.9 The key, however, is balance. These foods are also rich in antioxidants and other essential micronutrients, and should be consumed in reasonable quantities; three to five servings is plenty. Too much of a good thing can cause problems! Since the widespread distribution of iodized salt in the 1930s, the incidence of iodine deficiency in the U.S. has fallen dramatically.10 Restrictive diets – even those which claim to be based only on the consumption of “healthy” foods like fruits and vegetables – can result in various nutrient deficiencies. Eliminating salt, dairy, and grains while quadrupling your cauliflower consumption is a recipe for disaster. Fortunately, iodine deficiency is reversible – just increase your intake from excellent sources like seaweed. And take all fad or elimination diets with a grain of salt – literally!
Over two billion people worldwide suffer from iodine deficiency, many of whom live in developing countries without salt iodization programs. Adequate intakes of iodine range from 100-150 mcg/day, but there are only a few natural sources of iodine.4 The Salt Institute reports that about 70% of the salt available to Americans is iodized.5 Even so, over 10% of Americans are thought to be iodine deficient.6
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© The Student Body 2013
Exercise and Dieting • 11
E
ach morning on my way to class, I face the dreaded slope. From the bottom, reaching the top seems like an impossible goal. I could easily fall to temptation and take one of the frequent buses that take me to central campus, but I know that the exhausting trek up Libe will have its benefits. Reluctantly, I choose to endure the near torturous climb up. Moving from a suburban town, where driving is the most popular form of transportation, to living at Cornell, my daily aerobic activity went from being nearly non-existent to being constant. I am now forced to walk 15 minutes, up and down hills, just to get to each class. Since a young age, we have always been taught that we should be active. But why? Most people know that aerobic exercise somehow has cardiovascular benefits, but its other advantages might comes as a surprise to some people. Just from the name, “cardio exercise,” one could guess that it has some effect on the heart. This type of exercise can reduce the risk of atherosclerosis, which can lead to heart attacks. Recent studies are starting to show the connection between aerobic exercise and mental health. Aerobic exercising has been found to decrease the stress hormones, adrenaline and cortisol, while increasing endorphins. Endorphins are important in mood regulation, and heightened levels of it cause a sense of exhilaration. You have probably experienced the euphoric feeling after running - some believe this “runner’s high” is a result of increased levels of endorphins. But don’t be fooled, this sensation can result from any source of cardio exercise, not just running. Decreasing the levels of cortisol and adrenaline in the body also results in a sense of relaxation. These pleasurable effects do not necessarily have to be chemically based. Aerobic exercises can also diminish stress by serving as a distraction from its source.
sants do not start working for weeks at a time, aerobic exercise can be used as an immediate treatment. If aerobic exercise is continued over time, relapse rates of depressed people have been shown to decrease in comparison to non-exercisers. The beneficial effects of aerobic exercise on depression leads researchers to believe it may have a similar effect on other mental conditions. At school it seems like everyone’s stress level is through the roof. The constant prelims and assignments cause students to feel pressured and overwhelmed. Although free time does not really seem to exist, taking a break and engaging in aerobic exercise could lower your stress levels and make you relax. Lowering your stress level can help you be more attentive, increasing your studying efficiency. With the seasons changing, running outside might become too difficult. Luckily, our campus has some great indoor resources. Each gym on campus has a great selection of cardio machines including treadmills, ellipticals, steppers, bikes, and ergs. Don’t have a gym pass? Don’t worry! Walking around campus (especially up the slope), or swimming laps during open swim times are great ways to boost your cardio activity. Still skeptical about exercise’s effect on mental health? Go test it out! Next time you feel overworked, take a break and increase your heart rate through aerobic exercise. You’ll definitely feel the benefits of being active.
Much of the research done has focused on the effects of aerobic exercises on depression. Even in extreme cases of depression, just 30 minutes of treadmill training significantly decreased the symptoms. Since antidepres-
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Exploring Cornell
FITNESS CENTER CLASSES By Alexandra Holmes
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n my first three semesters at Cornell, one aspect of the school that has impressed me has been the group fitness classes. Even though students have to pay to go to the variety of classes, it is well worth it. Browsing through the Cornell Fitness Center class offerings, though exciting, is a little overwhelming. The possibility being able to go to flow muvz, spinning, and turbo kick all in one day seems pretty exciting. But, if you’ve never been to any of those classes, the possibility can leave you overwhelmed, and if you are like me, you decide not to go to any of them! I decided to man up and go to some of these unique classes, in hope of spicing up my workout routine and finding a new favorite class to keep me motivated. In giving a more candid description of a few of these classes, I hope to demystify some that you’ve considered and give you a better idea of what to expect.
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© The Student Body 2013
Exercise and Dieting • 13
FLOW MUVZ
Spinning
Pilates
TURBO KICK
I didn’t quite know what to expect from this one. I didn’t have sneakers, so I was just hoping that wasn’t a problem. For this class, we started balancing on one leg, moving our leg in various circles to exercise the hip. We proceeded to the floor where we did several rolls by putting our hands and feet in different positions. We did a “flow” on a mat that combined yoga, squats, and miscellaneous moves that we were first taught individually and then put together into a sequence. This description makes the class seem very random, but I felt empowered and centered after this class. I felt that I had really strengthened my muscles and joints. Basically, this class combined a little bit of everything, but each movement was explained and broken down so well that it wasn’t overwhelming or confusing. As an added bonus, I worked muscles I didn’t even know I had.
If you think that you are in really great shape and need a wake-up call to regain your motivation for working out, then pilates will be great for you (unless you have an extremely strong core & legs, in which case, you might find it easy). For almost the entire class, you are lying on your back, either lifting your legs or your chest, leading to some sort of core work. For me, I found that for much too long, I was just thinking about how much my abs hurt and wondering how much longer it would be until it was over. So, I’m sure that if I could consistently go to pilates, it would get better, but until then, I envy those who can endure this class and walk around with toned abs and muscular legs.
A personal favorite of mine, this is the first class I tried as a freshman at Cornell. At the start of class, you wheel a bike over to your own personal mat, adjust the seat and handlebars, and get on and begin peddling just like you are on a bike. The length of the spin classes varies, but the standard class is 45 minutes on the bike and a 15 minute cool down. You rotate between three positions: sitting (like traditional biking), a standing run, and a standing climb. Music choice and the intensity of the class vary quite a bit by instructor, but all of them are scaled from 1 to 10 based on perceived exertion and let you know what effort number you should be at to stay on track with the workout. It is best when the instructors pick songs with a beat that match the pace of your peddling. On your own personal bike, you can make it as hard or easy as you want, depending on how much you turn the resistance knob. If you are looking to feel pumped up by getting a great workout in a group environment with music, then spinning might just be the class for you.
Am I working out, or am I at a party? That is the question I asked myself throughout this class. The music was reminiscent of song mixes that I remember from cheerleading; quick tempo and frequently changing. The movements are very fast, but I found that if you just stand behind the instructor and keep your eyes on her, then it is pretty easy to pick up. The turbo part of the class is a short sequence designed to really get your heart-rate up and consists of running up doing high knees, burpees, skater lunges, and star jumps. This class made me want to keep going just so that I could master the sequences and moves. Turbo kick provides great cardio in a setting where you might just start believing you are in a dance club.
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14 • Exercise and Dieting
LIVING YOUNG, WILD, AND FREE: The Risk of the Female Athlete Triad By Cassidy Nagle
T
14
he freedom one has in college is both a blessing and a curse. Everyday college students are faced with decisions that impact their well-being. When it comes to two seemingly simple aspects of life, diet and exercise, college students have the power to choose what, when, and how much they eat as well as how, when, and how long they exercise. All-youcan-eat dining halls, convenient BRBs, and hundreds of varsity, club, and intramural sports to participate in surely complicate these decisions. College students, especially those with past diet-related issues, must consciously try to focus on making choices that keep them in optimal health.
Female college athletes (or fitness enthusiasts) are particularly susceptible to physical and mental health problems related to diet and exercise. After Title IX was enacted in 1972, participation in organized female sports has increased dramatically. Many girls, hoping to keep fit and live up to the societal pressures to be thin, choose to play a sport in college or at least frequent the gym or the running trails. While most would call this a smart decision, some girls, especially in this time of transition with newfound independence from their previously observant families, take their freedom to a dangerous level. Soon a “just trying to be healthy” attitude can rapidly transform into dangerous restriction of diet and over-exercising.
Over the years, eating disorders have increased on college campuses; many students have either experienced one themselves or have known someone with one. Although many college students are aware of anorexia, bulimia, and binging, they are unfamiliar with another common condition known as the Female Athlete Triad, which refers to the connection between disordered eating, lack of menstruation (functional hypothalamic amenorrhea), and decreased bone density (osteoporosis). It is important for women and men to know of this complex triangle in order to help prevent further damage to themselves or their female friends or loved ones.
Typically, the triad emerges when women do not get significant energy due to disordered eating or excessive physical activity, both of which negatively impact the individual’s daily net energy. Getting the appropriate amount of daily energy for one’s daily energy expenditure normalizes estrogen production, which helps maintain eumenorrhea (a regular period), regulate bone resorption, and promote bone formation. In contrast, those who exercise for extended lengths of time without increasing their dietary intake or suffer from disordered eating have too low of net daily energy. As a result, their FSH and LH hormone levels decrease, and they become estrogen deficient, which can lead to amenorrhea (absence of period for 90 days or © The Student Body 2013
Exercise and Dieting • 15
more), oligomenhorrhea (irregular periods, occurring in cycles longer than 35 days), and poor bone health. The triad affects everyone differently. Some individuals become amenorrheic from solely increased energy expenditure without a decrease in diet. Research shows that athletes who start to rigorously train before their first period are more likely to get amenorrhea, even if they eat well. Although most amenorrheics have a low BMI, some athletes maintain a fairly normal body weight, usually with a lot of muscle and little fat. These athletes may engage in weight-bearing and impact sports, which can help increase their BMD by 5-15%, prevent against injuries, and reduce the effect of amenorrhea on their bones. These athletes may also have normal bone mineral densities (BMD) in some areas (i.e. radius) and decreased BMD in others (i.e. lumbar). In other affected individuals, most notably those with eating disorders, bone mineral accrual will slow or even reverse and, after roughly a year, decrease their bone mineral density (BMD) to the point when stress fractures and other bone-related injuries are two to four times more common. The longer one is amenorrheic, the further her BMD decreases while her potential of having future osteoporosis increases. The female athlete triad is especially apparent in runners; some studies even report that 65% of college female distance runners suffer from it. On a
college campus, runners are everywhere: the track, the trails, the sidewalks, and the gym. Although running is an impact activity, running for endurance expends a lot of energy. Research reports “the prevalence of amenorrhea increases from 3% to 60% as training distance increases from less than 13 to more than 113 km”. Also, most female runners either restrict their diets, thinking it will benefit their training, or have similar caloric intakes to the average non-athlete, which is insufficient in replenishing their bodies after a long workout. The cure of the female athlete triad involves reinitiating eumenorrhea, which will result in mineral accumulation that begins to slowly improve BMD but may not be able to completely reverse the damage. To normalize an amenorrheic’s period, there are basically two options: take drugs (like hormone replacement therapy and birth control) or increase their net daily energy through changes to their diet and exercise regimen. Generally, professionals recommend either reducing the intensity and duration of one’s exercise (i.e. running less miles) or gaining 2 to 3% of their bodyweight. In addition, increased consumption of calcium and Vitamin D might be necessary for female athletes to protect bones. The drugs are unreliable, for they do not restart periods roughly thirty percent of the time. However, amenorrheic athletes who eat and weigh enough yet decline in their BMD may benefit from taking oral contraceptives, which contain estrogen and progestin, to reduce the risk of further bone loss.
“Soon a ‘just trying to be healthy’ attitude can rapidly transform into dangerous restriction of diet and over-exercising.” Reproduced from [13-17]
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16 • Exercise and Dieting
By Rula Saeed
Evolution’s Most Unwanted Trait O
ur early ancestors, the cavemen, were always in search of fats, and how can we blame them? Though rare, these high calorie foods were relished and considered the best way to enhance their highly nomadic lifestyles. Thanks to evolution’s outdated ways, this predilection for fatty, comfort-inducing foods has maintained itself even in the 21st century when every other aisle of the grocery store is stocked to the max with Nabisco’s finest, frosted, multiple crème-layer cookies of every shape, size, and flavor imaginable. Though many vow to never succumb to the unyielding grasp of sugar addiction and flinch at the slightest glimpse of a higher digit on their scales, all it takes is a week or two of prelim-induced anxiety paired with the downhill spiral of a dramatic love life for the gym membership to be exchanged for a pint of Ben & Jerry’s.
“
The answer is the stress hormone cortisol which links stress with food cravings and induces the body’s desire for carbohydrate-rich foods.
16
”
© The Student Body 2013 produced from [18] Re
Exercise and Dieting • 17
“
Next time you begin to notice that your once-a-month late night binge has become a nightly habit, consider a different way to handle your emotions either by sleep, 30-minutes at the gym, or by having a simple conversation with a couple friends. The college years are when many of life’s intellectual, social, and personal dilemmas float to the surface. Many students can balance up to six classes or a total of 22 credits, along with extra-curriculars, Greek life, and the ever-demanding role of just being a successful human being in all aspects. As it turns out, at some point during the year, ambitions pile so high that they all come crashing down and there you are, in the middle of a vacant library holding the shreds of your sanity in one hand and an empty 310 calorie bag of fiery jalapeño Cheetos in the other. What causes this positive correlation between workload and appetite? The answer is the stress hormone cortisol, which links stress with food cravings and induces the body’s desire for carbohydrate-rich foods. The primary effect these foods have on the body is the increased production of serotonin, which, in the end, becomes the sole way for students to improve their mood and performance under pressure. On top of that, the reason why pants have become harder to unbutton as the four years progress might just be that intake of these foods have become more frequent at late night hours when most college students are active writing essays, cramming for an AM test, or trying to fit in an hour or two of a social life. This so called Night Eating Syndrome (NES) is predominant in females and linked to increased stress and
”
“maladaptive coping strategies,” which are familiar among girls who frequently turn to binge eating fried, oily, or chocolate foods as an emotional catharsis. Students who experience severe NES seem to eat more after dinner than during it and continuously eat throughout the evening, leading to guilt, shame, and an increased sense of depression rather than enjoyment. Consequently, an increased rate of body dissatisfaction caused by increased late-night consumption is a positive feedback mechanism and often leads to more weight gain. Although many of us do not experience symptoms of NES to that severity, we still have to deal with the consequences of sugars and carbs being stored in our bodies as fat overnight. In the caveman days, this would have been a desire, but for college students now, this is the epitome of chaos and another problem added to a never-ending list. In the end, even if on one night our most loyal book-side companion at 2am is that fudge brownie from Libe Cafe, we still have many other nights to redeem ourselves either with the gym or with the necessary evil of tough love. Training our brain not to fall for the temporary euphoria that comes with comfort food is painstaking but beneficial to our mental and physical health. Even though we can’t completely get rid of our subconscious caveman-tendencies, we still have to try.
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p a s l e l o i
n
es is
the
The
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18 • Exercise and Dieting
Fa
t H o th yp
By Mei Xin Luo
T
he media’s imposition of an ideal body image has sparked a proliferation of dieting regimens in recent years. This obsession with body image has not only increased public knowledge of healthy living, but also generated confusion and uncertainty over which “facts” are actually scientifically determined and which are misconceptions. Mark Sisson, a fitness author who established a dieting blog called “Mark’s Daily Apple”, addresses the skepticism between a fat diet and gain weight. In 1972, Dr. Robert Atkins originally proposed in his book, “Diet Revolution,” that carbohydrate, instead of fat, was the agent responsible for sabotaging our diets. Carbohydrates in the blood stimulate the release of insulin into the blood, which acts to store fat in our cells. In a study done by Dr. David Ludwig in 2012, participants were placed on diets with varying carbohydrate contents. What they found, contrary to public expectation, was that the lower the carbohydrate ratio in the diets, the more energy is expended per day. In contrast, the participants who were on low fat diets needed to engage in an extra hour of exercise per day just to expend the same amount of energy equivalent to participants on the low carbohydrates diets. The results of this study then allowed researchers to conclude that carbohydrates increased risk factor for weight gain and obesity.
Most people also adhere heavily to public opinion that saturated fats are harmful to the body since they cause heart disease. The key to this conclusion was “The Seven Countries” study by Ancel Keys, which demonstrated a positive correlation between fat intake and heart disease. Yet, Mark Sisson cited that although this study was monumental, the original data for this study unveiled the larger picture – that there is, in fact, a very weak correlation between fat uptake and heart disease. Although the study had collected data from a total of 22 countries, only 7 countries were used in the analysis while the rest of the countries were omitted in an effort to create a stronger correlation. In addition, Sisson also made a good point suggesting that saturated fat has been selected for over the course of human evolution. Based on the principles of Darwin, it would make little sense that our bodies have continually selected for something that is harmful. Furthermore, in 2010, a study published in the American Journal of Clinical Nutrition clarified that there was not enough evidence to decisively link the uptake of saturated fats to an increase risk of heart disease and stroke. Studies done previously that had made groundbreaking conclusions were all based on the assumption that there was a positive correlation between saturated fat uptake and cholesterol levels.
Reproduced from [19]
18
© The Student Body 2013
Healthcare and Disease • 19
TRAPPED IN A
PL ATE AU
Infant Mortality in the United States By Gabriela Castillo
D
espite being a country that prides itself on being the most advanced, and prosperous country in the world, the United States has managed to achieve first place in one of the most unfortunate indicators of poor health and social conditions in a nation. According to a 2013 estimate in the World Fact book, the United States’ infant mortality rate puts the country at 174th in the world. The rank does not seem too unpleasant when compared to all the nations in the world, but when these statistics are compared to the number of infant deaths in nations of the industrialized world, the attitude changes toward this rank. The Institute of Medicine reported earlier this year, that with an average of 6.7 deaths per 1,000 live births, the United States takes on the highest infant mortality rate among the countries of Canada, the United Kingdom, France, Germany, Norway, Japan and Sweden. Careful consideration of these statistics indicates that infant death is nearly twice than that of Sweden and Japan. It is known that there is a strong correlation between infant death and birth complications such as preterm delivery, asphyxia and low birth weight. You would assume that the nation’s leaders wouldn’t think twice before addressing infant death in the United States. World Socialist calls the recent health dilemma of the United States a clear “…indictment of social inequality created by the capitalist system worldwide…” Furthermore, the same article observes that, “within wealthy countries, a widening section of the working class are subject to poor living standards and extreme disparities in health
care. Millions of Americans, as a result, fare little better—and in some aspects worse—than their counterparts in some of the poorest countries in the world.” The United States has seen steady declines in its infant death rates in recent years, but there have been enough improvements to move the country away from the highest industrialized world. Apparently, a lack of availability of prenatal and postnatal services is an apparent obstacle in addressing this critical issue. A recent study reported that nearly 62% of women have insurance, but they do not receive sufficient maternal care coverage. Efforts to provide women in America with accessible prenatal and postnatal services encountered resistance in recent years by several government officials. Regardless of the opposition, in March of 2010, President Obama managed to sign the Patient and Affordable Care Act into law. The law is scheduled to take effect starting in October of the year of 2013, and it will require all insurance companies to offer maternity care coverage benefits. This coming law shines a ray of hope for future mothers across the nation who, with any luck, will never have to suffer such an awful loss.
Reproduced from [20]
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20 • Healthcare and Disease
A Call to Arms in the Battle for Mental Health
By Ariel Wampler
Y
ou may have read in The Cornell Daily Sun about the Jed Foundation’s “Campus Seal of Approval” which Cornell recently received. The Jed Foundation’s mission is to reduce emotional distress and prevent suicide among college students. The efforts of the University, without a doubt, to address issues of mental health have been commendable: since 2010, a set of innovative initiatives and expansion of services have been enacted, attesting to Cornell’s commitment. The most visible of these is the installation of the nets under bridges around campus, but several other programs, such as Finding Balance in the ENGR 1050 engineering seminar, and Let’s Talk walk-ins with CAPS counselors, have been instrumental to decreasing the stigma of seeking help for mental and emotional woes. Concerns about mental health spurred Cornell to include a short break in February to correspond with Fall Break. Comprehensive information on Cornell’s current mental health resources and objectives moving forward can be found here: http://www.gannett.cornell.edu/campus/welfare/framework.cfm
Reproduced from [21]
not permit us to cavalierly congratulate ourselves and make no further progress on Cornell’s support systems. The National Alliance on Mental Illness reports that 40% of college students with diagnosable mental health conditions did not seek help, and that depression and anxiety are leading impediments to academic success. There are still too many students, faculty, and staff at Cornell who suffer in silence: a source at CAPS (Counseling and Psychological Services) reports that 30-50 students every year are admitted to the inpatient psychiatric ward at Cayuga Medical Center. While well-intentioned and heart-warming, exhorting members of the Cornell family to be resilient, to seek help, and to look out for one another can only achieve so much, below are a few policy proposals which may be worth considering:
1
As a community, we have accomplished a great deal, but the need for mental health promotion and care still outstrips what Cornell currently provides. Receiving this award does
20
A required info-session for freshmen and transfer students which is dedicated to information about the various mental health resources available at Cornell. Although one in four young adults (ages 18-24) has a diagnosable mental illness during the 2012-2013 year, only 17% of the Cornell student body visited CAPS at least once. These statistics suggest that there may be many Cornell students who are not receiving the care they need. Students may not © The Student Body 2013
Healthcare and Disease • 21
Policy Proposals Worth Consideration: utilize all the many resources Cornell offers, but one that the administration can address is the potential lack of awareness concerning the availability and discreetness of CAPS and EARS. Expecting students who need these services to find them on their own does not “encourage initiative” – it is little more than benign neglect. While orientation would be the most convenient time to hold such an event, many students will not begin experiencing issues until enough time has passed for stress to build, for freshman to miss their homes, and for interpersonal issues to crop up. Therefore, to be most helpful for students, the session should occur a few weeks into the semester.
2
Providing students returning from leave with reminders to reapply for financial aid. Currently, students who are on leave are not listed as “registered,” in Cornell’s administrative systems, and therefore do not receive the same notifications as registered students. Lack of access to such important information places unnecessary burden on students who return from a Leave of Absence, during the already stressful period of adjustment back to Cornell. Cornellians should be able to start their semester in a healthy state of mind. A simple modification to the reminder system that allows returning students to stay on track would ease the frustration and anxiety of navigating through a maze of Cornell’s infamous “Big Red Tape.”
3
Events in which panels or individual speakers share their personal struggles with mental illness. Some events like these already occur but they tend to be only narrowly advertised and ill-attended. Individuals who are brave enough to come forward with their stories would perform a valuable service for others – both by increasing awareness in the Cornell community and by giving a voice to those who may not yet be seeking help – and may find the process therapeutic for themselves. Karen Winters Schwarz, an author and mental health advocate who came to campus in October, highlighted the singular need for those who are in recovery from mental illness to speak out. Too often the only available perspective on psychological disorder is one of sensationalism, which reinforces a distorted image of the mentally ill as immoral, violent, or criminal. Bolstering the much more accurate narrative of the mentally ill as people who deserve compassion, and who are in fact much more likely to be victims rather than perpetrators of crimes, is an important step for reducing the stigma surrounding mental illness.
4
Reforming Gannett’s medical excuse policy. A recent editorial in the Cornell Daily Sun by David Fischer broached this topic, and there are likely several other students who can echo his experience and sentiments. At present, “Gannett Health Services does not provide excuses for routine illnesses, injuries, and mental health problems that may lead to missed classes, labs, studios, exams or deadlines.” However, not all professors are aware of this policy, and some will still ask for a doctor’s note to justify a student’s absence at a prelim or a late paper. When this note is not available, students may have to seek recourse through their dean, a harrowing and time-consuming process. David astutely noted, “It is a bit absurd to require a physically or mentally ill student to jump through hoops to remedy a situation that could be easily solved by a slip of paper.” Not every illness or injury Cornell students face is as trivial as a cold, or so serious that it warrants a stay in the hospital. It would also be insensitive to require an ill student to hike up Libe Slope to Gannett for an appointment, or to transfer TCAT buses twice in order to get to a local doctor if they had no access to a car. But students who miss a major assignment may feel compelled to go to the hospital, incurring tremendous cost, in order to obtain a “legitimate” excuse (through Cornell’s Crisis Management system). Students deserve to have more options than either an ambulance ride or a zero grade on a test or paper. A medical excuse system would, of course, come with potential for abuse – but this could be remedied by careful record-keeping (to identify frequent users) and strict rules for circumstances in which excuses would be granted. Gannett’s limited staff and relative inaccessibility – due to location, non-24-hour service, and often packed appointment schedule – are still problematic though. One potential solution could be to integrate the staff of Cornell’s Emergency Medical Services (EMS) with Gannett. EMS personnel could respond to health complaints which would involve a medical excuse request, evaluate the student (perhaps with Gannett staff input), and provide the student with necessary documentation to give to his or her professor(s).
5
Expansion of the Interactive Screening Program. This Web-based outreach program seeks to identify, engage, and refer to treatment students with depression or other serious mental health conditions. Due to staff constraints though, Gannett is only able to process survey data for new transfer students. Serious psychological distress can affect any member of the Cornell community, not just incoming transfer students, and relying on individuals to recognize that they or a friend requires help is bound to prove inadequate. Therefore, an ambitious but beneficial proposal, to provide more Cornellians with the mental health care they need, would be to screen the majority of the Cornell community and to hire additional staff as needed. Ensuring that students with major mental health concerns are assisted is a powerful opportunity to instill healthy attitudes and behaviors for facing challenges later on in life, to reduce the need for hospitalizations, and to prevent future tragedies.
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Infectious Disease By Neil Chitrao
T
he rise of antibiotics and other chemotherapeutic agents in the modern world has led to a certain degree of complacency regarding infectious diseases in the United States. Indeed, one might go as far as to say that the threat posed by pathogens, microscopic or otherwise, is largely restricted to Third World nations in underprivileged corners of the globe. However, recent trends in infectious disease prevalence, as measured by the Center for Disease Control and Prevention (CDC), suggest that America is experiencing an alarming recrudescence of maladies most attributed to the pre-antibiotic era. A variety of factors, including the infrastructural ramifications of the recent economic downturn, pathogenic resistance to antimicrobial drugs, and globalization have all led to an increase in the incidence of communicable diseases. Far from being “able to close the book on infectious disease”, as infamously suggested by Surgeon General William Stewart, in 1967, the United States must take action to counter the specter of pathogenic illnesses targeted economic relief for underprivileged areas and decreased reliance on antibiotics.
“...America is experiencing an alarming recrudescence of maladies most attributed to the pre-antibiotic era." According to publications by the National Institute of Allergy and Infectious Diseases (NIAID), the economic crisis that started in the fourth quarter of 2007 brought with it a dramatic rise in the incidence of parasitic illnesses such as enterobiasis and ancylostomiasis in the Southern United States. These diseases, both caused by nematodes, is normally associated with poor sanitation. Ancylostomiasis, more commonly known as hookworm, is usually transmitted cutaneously, when a person walks through an infested area barefoot. Enterobiasis, on the other hand, is transmitted by ingestion of the eggs, which commonly reside in dirt. Both of these parasitic diseases were largely eradicated in the United States by the 1940s. However, the recent economic downturn has not only affected poor Americans’ ability to seek treatment for relatively treatable disorders such as enterobiasis but has also resulted in the infrastructural degradation neces-
22
sary to permit the return of such worms. Necessities such as indoor plumbing and a solid public health surveillance system have been affected by the economic crisis, and impoverished Americans are paying the price. Compounding to this problem is the overuse of antibiotics in a clinical setting. The world has already seen the ramifications of the wanton use of antimicrobial drugs as a chemical panacea: the excessive use of penicillin during the Second World War to treat cases of gonorrhea among American soldiers in the European theater led to penicillin’s inefficacy against Neisseria gonorrhea, the bacterium that causes the STD. The reason for this is simple evolution: when the antibiotic is introduced to a population of bacteria, the only bacteria that are capable of surviving and reproducing are those that are resistant to the antibiotic. Thus, after repeated usages of the antibiotic, the only organisms remaining are those that are drug-resistant. These bacteria go on to produce populations of organisms that are capable of withstanding the deleterious effects of chemotherapeutic agents such as penicillin. This alone provides a reasonable argument for the sparing use of antibiotics. However, these drugs are being used in abundance, even when they are not strictly necessary. For instance, a large number of primary care physicians would think nothing of prescribing antibiotics to a patient complaining of the flu, in spite of the fact that the flu is viral in origin, and would thus not respond to antibiotic treatment. Such prescriptions are usually made to mollify the patient, but they have widespread negative consequences. Both of the phenomena described above have devastating repercussions, but they are reversible. Improvements in infrastructure in the South through economic relief could help ensure that all Americans have access to clean water and sanitation. Informing the public about the hazards of walking through dirt barefoot could help curb the incidence of hookworm. Furthermore, warning physicians not to overuse antibiotics, and limiting overthe-counter access to such drugs, would help limit the rise of antibiotic-resistant organisms. Simple measures such like these would produce immediate results, and would bring us one step closer to making General Stewart’s words a reality. Reproduced from [22]
© The Student Body 2013
Healthcare and Disease • 23
Oxygen Couriers of
Future
the
F
uture physicians will be dealing with radically new and improved medical technology. This section covers a spotlight on a medical advance that pre-meds might have in their future. The past few years have been highly fruitful in terms of advances in the medical industry. While many of the discoveries that have been made are still in their infant stages, these exciting springboards promise exponential advances in the years to come.
One group of researchers have been working on tackling the problem of delivering oxygenated blood to those who have damaged the oxygenreceiving parts of their circulatory systems (e.g. car accident patients whose faces have been damaged). While it is not always possible to clear an obstruction from the airway in order to return oxygen flow and prevent devastating brain damage, it is always possible to make an intravenous injection. From this idea sprang the invention of micro particles that are able to deliver oxygen like red blood cells. They are tiny, collapsible discs that serve solely the function of carrying oxygen through the bloodstream. They are composed of a tiny lipid bilayer. Such a bilayer has previously been utilized for imaging, but not critical oxygen delivery.
By Elizabeth Joyce
tain life for 15 minutes with blocked noses and mouths by the aid of these particles. By looking at oxygen saturation levels that remained above 40-70%, they were able to tell that the platelets were working as they had intended them to. This kept the organ systems from shutting down or sustaining major damage. Though there is still much research to be done before it will be ethical for human use, emergency medical technicians and others in the field of trauma and critical care are excited about the implications of more time to work with – critical minutes that could be a matter of life and death. Embolism and cardiac arrest were averted as well due to the introduction of these particles, as shown by trials in the control group.
Understandably there are some drawbacks to these particles- as the oxygen gradient is disturbed, it is not sustainable. The rabbits from the trials only lasted 15 minutes. Also, the tiny particles are able to collapse once they have disposed of their load of oxygen. Surely, researchers must look at the feasibility of the body’s ability to clean up these inorganic particles. Still, such revolutionary technology is at the forefront of life-saving technology that will forever change the face of circulatory One exciting trial showed that rabbits could sus- system medicine. Reproduced from [23] 23
24 • Healthcare and Disease
Why you should care about
Obamacare By Rotem Kimia
O
bamacare – or, more precisely, the Patient Protection and Affordable Care Act (PPACA) – is the most significant healthcare legislation passed in the United States since Medicare and Medicaid were passed in 1965. It is so controversial that, in fact, the US government had its first shutdown in 17 years starting September 30th, 2013. However, if you are like hundreds of thousands of Americans out there, you likely know very little about it other than the fact that Republicans hate it and Democrats love it. In fact, in a USA Today poll, 36% of Americans polled admitted to not understanding the impact the law might have on their family, while another 39% responded they “somewhat” understand. So what impact could Obamacare have on you? Or the country? And why is it so controversial? Should you support it? Or is it far too costly? It’s time to ask the simple questions – and get the answers.
Reproduced from [24]
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© The Student Body 2013
Healthcare and Disease • 25
What is Obamacare trying to fix, and how?
It’s no secret that the U.S. Healthcare system is an industry of its own, with the 5 largest for-profit insurance companies raking in a staggering $12.2 billion in 2009 alone. And it’s not just insurance companies that are profiting – Weill Cornell Medical Center (under the larger umbrella of the New York Presbyterian Hospital) posted an income of $6.8 billion in 2010. And while not all of this income is generated by service charges for patient care, it’s difficult to ignore the increasingly high costs of hospital services. PPACA primary focus is lowering the cost of healthcare and insurance. It does so, in part, by putting stricter regulations on insurance companies. For example, insurers now cannot deny coverage for individuals with pre-existing conditions, nor can they be charged more for coverage. It also requires individuals to purchase healthcare plans to reduce future potential health costs and for businesses with more than 50 employees to provide health benefits as part of the employment package. It also offers federal subsidies for individuals and families living under the poverty line who get healthcare, as well as expanding Medicaid eligibility. Lastly, it not only lowers health costs, it also increases what is considered minimum coverage by health insurance.
When was it passed, and when does it go into effect?
Universal healthcare was a major platform of the Obama campaign back in 2008, and was finally passed on March 30th, 2010 after nearly a year in the Senate. But if you’re like me, you likely felt no effect – many collegeaged students are insured under their parents’ workplace insurance or, if you attend Cornell, you signed up for SHIP before enrollment. In fact, most people with comprehensive health insurance that was obtained before the passing of Obamacare, with a few exceptions, are completely unaffected. The question of when Obamacare goes into effect is a difficult one to answer, as the act has multiple parts that are controlled and implemented in different ways. All components of the act that changed regulations – such as the new healthcare minimum and the expansion of Medicaid benefits – are already in effect. However, some aspects are not yet launched or are in development. Those aspects require significant federal funding.
What are the financial costs of Obamacare?
There are several valid concerns regarding the cost of PPACA, and those concerns have become particularly pertinent in these tough economic times. One concern is that not enough people actually get Obamacare. Insurance companies rely on the money of the healthy customers to pay for the health costs of
the sick. If not enough customers sign up – or, if too many sick customers sign up in proportion to the healthy – the program becomes a money sink. Who are these healthy Americans not getting health insurance? It’s us: young adults between the ages of 19 to 25 are least likely to sign up for health insurance, and yet are necessary for subsidising all the insured. Another serious concern is the way in which Obamacare lowers healthcare for those below the poverty line – it raises premium prices for insurance plans of those above the poverty line. And furthermore, some individuals whose health insurance is not deemed sufficient by the act will have to exchange plans for Obamacare, which adds increased costs as well. No one wants to have to pay more, and dissidence against the act is a natural response. Lastly, there will be significant federal cost to advertise the new plan and educate the public. From launching a website – which, coincidently, crashed the first day it launched due to high traffic – to hiring Obamacare liaisons to communicate the new policies in health clinics, getting people to understand the act is a cost of its own.
Do the benefits outweigh the costs?
It depends who you ask. Republicans would largely argue that no, the costs are too high to justify with the less than stellar benefits seen in the past couple of years. The cost of healthcare has not decreased, although insurance has, and many remain uninsured – arguably by choice. Furthermore, several Republican states have rejected Medicaid expansion and have gone as far as to limit advertisement of the new Obamacare policies. The increased cost to the already insured, coupled with the fact that many Americans will choose to remain without health insurance and will pay the penalty tax instead, makes for a costly policy to many. Add on the increased debt it may cause in the federal budget, and the act becomes less appealing. Democrats argue the opposite. The Democratic argument is not to increase spending, although there will be some foreseeable increase due to the program. They suggest a re-budgeting in which more of the funds are funnelled into these “welfare” programs. And by making sure everyone has insurance, the act ensures that hospital bills are paid for, leaving less people in debt. It also acts as a control for the business side of healthcare and insurance: limiting costs of insurance packages and hospital treatments allows closer government regulation of the privatised healthcare business. It’s a debate without an answer – the shutdown is still occurring, with Congress at a standstill over how and whether to fund PPACA programs. But whether you support or oppose the act, it is important to understand this historical legislation that will likely define the Obama administration.
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Thank you! to the creative minds behind this publication, our producers... Natsuko Suzuki
Vinayak Portonovo
Locavore Movement Trapped in a Plateau Iodine Deficiency
Exercise Your Stress Away
Ann Lei
Exploring Cornell Fitness Center Classes
Kathy Zhang
Amy Chen/Mytien Nguyen
Infectious Disease in the U.S.
Evolution’s Most Unwanted Trait
Becky Roh
Sisi Peng
The Risk of the Female Triad
The Collapse in the Fat Hypothesis
Michelle Nelson
Janhawi Kelkar
Myth of Processed Food
A Call to Arms in the Battle for Mental Health
Vitamyth?
Oxygen: Couriers of the Future
Natalia Mesa
Yunah Kang
Lucia You/Mytien Nguyen
Sheryl Quock
Navigating a Cornell Dining Hall
Why You Should Care about Obamacare
The Student Body Executive Board
Co-President, Editor-in-Chief
Sarah Parauda
Co-President, Graphic Editor
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...and their inspirations, the photographers 1. 2. 3. 4. 5. 6. 7.
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13. 14. 15. 16. 17. 18. 19. 20. 21. 22.
womenshealthmag.com elitesportsupplements.com foxnews.com fairmountac.com life-without-fat.com flickr.com/photos/g_firkser flickr.com/photos/84906483@N08 flickr.com/photos/peasap flickr.com/photos/webkat upload.wikimedia.org/wikipedia/ commons/b/b4/SalmonellaNIAID.jpg 23. flickr.com/photos/photohannah 24. flickr.com/photos/dborman2
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The Student Body Š 2013