TEDMED 2009: The Missing Piece In Understanding Our Health

Tonight marks the start to the 2009 TEDMED conference, which runs from October 27th through 30th at the Hotel Del Coronado in San Diego, California. TED, an acronym for technology, entertainment, and design, is a non-profit devoted to "ideas worth spreading." This year's TEDMED is the fifth in a series created by Mark Hodosh and Richard Saul Wurman, focused on the intersection between medical and healthcare, personal to public. I invite you to follow me as I live blog from the event this week and provide you with the most up-to-date information as it unfolds.

In the inaugural session tonight, we heard about tissue engineering and cellular-based tissue regeneration from Damien Bates, the chief medical officer of Organogenesis, and Anthony Atala, the director of Wake Forest Institute for Regenerative Medicine and chair of urology at Wake Forest University (think: crafting new organs and tissues--more to come on that in a later post). Then Neal Baer, the executive producer of ER and Law & Order, Special Victims Unit spoke about the power of storytelling for medical and health education (prior to an episode, which taught that HPV can lead to cervical cancer, a random sampling yielded 9 percent of people knew this vs. 30 percent after the show aired).

But the most compelling and immediately applicable information came from Bill Davenhall, the global marketing manager for Health & Human Services Solutions, ESRI, the largest geographic information system (GIS) software developer in the world. Davenhall spoke about the missing piece to understanding personal health: the environment. He said the basic formula for good health is:

Genetics + lifestyle + environment = risks

So, if you manage the risks you'll live a good life. He raised the very important issue that whenever we visit a physician we fill out questionnaires that refer only to genetics and lifestyle (what diseases are in your family history and whether or not you smoke/drink), but we're never asked about environment: i.e. the places we've lived, where we spend our time, and what risks we've exposed ourselves to through those choices.

The quest to understand came when Davenhall had a heart attack out of nowhere it seemed. He was given a clean bill of health before and after the attack. But It wasn't until he tracked his environmental history - childhood in Scranton, P.A. breathing in methane gas and burning coal waste, midlife in Louisville, K.Y. where he breathed in the exhaust of incinerated rubber, and then moved to California where he's spent his senior years so far breathing in carbon dioxide and high doses of ozone. He said if he ever wanted to get a heart attack, he should have lived in exactly the places he chose. It completed his puzzle.

He believes physicians should be asking place history, how close we live to a freeway, what the quality of our drinking water and food is, and advises the following steps:

1. We must teach physicians the value of geographical education and the emerging field of geomedicine.
2. While we're spending billions building an electronic health record, we must also build a place record inside that medical record.

And our technology might be at the right place to support it. Davenhall spoke about his friend who allowed himself to be tracked for two years through his cell phone and now has his own place history. He suggested that if we build our place histories into our iPhones, it could end up being what our physicans look at when we go in for a visit in addition to our other medical records.

Toxic release maps are public information and can be found on the National Institute of Health's website. Check it out to see if you live near any hazardous waste sites.

Tomorrow is a full day...so keep checking back for updates.

Here's to your health!

Full Coverage Of TEDMED 2009:

• The Future Of Cancer Medicine


• Do You Want To Live Forever?


• The Future Of Mind-Body Medicine

Get HuffPost Living On Facebook and Twitter!

 

Follow Alana B. Elias Kornfeld on Twitter: www.twitter.com/alanaekornfeld

Comments

[goodnews7]

09:33 AM on 10/29/2009

Our Government Run Health Services – Part 5 – FEHBP
The Federal Employees Health Benefits Program (FEHBP) allows insurance companies and employee associations, such as labor unions to develop health, dental, and allied plans and market them to governmental employees. The employee health benefits are provided to full-time, permanent, civilian government employees and qualified retirees of the United States Government, including members of Congress. The US Office of Personnel Management (OPM) oversees the program. The FEHBP is different from most of the other government run health services we’ve discussed so far in that it is much closer to the idea of an open exchange than the other programs, where the government guarantees certain benefits and makes sure that they are provided effectively. As such, it is close to the proposed public or co-operative exchanges that have appeared in some drafts of the proposed health care reform bill. In this article we’ll look at the background to FEHBP and its strengths and weaknesses. [...]http://silverbuzzcafe.com/?p=4481

[Old Writer]

11:20 PM on 10/28/2009

The main thing you're on to is that there exists
crucial factors beside the traditional
medical exams and histories.
Now expand your research into
additional preveviously neglected areas:
Occupation, emotional temperment,
personalities of close family members, etc., etc.
(I'd help you with this, but I'm 85
and I'm tied up with ten different projects.)
howtowritecomedy.com

[mrmd555]

02:41 PM on 10/28/2009

Looking forward to following this. An essential aspect of environment for our cells and tissues that is too often given short shrift even in progressive forums is mental/emotional/spiritual status which modulates stress/relaxation physiology which in turn influences nearly all other physiology.

Cellular environment equals what you eat, drink and otherwise absorb, what you think, and how you feel about what you think.

[bmermaid]

12:14 PM on 10/28/2009

This might be a very difficult factor to quantify thses days, when people travel so much. For example, I have never actually lived in San Fransisco, but have spent many, many weeks at a time there. I criss- cross the country many times every year, both by car & air. A stort time in one area may have more effect than a much longer stay in another, for all sorts of reasons.

[lastpost]

08:55 AM on 10/28/2009

Genetics + lifestyle + environment = risks / knowledge

[Alison Rose Levy]

08:51 AM on 10/28/2009

Thanks for this great piece!

Although the genetics+lifestyle+environment = risks have been used by a coterie frontier integrative physicians over the last fifteen years or more to successfully address illness as well as understand the roots of illness, it's not widely known. Recent research demonstrates that lifestyle can actually modify genetics by turning on and off genes that are either adverse or favorable to health.

The bugabear here is that both individually and through our regulatory policies and health care, we would have to address that the "wonders of chemistry" also have a downside and that environmental toxins also affect people.

For health information, news, science and action, get the free Health Outlook at www.health-journalist.com

[beerent]

01:51 AM on 10/28/2009

Knowing the environmental conditions surrounding a patient during their lifetime appears to be a great idea. However, the undertaking of such a practice has to be enormous. You would need highly accurate records of all relevant environmental factors as well as an accurate picture of the patient's true exposure to these factors. Much of this would be based on recollection of the patient as well as imprecise records of environmental factors dependendant on incomplete or non-existent data.

Great idea, in theory. In practice it will most likely be an art, not a science.

[wetdog2]

01:46 AM on 10/28/2009

I love the TED conference and have been blown away by many of their presentations. But ever since they had Rick Warren on, I've been more discerning about the quality of their talks. Quite a few have contained dubious claims and questionable hyperbole. I haven't seen this one yet, but I'm both curious and skeptical.

The "Genetics + lifestyle + environment = risks" equation seems interesting but I'm not sure each factor has equal weight. Given the recent advances in DNA analysis, we can accurately track for some genetic risk factors. Lifestyle, also, is relatively easy to track. Environment is a much harder thing to quantify and link back to specific conditions. No one would question it can be a determining factor in one's health, but is it always?

At best, it's one of many data points for doctors to track as they get better and more refined diagnostic tools to customize their analyses. And while Bill Davenhall's heart attack (from the article) is tragic, he is a single case and - not to be too cynical - he does work for a company that is trying to create a new market for environmental hazard map data.

Given the great number of data clinicians must track in treating a patient, I'm not sure if geography merits equal weight as genetics and lifestyle. I would love to hear input from medical doctors.

[Schneb]

12:53 AM on 10/28/2009

being tracked that way is a bit to big brother-ish. That it's being done 'for my own good' only adds to my knee-jerk paranoia.

Other than that, I'm a fan of this sort of break-through/outside the box thinking, and I love the TED concept, in general.

As a high school teacher, I've wondered about having mini-TED conferences in high schools. Put on by students and community members, by and for each other.

[Bushwhacked]

12:36 AM on 10/28/2009

Genetics + lifestyle + environment = risks. Hmm. Sounds reasonable, but the environment piece, represented in the discussion by "place" is dependent on information about air, water and other pollutants when the person lived there. If that's not easily incorporated, a doc in Sacramento ain't gonna go looking for what the environment was like in your little neighborhood in 1965, no know what was in the water you played around in down by the abandoned railway swamp.

Read more at: http://www.huffingtonpost.com/alana-kornfeld/the-missing-piece-in-unde_b_336329.html