Map of life expectancy at birth from Global Education Project.

Thursday, July 14, 2005

Medical mysteries

While the blogosphere is obssessed with the mystery of why the Queen of Mesopotamia languishes in Sir Patrick's dungeon, while Count Novakula continues to flit freely around the televisions studios sucking blood, I thought I'd propose a few mysteries of my own. These are problems of at least as much importance to the health of the population as the cause of Alzheimer's Disease or finding a magic bullet to kill cancer cells, but they don't get half as much media attention, money, or prestige, as all those biomedical breakthroughs, half of which end up being bogus anyway (take it from an Assistant Professor).

Why do Black men have such a dramatically higher incidence of prostate cancer than white men? (See below.) Why are African Americans at such higher risk of hypertension? (It's not straightforward genetics, Africans in Africa are not prone to hypertension.) Why is the African American infant mortality rate so disproportionately high?

On the other hand, why do Mexican American women have low infant mortality and comparatively good birth outcomes, even though their poverty rate is higher than that of African American women and they are even more likely to have little formal education? On the other other hand, why is the Puerto Rican infant mortality rate disproportionately high? Why do Latinos in the U.S. have such a disproportionately high risk for Type 2 diabetes?

Why do African Americans and Latinos get worse medical care than non-Hispanic whites, even when they have insurance and go to the same hospitals and HMOs?

Why don't half the people take their pills the way they're supposed to?

Why do people wait until the visit is basically over and they're halfway out the door before they mention to the doctor what is really bothering them? (If they ever do.) Why do doctors ask 90% of the questions? Why don't people say anything when they don't understand what the hell the doctor is talking about?

Why do people -- mostly male -- kill themselves? Why do people -- mostly female -- cut themselves? (Neither behavior makes obvious sense in terms of evolution, or for that matter, intelligent design.)

What's up with the placebo effect?

Anybody else got questions to add to the list?

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