Geomedicine : What does your address reveal about your health?

Objectives:  Understand the basic principles of geomedicine  Understand the connections between trace elements, geology, and health  Understand cases in which connections are less clear - “Missing Link”  Understanding if the ability to build and organize relevant medical content links places to health conditions, risk and outcomes?

Geomedicine: the branch of medicine deal ing with the influence of climatic and environmental conditions on health and prevalence of disease in various parts of the world

What does your health depend on?

TEDMED

Which factor has the greatest effect on your health? Rank the following on a scale of 1 – 4. 1= greatest ; 4 = least _____ Lifestyle _____ Heredity _____ Environment _____ Access to medical services

Where have you lived? Think about the places you’ve lived or where you live today, and learn more about the impacts of your environments on your own health. Think about how you might approach the impacts of your environments on your own health. There is much to learn about geomedicine and how it can become a valuable tool in clinical practice especially as we get closer to becoming physicians? I hope this discussion of geomedicine is the beginning of your personal journey to discover ways to stay healthy longer

The Missing Link Geography vs Personal Health? Many environmental conditions and exposures could greatly increase risk of heart attack, things like air quality and exposures to pollutants—some that we do not even know existed in the communities where we live or have lived. Every place you have ever lived is apart of your medical history  Your place history becomes another vital piece of information that can be brought into the diagnostic setting.  Essential mechanism that’s going to bring that kind of knowledge into our own personal health issues. Other geographical factors:  Socioeconomic (poverty stricken areas…suburbs)  Employment/Work related conditions (migrant workers-upper respiratory disease –TB)  Education (why?)

How the location of your home affects your health.. You live: Somewhere with trees galore (rural) -led to lower cortisol levels -lower blood pressure, -strong immune system You live: On the outskirts of a city, or the burbs -high blood pressure -headaches -arthritis -breathing difficulty You live: By the coast -stress levels are likely lower -have higher vitamin D levels You live: Near a busy road -increased risk of heart trouble -health risk factor as smoking -poor diet or obesity You live: Well above sea level -less likely to continue gaining weight *elevation can lower = lower appetite Temperature - production of various hormones organ function and bodily processes Climate(seaside, arid desert) -humid climate helps my skin to eliminate toxins and keep my tissues breathing and moving more freely.

You begin to see that the health concerns in one part of the U.S. are not a priority in another section of the U.S- incidence and prevalence of these kinds of diseases High death rate location

Disease free? Disease prone? Top 10  Arizona  Montana  Hawaii  South Dakota  Alaska  New Mexico  Florida  Utah  Wyoming  Colorado Top 10  Kentucky  West Virginia  Louisiana  Oklahoma  Alabama  Mississippi  New York  Michigan  Indiana  Tennessee Obesity Rates

Geology, Trace Elements & Health The ultimate source of the body’s trace elements is the earth – rocks & minerals Concentrations vary by rock type and rock location Concentrations are modified by natural processes as well as deliberate and accidental human activities

Trace Elements Definition: A chemical element required in minute quantities by an organism to maintain proper physical functioning. Earth’s crust is composed of only a few major elements; so, too, are organisms. Oxygen 61 Carbon 23 Hydrogen 10 Nitrogen 2.6 Calcium 1.4 Phosphorus 1.1

Iodine  Necessary for proper functioning of the thyroid glad  All cells in the body need iodine for proper functioning  All glands (thyroid, adrenal, etc.) especially need iodine for the production of hormones  Lack of iodine leads to goiter

Fluorine  Makes apatite (mineral in teeth) harder  Added to many municipal water supplies Without Fluorine With Fluorine

Zinc  Heavy metal  A critical trace element nutrient  Without zinc  dwarfism, dermatitis, loss of taste sensitivity, delay in the rate of wounds healing

Selenium Rare metal Lack of selenium causes abnormalities in many plants and animals In humans  cancers, malformation of nails and hair, depression, nervousness

Radon Odorless Invisible 2 nd leading cause of lung cancer in U.S. Radon test kits cost as low as $8.99

What experts are now saying… Significant contamination at military sites Lifestyles matter in types of exposures Medical care contributes a greater share There is an unequal burden in society Environmental causes underestimated

Future of Geomedicine Place histories common Geomedicine has the potential to transform the way physicians see patients and to provide a more holistic view of the many hidden factors that often defeat achieving successful long-term health outcomes. Place histories common Geomedicine has the potential to transform the way physicians see patients and to provide a more holistic view of the many hidden factors that often defeat achieving successful long-term health outcomes. Personal — epidemiology Rise of new sub-specialties GIS- Geographic Information System the collection of family medical history helps clinicians look for certain predispositions to diseases, geographic place will provide the context within which the clinician can assess environmental factors and make judgments about diagnosis, treatment, and prognosis. Much like the capabilities of lab systems to make clinicians aware of “panic values,” GIS can provide the same early warnings to suggest to clinicians environmental factors to be explored. GIS- Geographic Information System the collection of family medical history helps clinicians look for certain predispositions to diseases, geographic place will provide the context within which the clinician can assess environmental factors and make judgments about diagnosis, treatment, and prognosis. Much like the capabilities of lab systems to make clinicians aware of “panic values,” GIS can provide the same early warnings to suggest to clinicians environmental factors to be explored.

#3: The third thing people can do, of course, is to move. Many people make conscious decisions to move to places that better suit their health. The practicality of geomedicine is this: if you know that you’re exposing yourself to certain kinds of toxic materials and environments, you’re going to avoid them. So, for a lot of people, geomedicine will not only be a diagnostic tool but a prescriptive tool for helping people decide to move to a safer and healthier place. What can you do now ? #1: The first thing people can do is get informed about where toxic sites are located geographically. People can learn about what chemicals are in water they drink, or about pollutants in the air they breathe. So on one level, using geomedicine, people have greater transparency into what chemicals are where. It gives them the knowledge they need. #2: Secondly, thing people can do is push to get the toxic materials cleaned up. When people learn of the existence of certain kinds of pollutants, contaminants, or toxins that are harmful to human health, they tend to want to organized and get places cleaned up.

Summary Many will say that genetics is our health headwaters, but as the stream meanders across many different geographic landscapes, so does our health, accumulating unseen exposures and facing uncertain and not very apparent risks. The application of geomedicine is:  about translating what we know about illness and disease and how they are recognized geographically  Better understanding of the medical importance of naturally occurring trace elements could lead to the elimination of many instances of regionally chronic diseases  what we understand about the role that our various environments play in making us sick (or well)  Translating to practical information that allows us to make better choices about where we live and how we engage with our environment

Know your place history!