Thursday, May 1, 2008

The Disease Management Care Blog Puts a Circaseptan Spin on the Gallup-Healthways Well-Being Index

The Disease Management Care Blog has been following the Gallup-Healthways Well-Being index with some interest and expects the Index to eventually discover many needs in want of Healthways’ solutions. Following a flurry of press releases on how persons in the United States are ‘struggling’ while others are ‘thriving,’ the DMCB checked out the original on-line report to find out which group I belonged to and see how some Healthways solutions can help me.

Using a ‘ladder’ analogy, just under ½ of Americans are high up on the well-being index and expect to go even higher in the next 5 years. Hints about which countries have much lower and higher scores can be found here and here. What caught the DMCB’s eye, however, wasn’t the Danes’ contentment, but the weekly periodicity of the index. What gives?

There’s been a long-known association between the rhythms of time and human health. For example, there is a well known morning to evening variability in the incidence of heart attack and sudden death. This ‘circadian’ rhythm seems to be related to the increased physical activity, change in posture, increased heart rate, changes in blood viscosity and platelet reactivity associated with morning time. Of course, fertility status is monthly. Broader-timed seasonal variations have also been repeatedly observed in diseases such as multiple sclerosis and ulcerative colitis. Interestingly, the same appears to be true for control of blood glucose in diabetes mellitus. The reasons are less well known but may be related to viral activity or other environmental factors.

But the DMCB was curious about the weekly variation. In looking at the “Daily Mood Among Americans,” graph toward the bottom of the report, there is no overall change from January to April but there is a distinct weekly undulation in the index. Maybe it’s because of the social impact of weekends, which also appeared to be associated with 9 out of 10 of the happiest days during the period of study.

More is at stake than just happiness, however. Scientists have detected that there can be a weekly variation in the incidence of heart attack and stroke. It’s possible that stress could be playing a role, since many workers dread returning to the job on Mondays, or the retired miss their former jobs the most when the weekend is over. There is also the possibility that access to health care may be lessened on weekends and persons may wait until Monday before notifying a health care provider of symptoms. Some toxic effects of alcohol abuse may also declare themselves in the days following a binge.

However, there may be more to it than just social dimensions of our 5 day work week. Not only is there a more direct link to mood, check out the weekly variation in blood pressure that can exist among persons with no reason to enjoy weekends. The point is that humans may also have an innate 7 day rhythm that has even broader implications. Accordingly, the weekly variation in our well-being may not only be sociologic, but partly 'hard-wired' physiologic.

Not that Healthways can do anything about that - yet. The Disease Management Care Blog checked their web site and did not find a circaseptanally-oriented program offering that can sociologically or physiologically push me further up the Index ladder. Instead of thinking about this as a DM solution in search of a condition, I volunteer to have any DM vendor enhance my Well-Being Index by deploying this award-winning, peer reviewed, proven alternative personalized engagement and coaching strategy for me.

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