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To Your Health: NLM update Transcript

Is intolerance unhealthy?: 04/17/2017

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health - a consumer health oriented podcast from NLM - that helps you use MedlinePlus to follow up on weekly topics.

The definition of health should include an assessment of social tolerance — that physicians also should treat if needed, suggests a memorable opinion recently published in the Journal of the American Medical Association.

Robert Brook M.D., RAND Health in Southern California, explains the World Health Organization's well-accepted definition of health is (and we quote): 'a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity' (end of quote).

Dr. Brook notes this almost-70 year old definition is currently implemented by physicians during office visits when doctors inquire about issues, such as a patient's loneliness, or if he/she is able to walk one mile — in addition to taking vital signs. Brook adds that physicians routinely encourage patients to eat a healthy diet, quit smoking, exercise regularly, and practice safe sex grounded in evidence-based understandings of the impact of lifestyles on health.

Brook explains the physician-patient lifestyle suggestions are commonplace because (and we quote): 'it is understood that these are aspects of an individual's health that physicians should measure and attempt to change if warranted' (end of quote).

However, Brook adds (and we quote): '... none of these clinical activities or health definitions has explicitly incorporated any measure of intolerance or hatred into these assessments' (end of quote).

Brook immediately asks (and we quote): 'Can a country be healthy if large numbers of citizens hate other groups as defined by religion, gender, ethnicity, sexual orientation, or any other recognizable characteristics? Can physicians say that patients are healthy if they dream about, or have a plan for, killing people simply because they are different' (end of quote)?

Brook continues (and we quote): 'No community or nation should be considered healthy if hatred is pervasive. Nor should any individual be considered healthy if he or she is intolerant' (end of quote).

As a result, Brook suggests it is time to expand the World Health Organization's definition of health to include acceptance and tolerance. Brook notes (and we quote): 'a good place to begin might be to have physicians report their patient's score on some accepted scale while explaining that tolerance is as much a part of good health as low blood pressure and regular exercise' (end of quote).

Brook acknowledges a tool to measure an individual's social tolerance needs to be developed. He adds (and we quote): 'promoting tolerance will require committed coalitions of religious leaders, political leaders, military leaders, educators, and ordinary citizens. But medicine might be able to ignite and sustain that process by saying loudly, clearly, and often that individuals, communities, and nations cannot be healthy if they hate people just because they are different' (end of quote).

Overall, Brook finds physicians should assess intolerance and intervene as they do regarding smoking, or alcohol abuse. He concludes (and we quote): 'Assessments of health status at the clinical level should routinely include measures of tolerance, and identifying and promoting tolerance should become one of the profession's guiding principles' (end of quote).

Meanwhile, a more conventional definition of a healthy approach to life is well explained by a website from the American Academy of Family Physicians, which is accessible within the 'start here' section of MedlinePlus.gov's healthy living health topic page.

The National Institute of Diabetes and Digestive and Kidney Diseases explains how changes in daily habits are linked to better health within the 'related issues' section of MedlinePlus.gov's healthy living health topic page.

MedlinePlus.gov's healthy living health topic page additionally provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. You can sign up to receive updates about healthy living as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's healthy living health topic page, please type 'healthy living' in the search box on MedlinePlus.gov's home page, then, click on 'healthy living (National Library of Medicine).'

Finally, Brook's pioneering essay reopens a dialogue about what health is, how it should be assessed, and the role of health care providers to nurture healthier individuals as well as a better society. It is one of the more memorable essays I have read for 'To Your Health.'

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you! Please join us here next week and here's to your health!