Tag: health

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Killing fields

According to “Le Monde” dated 2025-5-26 the persons who died in the war initiated by Putin amount after 3 years to 250.000. The numb of injured soldiers would be 3-4 times as high. The loss of lives and tarnished life expectancy of persons involved in combat adds up to a huge loss for the Russian people. Being misled by political and military leaders, apparently substantial numbers of recruits for all sorts of services face the choice between the combat field or desertation. Tough choices which remind us of the moral conflict raised already during peace times if you were refusing to join the compulsory military service. Western people are better prepared for such moral dilemmas than the glorification of war in the Russian society. Of course, certainly in Germany we are thankful for the hardships the Russian army and people had to endure during the 2WW. Liberation Day would not have happened without the Soviets, Russia and Ukraine plus many other nations fighting until Nazi- Germany surrendered. The positional battles of the Great War seem to be back again enhanced with a war of drones. The killing fields for a generation of Russian troops is completely self inflicted. How many thousands Putin needs to acknowledge this cruelty? (Image exhibition by Yoko Ono Berlin Gropiusbau 2025-5).

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Maison de santé 1861 Berlin

In the middle of the 19th century Berlin was a small city. The area of Schöneberg (pritty hill) was still perceived as the rural outskirts and featured the first botanical garden next to the town center. A little bit more outside of Berlin the “Maison de santé” was founded as early as 1861 to cure mainly respiratory diseases and what later became the first private clinic proposing a new way to treat psychiatric disorders. Dr. Eduard Levinstein was the founder and the clinic had continued its operations for almost 50 years with his wife and sons taking the lead later on. Prof. Wilhelm Griesinger, known for the scientific approach of psychiatry was a proponent of the non-restrained approach to psychiatric disorders, which allowed persons move more freely while being supervised. The documents and the publication (1877) shown in the exhibition at Museum Schōneberg demonstrate the scientific approach to the treatment of addictions, most notably morphine, which had been widely used during the war of 1870 as tranquilizer and pain relief. The wave of addictions needed hospitals and clinics to treat these addictions. The “Maison de santé” had been established as a retreat and cure for other addictions as well. The memory of the early scientific approaches is an inspiring place and reminder to take care of all forms of addiction. Taking care of body and mind is still the state of the art approach today.

The Exhibition catalog is forthcoming, but the visits and material on display of interest beyond the inhabitants of the „Pritty Hill“. Exhibition catalog is forthcoming

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Archi health

The links between architecture and human health are manifold. There are direct effects of healthy versus unhealthy materials in construction. For the purpose of making buildings fire proof or more resistant to heat asbestos had been used for decades which still causes health hazards nowadays in the removal of this cancerous material. Paint has to be chosen wisely as well as isolation materials. Indirect or second round effects of materials have to be considered additionally. Cement in construction uses a lot of energy in its production and has only been recycled since a few years in significant amounts. Room climate or even psychological effects of architecture have been considered to be important more seriously in recent years. A new discipline entitled “neuro-architecture” may be developed soon. Schools, sports facilities, hospitals or community centers benefit from healthy architecture. Cost benefit analyses which take into account long term effects and even recycling of materials shift the balance much in favor of health considerations also in architecture. “Fast and dirty” will be much more expensive than “slow and healthy”. Future generations will be thankful. (Image: Spreewald Primary school Berlin).

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Health Systems

Comparing health systems across the EU can be complex at times. However, there seems to be a consensus that the Irish health system is an oddity within the European health systems. On the one hand Ireland is a rather wealthy country in terms of GDP, but the primary care system excludes a high percentage of people from access to it. The scientific journal “The Lancet Regional Health” published a paper and comment on this rather unique exception to the rule to offer a universal health care system to its citizens. The controversy is about the coverage of costs of a visit to a general practitioner. More and probably earlier visits to a GP reduce the (over)burdening of
hospitals later during the life course. Prevention helps a great deal to lower overall costs of a health system.
The roots of the Irish health system have been built upon “subsidiarity”, which means that the public support system should only step in, if the individuals or families are unable to cover costs by themselves. Poor households had to apply for a card giving them access to medical care free of charge. Building hospitals was the next challenge and local communities managed to raise funds in support of such additional structures. In 2025 it can be very costly to enlarge the coverage to a universal access to primary care and the challenge to attract sufficient numbers of general practitioners is a very European one. In this respect Ireland is just like any other European country again.
The question of how to best achieve a universal health care system remains an important one. Apparently, you can be rather “health poor” in an otherwise “economically rich” country.

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Biased Results

The use of statistics in presenting results of research is common practice. Empirical studies are summarized using statistics and statistical methods based on samples of bigger populations are cost efficient. However, care needs to be exercised when interpreting results to guard against inappropriate conclusions derived from biased estimates. Since the topic has been highlighted and methods proposed to handle them, these methods were deemed worthy of a Nobel prize.  The basic problem of a bias due to a selective sample has been demonstrated by Stockwell et al. (2024). The authors investigate the old question, whether a little bit of alcohol consumption (per day) could be beneficial for our health. The statistical issue which needs careful examination is the construction of the control group against which the results are compared. Apparently many studies have biased control groups which included persons in the not drinking control group who had stopped drinking for bad health previously. Compared to those persons with other health conditions those drinking a little bit compared rather well. But of course such individuals should not be present in a control group. Of the control group is biased due to many persons with below average health the groups of interest consuming higher levels of alcohol do not perform so badly. Hence, interpretation of results from medical or social science studies has to consider carefully the actual or potential sources of bias. Not really a new results in statistics, but still not well known or understood by the public at large. Drug consumption as well as studies of this consumption could deserve the same sticker: handle with care. (Image: Extract from Tenier II David, Les fumeurs, also entitled Chanson à boire, 17th century, Paris Petit Palais).

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Intimate change

Society changes and with it so does intimacy. The major changes pass through the behavioral changes of persons and sooner or later the whole society adopts such changes as the new normal. Trends of individualization have moved over centuries as the exhibition in the Museum of decorative art (MAD) in Paris demonstrates. At the same time the changed individual approaches to intimacy have become more widely spread quickly over time. Social media have accelerated such new trends again. Social class is yet another intervening variable in this context which created different speeds of adjustment as well as sustaining differences in kind. 

Religious beliefs and practices have made claims about how individuals should handle intimate relationships and affairs. Legal issues are defined by each society to guide moral practices as well. Hence, the sociology of intimacy is a huge topic and comparing societies an interesting topic. The development of intimacy over a person’s life course, however, is given little attention due to a lack of adequate longitudinal data. From the exhibition we are encouraged to think about the relationship of hygiene and intimacy. Bathrooms accompany us throughout our lives and privacy was originally a bourgeois concept. Over the life course we move from dependency to independence and maybe dependency again in very old age. The images (below) from the MAD exhibition range from basics of bath tubs to a painting of Edgar Degas in the background. Instagramer or YouTuber share lots of images and stylized arrangements of bathrooms on social media. It seems that intimacy is moving further into the public domain. 

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Law and Witches

Medical and chemical authorities have been questioned for many centuries. As far back as Friedrich Spee (1591-1635) in the early 17th century there were even among the clergy men with enlightened views on what might be helpful ways to assist people on their journey to better health or simply pain relief. This did include many unhelpful or detrimental methods as well. Scientific rigor was not well established at that time, which opened up many doors for alternative diagnosis and treatment. From a historical and sociological perspective the closing procedures of professional organizations are interesting as well as opposition to them. Early moderators between hardliner positions are rare at the times of forceful and fierce competition between opinions and doctrines that characterized medieval history. In the absence of an independent judiciary earlier moderation could be influential in specific instances. A testimony for can be found in a documentation of the biography of Friedrich Spee and the society that promotes the memory of such exemplary behavior.

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Law and Legality

Some persons consider themselves to stand above the law or push all interpretations of regulations beyond usual understanding of it. Even after a person has been dealing with pharmaceuticals or drugs used also for doping purposes, the conviction of such a person may take several years if not decades. In France, Mr Bernard Sainz seems to be a good example of such a relentless case of practicing para-medical consultations to assist mainly cyclists in endeavors to win championships or professional status. Le Monde  and Cash investigation have raised awareness of the public for such dubious practices. The “French Federation du cyclisme” and medical doctors association fight a continued legal battle against this persons exercising illegally such doping assistance. 

With apparently 56 legal procedures in connection with this person, the legal system has to bear the majority of costs of such illegal practices.

The reach of such dubious practices might be extended if the systems beyond doping, but for assisted euthanasia cannot be controlled effectively. Hence, the precursor cases of positive stimuli like doping pose similar challenges to the legal system as “negative stimuli” weakening persons as assistance to die. The end of a life course is not only a medical issue. Society-wide debates need to take place in order to organize a large consensus on the implications more liberal practices shall entail. 

(Image: Palais de Justice, Paris 2025)

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Suicide Prevention

The annual mortality statistics and special reports on suicidal tendencies are a tough reading. OECD Statistics give a at least an approximate, comparative perspective. Reporting routines and medical confirmation of a suicide or suicidal behavior still vary quite a bit between countries. Nevertheless, the usually reported incidents per 100.000 persons remain rather abstract.
Absolute numbers speak a clear language. For example in Germany there were about 10.300 recorded suicides in 2023, France had to mourn about 9200 in 2022. To put the size of the problem in perspective it is helpful to know that in Germany all other not aging related causes of death like traffic accidents, drugs or murder make up for around 7.000 deaths per year. The targeting of resources and prevention efforts on these vulnerable people seems inevitable. However, we see only limited additional efforts to curb the problem.
A more detailed analysis of the frequencies reveals the gender and age differences. More men commit suicides and older (very old) people have higher risks. The oldest age group of men is most at risk.
Since the Covid-19 pandemic young women show rising trends in many countries again of suicidal attempts and self-inflicted wounds. Despite a continuing effort of research (Links) there is no single cause to explain the occurrences.
As a working hypothesis, which awaits empirical tests, I would look into societal factors that stigmatize persons who are made to believe or feel like they are beyond the normal spectrum of society. The lack of acceptance of diversity concerning gender, age, ethnicity, body shapes or mental states like anxiety. Poverty might cause immense distress and suffering. Large shifts in wealth in both directions cause additional risks.
It seems as if our minds and society are constantly in a kind of „regression towards the mean“ posing challenges to those furthest away from the average or perceived norms. Percentile ranks or percentile scores are commonly used to express a person’s position in a frequency distribution. For example you are better/lower than 90% of persons of your age group. Such statements might cause further distress for persons. However, summarising across several (psychological) measurements, they may yield encouraging indications as well. Actual and perceived positions in such percentile ranks add another “social risk” as perceived positions may govern behavior.

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Defence Spending

As in research there are many dual use products, which can be part of defence spending. Robotics in production or rockets to launch satellites for telecommunication are such examples. Much less known to the public is the amount of military spending that goes into medical developments that benefit both the military as well as the civil population. Countries build a whole ecosystem round the provision of medical services for defence purposes , which consists not only of a sufficient number of qualified persons, but also companies that provide specialised products. Most of them have civil applications as well after minor adaptations.
Oxygen provision was a prominent example of a product that has civil and military uses in treatment of respiratory infections or contaminations. A mobile transportable operation table is another element of daily rescue services as well as potential use in situations of conflict, just like anesthesia machines. An increase in spending on such infrastructure and the necessary long-term training of persons operating and maintaining these medical applications take time and considerable financial resources.
The current debate in Europe and NATO neglects the considerable time delays in production and provision of the equipment. Research on “Skill Needs in OECD countries” has shown the substantial delays between sudden skill needs and the time to train high-skilled persons.
The International Review of the Armed forces Medical Services is a journal dedicated to publish up-to-date information on needs of medical products and persons trained to use them in special emergencies. The need to safe lives in extreme and dangerous conditions needs preparation of thousands of specialists. Of course we hope that such an incidence will not happen. The persons and material have an obvious potential to serve the civilian population in more peaceful times as well. The unfortunate “hog cycle” in skill provision is not a problem for dual use products or services.
(Image: edited extract of a mobile operation table)