Another week, another release of
scientific studies calculating the risk of everyday activities that
might kill you. This week, we have two: one regards for-profit
nursing homes, and another looks at pastrami sandwiches.
It is so easy to inappropriately
condense years of study over thousands of complex cases into a
catchy headline. I'm often tempted to ask for a meta-study on the
relationship between steady consumption of news reports regarding
everyday health risks and depression.
There is a fair amount of salt to be
taken with these kinds of news reports — which itself is
probably not good for your health.
Especially, we are told, when it comes
to salted or cured meats. The France-based International Agency for
Research on Cancer now rates processed meats (hot dogs, sausages,
smoked meats or fermented meats) as Group 1 carcinogens.
What's a Group 1 carcinogen? It is
something that exhibits a strong link to cancer that can be proven in
studies, but not the actual risk of how much cancer it causes.
Tobacco is in Group 1, as are diesel fumes. So, if you're a long-haul
trucker who smokes and eats ham sandwiches every day, that can't be
good.
It's not good, but you have to compare
risks — and that's what these studies do not really tell you. For
each 50 grams of processed meats that you would eat daily, says the
IARC, your risk of colorectal cancer rises by 18 per cent.
But what's the risk of getting
colorectal cancer generally per 100,000 people? Well, it's the second
highest cause of cancer death in the U.S.; 10 deaths per 100,000,
according the list on Wikipedia. Bad, but way down the list of all causes
of death. You are almost twice as likely to die in a car accident,
for instance (19.1 deaths per 100,00). But who is out there striking
fear in your heart about that?
If you want to fear anything, watch out
for cardiovascular disease and heart disease, which together kill 385
people per 100,000 per year. Get your exercise, that's all I can say.
So, an 18-per-cent increase in risk, if
you eat one hefty sub sandwich a day? People live with a lot worse
things, smoking for one.
Red meat is a Group 2a cancer risk,
along with glyphosphate (a widely-used weed killer) and diazinon (a
widely-used bug killer). That means the evidentiary link between
these things and cancer is pretty good, but not as strong as the link
between tobacco or salami and cancer.
Is any of this going to change your
behaviour? Personally, I love a smoked-meat sandwich once in a while.
Here's another study which might give
you pause, along with government policy-makers. And here's another
research institute with a long name: the Institute for Clinical
Evaluative Sciences.
They found that mortality and instances
of hospitalization within one year of being admitted to a for-profit
long-term care facility is statistically higher than if you are
admitted to one run by the government or a charity.
To boil the risk down to a headline: if
you assign a value of 1 to the risk of death or hospitalization in a
non-profit seniors care facility in Ontario, the risk hazard in a
for-profit institution is 1.10 for mortality and 1.25 for
hospitalization after one year.
Why in Ontario? Because of the laws. In
Ontario, all core care is paid equally in seniors long-term care residences, whether it is for-profit or not. It is illegal to charge people more for core care services just to make a profit .
That eliminates a major variable in
comparing outcomes of care. Of the 640 care facilities
compared in this study, 60 per cent were for-profit, and 40 per cent
were not. This compares well with both the U.S. and U.K., where the
majority of long-term care beds are in for-profit institutions.
The study followed 53,739 admissions
from 2010-2012, and examined outcomes at 3 months, 6 months and 1
year. They recorded who died, went to the hospital, or were
transferred someplace else (like hospice — in which cases they were
not part of follow-up study).
In my mind, the differences are
statistically there, but I would still take the first bed locally
available, when my need arose.
This is more a thing for government and
care advocates. Tax-paid health care costs for seniors are rising. If
there is a 25-per-cent less chance of needing to pay for someone's
hospitalization when a government opts for government-run facilities
versus allowing more for-profit investment in that area, it makes a
strong case to do that.
Strong enough to do the math anyway. If
the extra cost risk for health care is so many millions, is it still
cheaper to have for-profit investors to put so many millions into
long-term care beds, which taxpayers (and seniors themselves) pay
back over a long period of time?
When we ask governments to absolutely
balance their budgets each year, this is the kind of math that they have to
do.
Perhaps they might keep the ham and hot
dogs lower on the menus. But when I'm in my 90s, I'm gonna say the
heck with it and bring me a pizza.
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