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What causes breast and oral cancer, heart disease, strokes, liver cirrhosis, depression, memory impairment and reduced fertility? . . . . . . . . Alcohol.

More dangerous than heroine

NHS figures show that alcohol related hospital admissions peaked in 2010 when over a million people were admitted. Alcohol Concern predicts that by 2015, the annual number of hospital admissions due to alcohol will reach 1.5m, and cost the NHS £3.7bn a year. A 2010 study in The Lancet suggests that alcohol is more dangerous than heroine. A study by the Independent Scientific Committee on Drugs agrees, and ranks alcohol as three times more harmful than cocaine or tobacco.

The WHO's 2014 Global Status Report on Alcohol and Health said that in 2012 there were 3.3m alcohol related deaths worldwide, and called on governments to implement policies to reduce the harmful use of alcohol.

 

 

˜Yes minister" government response
The UK government guidelines on drinking are being reviewed. Currently, they suggest hat a women should not drink more than two to three units of alcohol per day, and a man three to four units. But medical experts argue that people don't realise how much they're drinking.

Liver
Although the toxicity of alcohol is complex, there's a significant relationship between the greater the alcohol intake per week, and the greater the liver damage.  Over the past 25 years, UK deaths from liver disease have increased by 500%; the overwhelming majority alcohol related. Only in the last few years has this increase slowed. Alcohol has a bigger impact than smoking on health because alcohol kills at a younger age. The average age of death for someone with alcoholic liver disease is their 40s.

Heart
Moderate alcohol consumption raises good cholesterol, stops the formation of blood clots in the arteries, and helps protect against heart disease. Drinking more than three drinks a day has a direct and damaging effect on the heart. Heavy drinking, particularly over time, can lead to high blood pressure, alcoholic cardiomyopathy, congestive heart failure and stroke. Heavy drinking also puts more fat into the circulation of the body, which is dangerous for the heart.

Cancer
The link between alcohol and cancer is well established. Cancer occurs when DNA is altered. Acetaldehyde is a toxic created when alcohol in the liver is broken down by an enzyme, and has been shown to damage DNA. When you drink, the acetaldehyde corrupts DNA. One of the most common genetic defects in man is our inability to counteract the toxicity of alcohol.
 
A 2011 study published in the British Journal of Medicine estimates that alcohol consumption causes at least 13,000 cancer cases in the UK each year. Cancer experts say that for every additional 10g per day of alcohol drunk, the risk of breast cancer increases by approximately seven to 12%.

Other conditions
Studies also show that increasing alcohol intake by 100g per week increases bowel cancer risk by 19%. A recent report in BioMed Central's Immunology Journal found that alcohol impairs the body's ability to fight off viral infections. Studies on fertility suggest that even light drinking can make women less likely to conceive while heavy drinking in men can lower sperm quality and quantity.

Takeaway
It's time for governments to implement policies to reduce the harmful effects of alcohol.

Escalating costs and patchy quality
According to the World Healthcare Outlook of the Economist Intelligence Unit 2014, total global health spending is expected to grow at over 5% in 2015.
 
In Europe rising government debts, constraints on tax revenues, and aging populations will force health providers to make difficult choices about the provision of healthcare. Rising demand, and continued cost pressures will increase pressure on traditional healthcare business models and operating processes to change.
 
Despite the expected annual productivity and efficiency savings of some 4%, UK healthcare expenditure in 2015 is estimated to be about 10.3% of GDP. In the absence of changes to the delivery model, the UK's NHS funding gap is likely to increase significantly in 2015.
 
In their struggle to manage the escalating healthcare costs, health providers will accelerate their transition from volume to value. This will mean a greater emphasis on improving outcomes while lowering costs. This will drive payers to seek out global best practices of delivering affordable quality healthcare such as Narayana Health.

Access 
Improving access to healthcare will be one of the most pressing policy issues in 2015. Shortages of health professionals represent significant challenges in healthcare access, and healthcare systems will be pressed to recruit, and retain health professionals.The US is addressing this. US employment in healthcare increased from 8.7% of the civilian population in 1998 to 10.5% in 2008, and is projected to rise to 11.9% (nearly 20 million people) by 2018.
 
The UK is not in such a good position. In 2012 the UK had a shortage of 40,00 nurses, which it hasn't resolved. This is compounded by shortages GPs. Europe has an estimated shortage of some 230,00 doctors.
 
Increasingly, developed countries recruit health professionals from developing economies. The morality of this will be further questioned in 2015 as the policy significantly erodes the number and quality of healthcare professionals in emerging countries.
 
Changing technologies
The development of healthcare technologies has been rapid, and in some cases disruptive. Technologies such as telemedicine, electronic health records, mHealth, e-prescriptions, and predictive analytics have changed the way health providers, payers and patients interact, and contributed to improved quality of care, lower costs and improved outcomes. In 2015 expect the spend on healthcare technologies to slow.  
 
Security    
Reportedly, there is a growing and lucrative black-market for personally identifiable information, and personal healthcare information. Many healthcare organizations already have low security budgets, and only about 50% employ adequate encryption technologies to secure their endpoint data. Compared with other industries, healthcare experiences significant losses of endpoint healthcare data. Security challenges for the healthcare sector will accelerate in 2015. 

Diabetes education and outcomes
Current providers of diabetes education fail to demonstrate how their offerings affect outcomes, and people are not interested in educational courses if they're not linked to outcomes. A 2012 London School of Economics study concludes that there's a lack of diabetes outcome data in the UK, and, "No one really knows the true impact of diabetes, and its associated complications."

The 2013 Annual Report of Diabetes UK (DUK) states that 50,000 people with diabetes used the Charity's blood glucose tracker app, 500,000 took its diabetes risk test, and DUK distributed 250,000 foot-guides, but the Report fails to mention what impact these important activities had on patient outcomes. 

Shift of power
Traditional providers of diabetes education have yet to appreciate that the information age has shifted the balance of power from health providers to patients.
 
Mobile devices are ubiquitous and personal. By 2018 smartphone penetration in the UK is expected to be 100%. The over 55s are projected to experience the fastest year-on-year smartphone penetration, and the difference of smartphone penetration by age is expected to disappear by 2020. Further, competition will continue to drive down prices of mobile devices, and increase their functionality. 
 
Over 70% of people living with diabetes regularly use their mobiles to search the Internet for healthcare information, and use social-media to share information about health providers, and educational courses.  This is carried out 24-7, 365 days a year.
 
Traditional providers of diabetes educational courses should be minded that 35% of all patients who use social-media say negative things about health providers, 40% of people who receive such negative information believe it, and 41% say it affects their choices. Social-media is the new frontier of reputation risk for providers of diabetes education.
 
Takeaways
Traditional providers of diabetes education must become more open to independent service providers, and enhance their digital strategies to make their education offerings smarter, faster, and better. 

Frequently misdiagnosed
The frequent misdiagnosis of ovarian cancer means that it often presents late when it has already metastasized. It's the most aggressive gynecological malady, with poor survival rates: only 40% survive beyond five years, and it can affect any woman.
 
The reason why early symptoms are difficult to detect is because inside the abdomen, the ovary has a lot of space to grow into before it starts to press onto other structures such as the uterus, bowel and bladder.
 
Early detection is key
All women should be on guard of the symptoms, which may be vague at first, and similar to other conditions, such as digestive disorders. The commonest symptoms are discomfort or pain in the lower abdomen or pelvis, and also there may be backache or a swelling felt.
 
There is a survival rate of up to 90% when ovarian cancer is caught early, compared with less than 30% if it is discovered in the later stages. 

Increasing incidence in younger women
Around 1 in 55 women will get ovarian cancer at some time in their life, and it is more common over the age of 40. Less than 1 in 20 ovary cancers occur in women younger than this. There are inherited factors involved in some cases, and research is underway to find out how best to screen women at increased risk of the disease. Since the mid-1970s, the incidence of ovarian cancer in women between 15 and 39 has increased by some 56%.
 
Takeaway
Currently, early detection, and rapid referral to a specialist gynaecological cancer unit is the key to transforming survival rates for ovarian cancer. Patients therefore have to rely on seeing a doctor, and being correctly diagnosed in time.