A stroke is a very serious medical incident. The NIH defines it in easy language as the the moment in which “blood flow to the brain is blocked or there is sudden bleeding in the brain“. Thanks to a European HORIZON project forecasting models are produced to estimate the likely incidence until the year 2050 by age and gender within Europe. The good news is major regional imbalances of incidence and mortality have been reduced and will likely be reduced across Europe. The challenge remains the aging of societies which necessitates to address the issue of strokes in each single region of the European Union. We know that the shorter the time to treat a stroke immediately after its occurrence, the better the survival chances and the better the prognosis for (partial) recovery.
In the US the widespread use of blood thinners which tripled over 30 years has not lead to the reduction of intracerebral hemorrhage (Link to studies). High blood pressure and arhythmic heart beat are major causes of this often disabling medical event. The study by Wafa et al. (2024) uses age-pyramids to demonstrate the effect that as European societies are aging the incidence of intracerebral haemorrhage occurs with increasing age and even more so for women than men of 80 years and older.
Prevention of high blood pressure through walking or careful endurance exercise seems even more indicated for an aging society.
Image below from Wafa et al. (2024), The Lancet Regional Health, Europe.
Work Satisfaction
There is an important distinction between job satisfaction and satisfaction with one’s work. Being satisfied with the work you have done or something you created or co-created has become almost a privilege. Production in capitalism has mostly different objectives like rent seeking rather than satisfaction with one’s work. Compromises between both are a major learning process about the functioning of labour markets. Remote work, for some, contributes a lot to more job satisfaction. For others a healthy work environment is the top priority. Many people however focus simply on pay packages and this is often out of sheer necessity to escape poverty eventually. Trades have a tradition to allow satisfaction with one’s work, more than most jobs in industry. Flat hierarchies and subordination to your own standards, rather than pressure from supervisors, are much more common. Recognition of your work adds to the pay you receive. Job turnover is related to job satisfaction but also to satisfaction or even identification with the product of your work.
There is more to work than pay. Recognition in form of winning a price in a competition may help to keep awareness high that pay is only one element of remuneration. “meilleur ouvrier de France“ is such a kind of recognition. It encourages people to try new things and test new ideas. This is a major source of satisfaction with one’s work. We might even feel sorry for someone shouting “I can get no satisfaction”. He probably has to try in a simpler or different fashion rather than to try harder. The city Dijon in Burgundy seems to have a pretty high number of people with high levels of work satisfaction and happy to show it.
Health inequality
Almost all studies irrespective of the methods applied find that health is a matter of related to social inequality. The study by Lyons et al. (2023) in the Lancet demonstrates the same basic findings. This study uses the concept of multimorbidity and time until first and subsequent diagnosis as the measures of health. Mortality between different socioeconomic groups in Wales (UK) is largely confirmed. It is not only men beyond 70 years of age that face this unequal health trajectories, but already in the age group of 10- 20 years old teenagers the time until first diagnosis is different between the poor and wealthy neighbourhoods.
Differential health trajectories have a very early onset and seem to widen throughout the live course. The longitudinal nation-wide study in Wales allows to determine the impact of socioeconomic deprivation on health. The conclusions imply a combination of health and social policies to address health inequality. Clinical practice alone is unlikely to reverse the trends as onset of disease in form of first or subsequent diagnoses start from a very early age onwards in deprived areas.
Health as part of the curriculum in education systems is an obvious conclusion as well. This needs to take preventative approaches more seriously to give children and adolescents a more equal start into adulthood and professional working life. Education systems have to be reformed to become part of the solution rather than creating unhealthy trajectories themselves due to stress and unrealistic, unhealthy goal setting. Walking or cycling to school, more healthy school meals and learning about nutrition as well as processes of metabolism in the body should complement a more active school life-style. The dangers of developing ill health early seem to be greater nowadays than before. That is probably the most worrying news of the study. Sedentary life-styles seem to be a result of deprived neighbourhoods with less areas for comfortable, healthy walking or outdoor exercise.
It is an accumulation of effects due to neighbourhoods, commuting patterns and work-related health risk. Counties within regions grow more distant from each other as well as regions within countries. Youth is well aware of these health and social differentials. Eventually they will claim their “lives” or “equal chances” back again. Sociology has provided many clous to address these issues: Segregation or discrimination of groups of society, gentrification of neighbourhoods, intersectionality of health and social issues, to name just a few.
In order to target at-risk populations better and intervene with prevention rather than curative, we have to integrate social and health approaches much more than we used to do. The way forward is to improve the targeted, preventive approaches in order to improve the equality of chances to education, health and work.
(DOI: LINK to study)
Altern
Wissenschaffende, wie Kunstschaffende, haben ihre Modelle. Meistens sind es abstrakte Gedankengebilde, gerne noch mit schönen mathematischen Formeln verziert. Prototypen haben ihren eigenen Charme. Forschung über das Altern hat es da nicht so leicht seine ästhetischen Modelle auszustellen. Dabei macht uns die Natur einiges vor, wie das geht. Neben dem Axolotl sind Würmer mit nachwachsenden Gliedmaßen vielversprechende Ansätze der Erneuerung im Alternsprozess. Jedes Frühjahr ist die alte Eiche eine inspirierende Quelle der Anpassungsfähigkeit. Hitze, Klimawandel, saurer Regen und Pilze hat sie jahrhundertelang bewältigt. Jedes Frühjahr freuen wir uns über die Zeichen von Vitalität und grüner Pracht. Wiedermal Schädlinge nach Trockenheit abgewehrt und Resilienz bewiesen. Wir möchten es nicht gerne hören. Sie wird uns wohl überleben, dank ihrer Kraft der Ruhe. 