User:MaynardClark/Subhealth

Sub-optimal health, poor health, is known often in China as sub-health. The imprecise term 'sub-health' suggests a 'grey' health status 'somewhere' between health and illness or disease. Varying discomforts which vibrantly healthy persons seldom experience are the uncomfortable symptoms of ill health or subhealth and may appear without any medically identifiaable illnesses. This concept was first presented in the 20th Century as "the third state" by social epidemiologist Dr. Lisa F. Berkman, Professor of Public Policy and Epidemiology in the Harvard School of Public Health. It is also interpreted as different terms like “intermediate state”, “grey state” or “a general malaise”. Sub-health is a term which is widely used by Chinese scholars. In other contexts, in which sub-health could be termed 'predisease' and be followed by treatment or a recommendation of needless and potentially risky treatment or behavioral changes, medical risks of needless healthcare interventions may be embodied by the affected person.
 * Predisease is a type of disease creep or medicalization in which currently healthy people with risk factors for disease, but no evidence of actual disease, are told that they are sick. Prediabetes and prehypertension are common examples.  Labeling a healthy person with predisease can result either in overtreatment, such as taking drugs that only help people with severe disease, or in useful preventive measures, such as motivating the person to get a healthful amount of physical exercise.

Unnecessary health care (overutilization or overtreatment) is when medical services are provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overutilization is the predominant factor in its expense. Factors that drive overutilization include paying health care providers more to do more (fee-for-service) and covering patients' costs by a third-party (public or private insurance) payer. These factors leave both doctors and patients with no incentive to restrain health care prices or use.

Similarly, overtreatments are unnecessary medical interventions (therapies). They could be medical services for a condition that causes no symptoms and will go away on its own, or intensive treatments for a condition that could be remedied with very limited treatment. Overdiagnosis, when patients are given a diagnosis that will cause no symptoms or harm, can lead to overtreatment. In the 1970s and 1980s, Jack Wennberg's pioneering studies documented unwarranted variation, different rates of treatments based upon where people lived, not clinical rationale.

When care is overused, patients are put at risk of complications unnecessarily, while health care providers (such as doctors and hospitals) receive revenue from the over-treatment when coupled to a fee-for-service (FFS) payment model; FFS is a large incentive for overutilization. In the United States, the country which spends the most on health care per person globally, overutilization is the most important contributor to the high cost. The New York Times reports that a "chronic overuse of medical care" exists in the United States. Unnecessary care, defined as services which show no demonstratable benefit to paitents, may represent 30% of U.S. medical care.

Most physicians accept that laboratory tests are overused, but "it remains difficult to persuade them to consider the possibility that they, too, might be overutilizing laboratory tests".

Contributing factors and examples
Factors that contribute to overutilization include "self-referral, patient wishes, inappropriate financially motivated factors, health system factors, industry, media, lack of awareness" and defensive medicine.

Physical
Common physical symptoms include fatigue, cumbersome limbs, shoulder and back soreness, and general body weaknesses, showing the symptoms of tidal fever, sweating, congestion, and shortness of breath. Women may have irregular menses, poor sexual performance resulting from endocrine disorders, menopausal complex, and age-related decline. More serious suffering might include palpitation, dizziness, blurred vision, and general lack of strength, following serious illness or chronic disease.

Mental
Common mental symptoms include chronic fatigue from overly stressful physical and mental work or long term stress, resulting in insomnia, forgetfulness, somnolence, profuse dreaming, dizziness, distention in the head, mental fatigue, poor appetite, dizziness, blurred vision, depression, fright, vexation, agitation, and irascibility.

Causes
Most risk factors for subhealth are preventable because they are controllable related features of daily living.

Stress
Long-term stresses play a major role in most cases. The high level mental pressure impair people’s cardiovascular systems and digestive systems. It increases the blood pressure, accelerates the heart rate, hardens the arteries and even initiates the stress ulcer. The mental fatigue and cognitive function will be triggered and reduced respectively. Stress can also affect the quality of sleeping by confusing people’s internal clocks. The immunological function will thereby be reduced that causes people easily to suffer from sub-health.

Unbalanced eating habits
The modern fast-food culture and the irregular diet matter the sub-healthy states. People who under these two eating habits are easily to get nutritional unbalance in two form: surplus or shortage of food nutrition and calories. The excess nutrition and calories causes high level of cholesterol, blood pressure and blood sugar. It incurs metabolic diseases like obesity or diabetes, lowers people concentration. The shortage one impairs people’s bone structures, immune systems, visions and so on. Both of them lead to chronic illnesses that make people to be sub-healthy.

Lack of sleep
The lack of sleep have a straight relationship between sub-optimal health. It weakens people immune systems and chronic systems. It brings people to suffer from heart diseases, fatigue and judgment. According to the survey done by the Hong Kong University, 61% of interviewees who slept less than 8 hours per day had more sub-health symptoms than those who slept more.

Lack of exercise
Insufficient activity results in lowered immunity, a feature of suboptimal health. Mild activity, gradually building incorporating more vigorous exercises, can restore immunity, with reduction or elimination of the symptoms of poor health. Under the sub-health state, there will be insomnia, fatigue, dizziness, headache and other symptoms, people cannot concentrate and decrease working efficiency. Apart from feeling irritable and anxious, it also affects interpersonal and coordination work, this let people feel alone and helpless. Depression and attention deficit reduce the ability to judge and deal with and even loss of self-control. In severe cases, frequent sick leave leads to increased job loss and missed opportunity for promotion.

Most of the sub-health state is a former chronic non-communicable disease. The majority of malignant tumors, cardiovascular disease (CVD), and diabetes are transferred from sub-health groups. Sub-health state significantly affects the performance of life, learning quality, and even endangers the lives of special operations personnel, such as high-altitude operations personnel and sports personnel. Psychological sub-health can easily lead to psychological disorders and result in suicide and family harm. Most of the sub-health state and circadian disorders constitute a causal relationship, directly affect the quality of sleep, increased physical and mental fatigue. Severe sub-health can extensively affect the health of life and cause premature death, early disease and early disabled.

Exercise
Recommendation for 20–30 minutes with medium intensity aerobic exercise at least three times a week is given to strengthen cardiovascular function, metabolism, and the immune system. Such aerobic exercise may be walking, running, or playing light sports, such as badminton, volleyball, or tennis.

Diet
According to a registered dietitian, the nutrition in diet should be comprehensive and balanced to ensure the daily intake of carbohydrates, protein, fat, vitamins, minerals and other essential nutrients so as to keep the body in healthy condition. However, the proportion of each nutrient should follow the food pyramid.

Emotional control
Maintaining emotional stability and reducing stress level can be beneficial in enhancing immunity. Activities are recommended such as reading, listening to music, maintaining good interpersonal relationship.

Environment
Vulneralbe persons may improve their emotional situation by reducing noise and pollution and living in quieter, less polluted living environments. Breathing fresher, unpolluted air with higher concentrations of negative oxygen ions can help stabilize emotions.

Habits
Smoking, drinking alcohol, and using other intoxicants damages immune systems; these practices should be stopped. Regularly monitoring one's vital signs is recommended: track one's health condition through regular weighing, blood pressure, blood glucose levels, BMI, and muscle mass, and correct misbehaviors and seek treatment where appropriate. Adequate sleep and rest is required for a healthy immune system.

Framing 'subhealth' in terms of wellness (or its absence)

 * wellness (or its absence)
 * Universal 'right to health' as right to optimal health - seldom realized.
 * Culpability for subhealth