Solutions economic and social

Solutions economic and social: Dr David Allen Wood delivers the most important lecture of ESC 2013

SEP 2, 2013 11:02 EDT

At 8.30 am, the Dr Geoffrey Rose Lecture was delivered by Dr David A Wood, the Garfield Weston Professor of Cardiovascular Medicine at the International Centre for Circulatory Health, National, Heart, and Lung Institute, Imperial College London, and honorary consultant cardiologist to Imperial College Healthcare NHS Trust.

With press conferences cranking and hot lines looming, attendance was sparse, but the message, no less poignant. With his family proudly looking on from the front row, David A Wood delivered the most important and powerful lecture of the European Society of Cardiology (ESC) 2013 Congress. He graciously accepted a certificate, stood in for a few photos, and left the room.

It struck me that every world leader should be hot on this man's heels, begging for an audience. Why has President Obama not phoned him for a conversation? Does Prime Minister Cameron seek his guidance on a regular basis? After all, the essence of exactly what it requires to drive longevity, beat down preventable disease, and cure many of the ills of our economic banes patiently waits within that massive intellect he humbly carries in his cranium. It saddened me that despite his enormous academic stature, he is still unlike many of us "regular people," fellow enthusiasts for prevention who feel a keen sense of urgency weighted heavily by frustration. He holds the master key to save the masses from suffering and illness. He even stands at the door and knocks but often finds no lock in which to place it.

EUROACTION

My observations take nothing away from his accomplishments with EUROACTION, too numerous to mention but including a 36% increase in daily physical activity among the cardiac-rehab population, a sharp increase in fruit and vegetable intake and a marked reduction in saturated fat.Lisa Nainggolan's 2008 heartwire coverage on the successes of EUROACTION included several quotes from Dr Wood.

"The program was intentionally set up in busy general hospitals and general practices, outside specialist cardiac-rehabilitation centers, to provide a service for all coronary and high-risk patients in routine clinical practice. It was coordinated by nurses, because of evidence that such programs improve outcomes," he said.

Dr Wood also recognized the importance of affecting the patient's immediate environment by involving their loved ones in their program.

"One of the central features of our program was the family-based intervention. Without exception, all other prevention programs have focused only on the patient in isolation. We argue that it is more appropriate to address lifestyle and other factors in the context of the family, and our results reinforce this. Those patients who made the greatest changes were associated with partners who made similarly large changes," he said to Nainggolan.

Despite EUROACTION's resounding successes, Dr Wood still realizes that these were mere drops in a huge bucket spilling over with desperate need for improvement. EUROACTION, though perhaps the world's best effort to address our cardiac preventive care issues, can never have the meteoric impact on a desperate planet gone so wrong. Without the cooperation and, as important, "the activation" of many political, social, and educational agencies, he understands that optimal outcomes cannot be achieved.

Politics and profit

Dr Wood confesses he was a political activist of the 1960s. He flashed a slide of protestors, complete with homemade signs, slogans and banners enthusiastically displayed by 20-year-olds. Their standard period uniform of polyester shirts unbuttoned to the waist, long hair, and wire-rimmed glasses marked the era. It was during this time that he had filled out an application to the communist party, an aspiration completely derailed by a medical student exchange program to the USSR. Upon his return to Britain, he shredded his application and abandoned a political career in favor of epidemiology and medicine. "Communism didn't seem to be working," he said.

"But now with capitalism, I also have my doubts," he lamented, his cadence now taking on a slightly pastoral quality. "The 'casino banking system' has led to our collapse. We have paid for the banking folly, as the goal is primarily profit in the shareholders' pockets."

He then outlined the three most impactful issues as the root cause of social and physical decay at the hands of capitalism. "The tobacco industry created addiction, then feeds it for profit," he said. "The food industry drove up the unnatural trans-fat, salt, and simple sugar content in our food supply, which in turn feeds the growing obesity epidemic that fosters diabetes." Even the automobile industry was not safe from his criticisms as he pointed out "the lack of places for biking and walking."

Indeed, in some cities there are very few opportunities to walk or bike to work. I'll add that Amsterdam seems to be immune from that particular issue.

Hope

Dr Wood pointed out that in September 2011 for only the second time in history, world leaders met at the UN to discuss "health" as a topic, including prevention and control. Plans were undertaken to achieve a 25% reduction in the incidence of noncommunicable disease by 2025. This has culminated in the WHO action plan for 2013–2020. "But in order to achieve success, we need political engagement on the issues of tobacco, diet, and physical activity," he advised.

Dr Wood's introduction came shortly this morning after a quote from Dr Geoffrey Rose for whom the lecture is named in memoriam. "The primary determinants of disease are mainly economic and social, and therefore its remedies must also be economic and social. Medicine and politics cannot and should not be kept apart."

No doubt Dr Rose would be most proud of the innovations and philosophies of Dr David Allen Wood. May he successfully carry forward his vision and passion for "solutions both economic and social." If nature allows him the full measure of a long and healthy life, perhaps he can find a way to solidly and permanently weld medicine and politics in order to improve the world as we know it.