Issue: 51

April - Bittersweet
In the wake of the glorious Villanova Wildcats NCAA championship victory, my dad succumbed to cancer and went to his heavenly reward. A U.S. Army veteran, father of six, grandfather of 23, and great grandfather of 12 (with three more in the incubator!), he died peacefully at home surrounded by the people he loved. Many of you have been through similar experiences and have been kind to share your sympathy, reflections on life and faith in the afterlife. If dad could talk to me now, rather than words of comfort, he would simply say, "To whom much is given, much is expected (Luke 12:48)." That was his credo.

John A. Schmidt, MD 
Changes in Life Expectancy by Race and Hispanic Origin in the United States, 2013-2014
On April 20, The National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) reported changes in life expectancy from 2013 to 2014. Here are the key findings:
Life expectancy at birth for the total US population (78.8 years), males (76.4) or females (81.2) did not change.
Life expectancy at birth increased by 0.4 years for black males and 0.1 years for Hispanic males.
Life expectancy at birth remained unchanged for black females, increased by 0.2 years for Hispanic females, and declined for white females (0.1 years).
Life expectancy at age 65 increased for all groups (except females) by at least 0.1 years with Hispanic males (0.3 years) and Hispanic females (0.2 years) realizing the greatest gains. The average number of years remaining at age 65 ranged from 16.2 for black males to 22.2 for Hispanic females. In other words, most people surviving to age 65 will live until at least 80 years of age!
The increase in black male survival is heartening given that this group has lagged, and still substantially lags, the longevity of the general population. The stagnation for the general population and the reversal for white females are disconcerting but it is too early to know if these are trends or statistical "blips". 
Health Inequality in Philadelphia and other Major U.S. Cities
While browsing the Philadelphia Inquirer, I came across a report from the Center on Society and Health from Virginia Commonwealth University. The Center has mapped life expectancy by zip code in Philadelphia, New York, Chicago, and nine other major cities. The results are startling.   For example, in my native Philadelphia, people living within a few blocks of the Liberty Bell ("Old City" and "Society Hill") live on average to 88, substantially beating the stats quoted above from the CDC. In contrast, babies born in zip codes only five miles away will, if current trends continue, die 20 years earlier! As the U.S. News and World Report editors wrote, your zip code is more important than your genetic code! These findings have highlighted the major health inequalities that exist in some parts of the United States. The explanation is complex and includes medical, legal, environmental, and socioeconomic factors. Two things are clear: first, the status quo is completely unacceptable and, second, concerted efforts on the part of individuals, communities, schools, health care systems, and (gasp, I'm a Republican!) governments are needed to rectify what is an embarrassment to us all!
Felons Regain their Rights
I know this is supposed to be a medical newsletter but occasionally I am blindsided by a fact that we all need to ponder and probably haven't! This reflection was prompted by a report in the Washington Post on April 22 that Terry McAuliffe, the democratic governor of Virginia, will allow approximately 200,000 ex-felons to register to vote in the upcoming presidential election. The governor's decision particularly affects black residents of Virginia where one in four African Americans has been permanently banned from voting because of a felony conviction. McAuliffe was quoted as saying, "Once you have served your time and you've finished up your supervised parole...I want you back as a full citizen of the commonwealth. I want you to have a job. I want you paying taxes. You can't if you're a second class citizen." The article features an interesting map showing how practices vary widely across the 50 states: Maine and Vermont allow everyone to vote while states like Iowa, Kentucky, and Florida permanently disenfranchise all people with felony convictions. In New Jersey, people in prison, on parole, and on probation cannot vote. Some say McAuliffe's actions were politically motivated (of course, he is a Democrat!) but it's hard to argue with his logic. 

I am reminded of an anecdote told me by the principal of the Gesu School in North Philadelphia. Sister asked the children in the fourth grade class how many knew someone in prison and almost all raised their hands!! As a physician, my specialty is giving people a second chance at life. Our laws should do the same! 
Air Quality, Natural Gas, and Hydraulic Fracturing
As reported by CNN On April 25, New York State rejected a 125 mile natural gas pipeline that was intended to transport natural gas collected by hydraulic fracturing ("fracking") from Pennsylvania to Boston, New York City and other energy-hungry northeast markets. Environmentalists concerned about the effects of fracking on water quality hailed the decision.
While I share their concerns about water quality, I am equally concerned about air quality. Natural gas burns much cleaner than coal and gasoline releasing far less of the sulfur and nitrogen oxides that are toxic to us, our children, and our pets.
An interesting editorial in the April 19 issue of the Annals of Internal Medicine entitled "Addressing Air Quality and Health as a Strategy to Combat Climate Change" puts the pros and cons of fracking into sharp focus. The authors come from Utah where the state's mountainous geography creates temperature inversions which impede atmospheric flow and result in the accumulation of particulate matter, nitrogen oxides, sulfur dioxide, carbon monoxide, and ground-level ozone. These coal and gasoline derived pollutants endanger the health of asthmatics, persons with emphysema, pregnant mothers, and those with cardiovascular disease especially when the Air Quality Index (AQI) exceeds 100. Summer is particularly perilous because direct sunlight drives the creation of ground-level ozone from nitrogen oxides. The authors advocate for natural gas fueled vehicles as one important step to safeguard our health. Click here to see what steps you can take to protect yourself against air pollution this summer.
In 2010, the MIT Energy Initiative proposed that natural gas could serve as a bridge fuel to a low-carbon future powered largely by nuclear, solar, wind, and biofuels. In the meantime, we have to keep patients safe from the hazards of dirty fossil fuels by investing in natural gas as a stop gap alternative to coal, diesel, and gasoline! If not hydraulic fracturing, what then?
Now Hear This!
Monica, Valerie, Morgan, and I wish all of our Jewish friends, colleagues, and patients a Happy and Holy Passover!
I also wish to thank you for your patience, prayers, cards, and sympathies during this difficult time. My mom, the original steel magnolia, kept dad on his toes for more than 66 years! Steel on the outside, heart of gold on the inside, she is my hero. She is fond of quoting Anne Morrow Lindbergh, the wife of the famous aviator, who said, "Only when a tree has fallen can you take the measure of it. It is the same with a man." Numerous albums, boxes of memorabilia, and miles of super-8 movie film have helped us glimpse the hopes and dreams of a young couple who weathered the Great Depression, won the war, and educated a large family with perseverance, self-sacrifice and a lively faith. Please keep her and my family in your prayers. Thank you!
In This Issue
April - Bittersweet
Changes in Life Expectancy
Health Inequality
Felons Regain their Rights
Air Quality
Now Hear This
John A. Schmidt Jr., M.D.
Board Certified Internist
Dr. Schmidt is one of the leading internists in Monmouth County offering Medical Home services.  

He is an Associate Attending in the Department of Medicine, Jersey Shore University Medical Center, and  Clinical Assistant Professor in the Department of Medicine, Rutgers Robert Wood Johnson Medical School.

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In Memory of

"Somewhere there waiteth
     in this world of ours
     For one lone soul,
another lonely soul....
Each chasing each through
     all the weary hours,
And meeting strangely
     at one sudden goal;
 Then blend they, like green
leaves with Golden flowers,
   Into one beautiful and
     perfect whole.....
 And life's long night is
     ended, and the way
   Lies open onward to
     eternal day."
           - Edwin Arnold
John A. Schmidt Jr., MD
Meaningful Medicine in Your Medical Home
709 Seventh Avenue
Belmar, NJ 07719
Phone:  732-282-8166  
Fax:  732-280-0147 
E-Mail:  [email protected] 
Disclaimer: The articles in Healthy Living are for general information only and are not medical advice.
Discuss all medical concerns and treatment options with your physician.