The Social Determinants of Chronic Diseases

Education and social conditions determine the quality of life. The place we are born, grow, work, and live, determines our attitude and ability to maintain health, or proneness to disease. The World Health Organization confirms the significant social element of diseases. Several theories try to explain the determinants of disease.

Life Course Theory recognizes the accumulation of socioeconomic conditions over the life course. The life-course theory considers how the social and material environment, income inequality, stress, nutrition, lifestyles, gene-environment interaction, public safety, and various other factors determine health. Socioeconomic advantages over a person’s lifetime lead to better elderly health.

Fundamental Cause Theory: Socioeconomic status (SES) influences multiple diseases in multiple ways. For centuries, affluent people have lived longer and had better health. Socioeconomic resources, such as money, education, status, power, and social connections, can help protect one’s health. Lack of those resources promotes sickness and premature mortality. People with control over their lives typically feel good about themselves, cope with stress better, and have the capability and living situations to adopt healthy lifestyles. People in higher SES have a better chance of survival from preventable causes of death. Access to money, knowledge, power, prestige, and social connections help to maintain health.

Social Capital: Group/network memberships, including online groups and cybernetworks, provide social support and access to group resources in times of need. As a concept, social capital has both subjective (cognitive) and objective (structural) components. Objective elements are formed by law enforcement, emergency support and medical and social services. Personal elements are the feeling of belonging, which promotes a sense of well-being. The sense of belonging, shared norms, reciprocity, and trust, which affects health-related behaviors (e.g., tobacco and alcohol use, diet, exercise), education, and employment. Sharing and exchanging resources (e.g., caregiving, transportation to medical appointments, financial assistance to access medical services) also affects health and mitigates stress.

Social groups can achieve collectively health goals, such as passing a non-smoking rules, placement of bike lanes and forming farmers' markets, or drug prevention programs. They can distribute health-related information or health-promoting innovations. Social capital is vital for self-management of chronic disease, because it fosters adherence in care regimens. It can prevent or facilitate depression and other health-related behaviors. 

Social rules determine what is appropriate or inappropriate. Lifestyle choices and personal routines are characteristic of specific groups and classes. The collective behavior becomes part of the mental make-up, subconsciously directing attitude and behavior.

Health Lifestyle Theory: Your circumstances, such as age, gender, and race/ ethnicity; social networks (kinship, religion, politics, workplace, and others), and living conditions (e.g., quality of housing, access to essential utilities, neighborhood facilities, public safety) influence life choices. These determinants also govern our life's choices to achieve our goals. Choices and possibilities interact and form a disposition to act, leading to practices (action), such as alcohol use, smoking, dietary habits, and other health-related activities.

Conclusion: your social class can significantly influence your long-term health. It can make you sick and influence your life expectancy.

The above post has been based on the scientific study, The Social Determinants of Chronic Disease, supported by the National Institute of Health.


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The thermodynamics of brain computation

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Join experts at the European Neurology Congress in Venice Italy. Speakers who are doing creative approaches, advancing the technology and understanding share their knowledge and expertise and can help your professional development. Networking with experts and like-minded people attending the conference gives you an opportunity to develop vital connections. 

Read my abstract for the conference: 

The brain’s regulation is based on its high entropy resting state, which is maintained by an energy requiring process. Recurrent energy-information exchange allows the examination of brain activity based on thermodynamic considerations. The brain’s self-regulation ensures a readiness to respond to stimulus and forms the basis of discrete processing of stimuli (Figure 1). In the neural tissue electromagnetic activity inversely moves energy and information between the cortex and the limbic brain. High frequencies, triggered by a stimulus, compress data and build an evoked potential. In the cortex, neuronal activation extinguishes the oscillations but accumulates an electric potential. The reversal of information flow via low-frequency oscillations expands the area of activation. Thus, fast and slow frequencies form the polarity effects of the brain’s electrical activities. Stimulus represents spatial information, whereas the brain’s activation cycle as well as human physiology, thoughts, speech is structured in time. Therefore, sensory processing is an orthogonal transformation. Repeated activation changes the energy need and weight of synaptic connections, forming favored activation patterns. Improving responses to stimulus form a mental abstraction of the environment and lead to memory and learning, which maximizes the system’s potential to respond intelligently to future changes. The state of the observer, i.e., the brain, determines the information value of the signal, leading to holographic computation. Perception has a distinctly subjective quality, which is projected forward to anticipate the future. Analyzing neural computation based on physical principles can improve our understanding of brain operation in both health and disease.

Figure 1.  Changes of the brain energy balance due to the stimulus. The brain frequencies change from high, on the left (#1), to low, toward the right (#3), determining the direction of information flow in the brain (shown by a thin line). The resting state of is relatively energy neutral before stimulus (#1) and after a response (#3).  The evoked potential is illustrated by 2. The high energy need of enhanced brain frequencies induces urgency, whereas the high amplitude of the lowest frequencies coalesces into the overarching coherence of the resting state (#3).

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The power of placebo

Modern medicine has transformed how we think about disease. The success of operations and pills gave the false hope of completely eliminating diseases. However, the side effects of illness and the human condition, such as depression, chronic pain, anxiety, and fatigue, have been challenging for traditional medicine to address. These conditions are rooted in complex brain states, conditioning, individual beliefs, expectation, and social environment. 

Doctors and nurses often can tell whether the patient will get better or succumb to the disease at the first meeting. The conditions of the medical treatment are responsible for a substantial part of the healing. Effects that do not come from direct therapy are called a placebo. Placebo responses can be significant. Recent evidence suggests that genetic variation also plays a role in the placebo response. A large part of the overall therapeutic response to drugs, surgery, psychotherapy, and other treatments may be due to how the medication is administered and the patient’s views about it, rather than the specific treatment itself.

Considering placebo effects is crucial because drug effects interfere with internal psychological and brain processes. Individuals with reduced brain activity in areas associated with pain and negative emotion but greater activation in the frontal cortex and brain stem produce the most significant drug effects. Significant placebo responses seem to arise from openness toward emotional and physical experiences, well-being, but some detachment from pain and discomfort. Thus, the effectiveness of treatments depends on the psychological or social support of the patient as well.

The promise of treatment is already a powerful physiological remedy.

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Interview with bestseller author Eben Alexander III MD

In my series of learning from people with wisdom and professional experience, I interviewed academic neurosurgeon Eben Alexander about his understanding of consciousness and his hopes for the future of this science. Dr. Alexander worked at the Brigham Women’s Hospital, Children’s Hospital, and Harvard Medical School. He is the author of the New York Times #1 bestseller Proof of Heaven, The Map of Heaven, and Living in a Mindful Universe. Here is the transcript of the interview.

Is near-death experience (NDE) related to experiences by people with spiritual powers, such as shamans? 

I believe that NDEs involve encounters in a realm that overlaps some experiences that occur in dreams, profound meditative states, visions supported in prayer and spontaneous epiphanies, psychedelic drug experiences, shamanic journeys, psychic medium readings, etc. More than half of NDEers report the spiritual vision as more accurate, detailed, and meaningful than the “consensus waking reality.” 

In your opinion, what could be why only a tiny portion of coma patients have transcendent experience?

I believe there is a well-developed system of “programmed forgetting,” similar to the normal forgetting of childhood. Thus, only those who are open-minded and willing to try to access these more profound truths can gain deep insights. As we become more awakened as a group, the number of gaining these transcendental insights will increase.

You say that NDE experiences leave more vivid memories than life events. Is there a study examining differences in brain activation patterns between regular and NDE memory?

There are several studies, two of which are utilized in our book, Living in a Mindful Universe (pp 16-17), from Belgian neurologist Steven Laureys *and Italian investigator Arianna Palmieri **. Bruce Greyson has also provided a similar study.

* M. Thonnard, et al., “Characteristics of Near-Death Experiences Memories as Compared to Real and Imagined Events Memories,” PLOS ONE 8 (2013), 3, doi:10.1371/journal.pone.0057620.

** A. Palmieri et al., “‘Reality’ of Near-Death-Experience Memories: Evidence from a Psychodynamic and Electrophysiological Integrated Study,” Frontiers in Human Neuroscience 8 (2014), doi.org/10.3389/fnhum.2014.00429.

During an NDE, the mind must exist independently from the brain. So how can a disconnect (between the mind and brain) occur, and how can it be reversed?

The main question is metaphysical/philosophical: How do the brain and mind interact? What is causative? Our consciousness seems localized in our brains, yet there is tremendous scientific evidence for non-local consciousness (e.g., telepathy, precognition, remote viewing, out-of-body experiences, etc.). The emerging scientific model accepts the primordial existence of consciousness (mind-at-large or primordial consciousness), with the brain serving as a filter that allows that primordial consciousness as a very limited trickle of awareness. The disconnect can happen under extreme physiological stress (as in NDEs). Still, it can also be manifested through powerful psychic sources, such as when a soul leaving the physical realm interacts with the soul(s) of loved ones in sharing that extraordinary transition (shared death experiences). The disconnect can also happen due to intentional meditative efforts, such as out-of-body experiences and remote viewing. Telepathic communication can be accomplished through the Ganzfeld technique of diminished sensory input to consciousness, allowing broader information from the “mind-at-large.”

What is the connection during normal life function between consciousness, the mind, and the brain? 

I tend to lump “mind” and “consciousness” together, although that lumped concept also admits that mind/consciousness includes 1) “conscious mind,” 2) “subconscious mind,” and 3) “collective mind.” Information in 2 and 3 can be obscured from 1, but 1 ultimately grows to assimilate much of what is in 2 and 3 through learning and teaching, ultimately the evolution of all of the consciousness itself. Finally, note that 1 is not merely the thoughts of the ego/linguistic brain but can be expanded, primarily through prayer, meditation, or STEs in general, acknowledging the observer of awareness as a more expanded version of our consciousness. 

Can we form a scientific hypothesis of consciousness that is coherent with the spiritual account of so many people?  

Yes – that is our goal in our presentations and our book Living in a Mindful Universe. The Primordial Mind Hypothesis in that book uses the concepts of the primordial mind, the filter theory relating brain and consciousness, and appropriate interpretation of the measurement paradox in quantum physics--all to propose a metaphysics that is consistent with vast swaths of human spiritual experience that are inexplicable from the simplistic materialist (or physicalist) model.

I am also interested in whether your conclusions about your original NDE have changed over the years. 

The NDE provides an extraordinary catalyst promoting changes in the worldview of the individual, who then spends the rest of her/his life assimilating and making sense of the events of the NDE. The ultimate result is to “know thyself,” which includes richer knowledge of one’s oneness with the universe at large. My worldview has been steadily shifting as I have learned more about the grand nature of conscious experience – this is a work in progress (as is all of the human investigations into the fundamental nature of reality). 

End-of-life electric spikes can be measured at about 60 to 120 ms after the patient becomes pulseless. A similar activity can also be observed in the decapitation of rats. Does your experience give you any suggestions of what these surges signify? Could they be related to NDE?

They present an interesting observation that needs to be assimilated with all the other facets of an NDE. Still, I doubt the surges provide any significant overall explanation, given the extraordinary and complex landscape emerging around the phenomenon of consciousness. So also is the accepted conclusion among scientific investigators that increasingly show, the brain is not the producer, as much as a filter of primordial consciousness. Especially as one realizes the depth of the scientific evidence for reincarnation (over 2,700 cases of past-life memories in children where the best explanation is of actual reincarnation, and 35% of whom have birthmarks corresponding with the mortal wound of a previous lifetime–see uvadops.org).

To read more about Dr. Eben Alexander and his long professional career in medicine and science, please visit his website: www.ebenalexander.com

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Searching for the perfect diet: fibers, carbohydrates, fats, oh my!

We know that many of the chronic diseases are related to poor diet. However, we cannot seem to learn what is considered safe choices for our long-term well-being. Since the 1970s, the prevalence of heart disease seems to follow well-intentioned dietary guidelines. Some scientists have shown that the epidemic of coronary heart disease was caused by refined sugar combined with a low intake of dietary fiber. Others have found that coronary heart disease results from the consumption of saturated fatty acids. This latter viewpoint became a widely accepted mantra for many decades. 

In long-term studies, however, higher mortality is related to high carbohydrate intake and not fat consumption. Low-carb diets appeared to be significantly healthier. Although saturated fat was associated with stroke, dietary fat does not seems to play a role in other cardiovascular disease mortality. Also, the main types of fats should be unsaturated fats from plant sources rather than animal fat. Nevertheless, there is no magic, healthiest diet. In fact, low-fat diets might increase the likelihood of heart attacks and heart disease. 

If that was not confusing enough, a 2018 study shows that fats seem to boost appetite. Mice kept on a high-fat diet exhibited signs of changes in the activity of specific genes, related to reward processing. Connecting food with reward might lead to increased food consumption, which leads to obesity.

Replacing saturated fats with whole grains reduces the blood cholesterol level, which lessens the risk of coronary heart disease. Viscous fiber, found in oats, beans, and fruit, reduces the cholesterol level more than insoluble fiber, the type found in whole wheat. Foods to avoid or consume in moderation are processed and red meat, sugar-sweetened foods and beverages, and refined grains.

A recent discovery that the food you eat is influencing your brain health gives dietary consideration even more importance and urgency. For example, calorie restriction significantly improves blood supply to the brain. In mice, the Ketogenic Diet (high levels of fat and low levels of carbohydrates) leads to positive results in patients with epilepsy, Parkinson’s disease, and autism. Detailed studies have shown that reduced blood glucose levels and lower body weight might have resulted from the improved microbiome in the gut. The most exciting finding has been a reduction of amyloid-beta, a known hallmark of Alzheimer’s disease, from the brain. Thus, Paleo diet, caveman diet, or stone-age diet might protect from Alzheimer disease.


Read the article: The finding was reported in cell metabolism.

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Unification of quantum mechanics and relativity in a four-dimensional universe

Laniekea galaxy cluster in black (Picture credit, Tully et al, 2014)

Laniekea or "immeasurable heaven" in Hawaiian is the name of our home galaxy cluster. Understanding our place we must consider the cosmos the smallest and the largest scales. String theory applies to the fundamental forces and particles. However, relativity offers the global structure of space. In a stringy model, micro-dimensions are separated by an information-blocking horizon, where discrete particle vibrations form standing waves and entanglement entails inverse transformations of micro- and macro-dimensions (space). Entanglement forms opposite, yet complementary points, satisfying conservation principles. When complementary sister particles undergo interaction, the wave function collapses and reformulates information and the field curvature. This way, the field curvature, and the particle wave function evolve together.

Because local particle interaction either contracts or expands space, over large scales, it formulates polar regions. Regions with expanded micro-dimensions accumulate pressure, which is experienced as gravity, whereas regions with greater macro-dimensional volume expand. According to Landauer’s principle, information accumulation within micro-dimensions enhances temperature, whereas the expansion of macro-dimensional space cools down. Thus, micro-dimensions form black holes. The model offers an intuitive view of quantum mechanics and eliminates discrepancies with relativity; it also correlates well with the latest cosmological data. This stable and unified alignment of the universe satisfies Mach’s principle and Occam’s razor.

Postulates of the model:

1. Particles (wave function) form closed strings of three complex dimensions (i.e., micro-dimensions). 

2. Any arbitrarily small sample of the universe can be divided into micro-dimensions (particle) and surrounding space (macro-dimensions)

3. The closed strings are embedded within constant field curvature space. 

4. Entanglement changes the wave function’s frequency, satisfying quantum mechanics. 

5. GR dictates that interaction correspondingly modifies the field curvature.

6. Energy/information transfer between micro and macro-dimensions engenders their orthogonality: space represents the here and now, whereas the wave function is non-local and independent of time. 

Consequences of the postulates: 

1. The loop of micro-dimensions represents the velocity of the particle, whereas macro dimensions correspond to its position, leading to the Heisenberg uncertainty principle. 

2. The frequencies of the wave-function are exclusive to specific spatial curvature, i.e., age.

3. Entangled particles produce spooky action at a distance. 

4. The model satisfies the AdS/CFT correspondence

5. It satisfies the holographic principle

6. Interaction requires mirror symmetry between the complex wave function (micro-dimensions) and the action (Hamiltonian)

7. The model explains that the micro-dimensions exist as a wave, but interaction brings forth their particle nature. (It gives an elegant explanation to the Bell's theorem, the delayed choice quantum eraser, and others)

8. Entanglement produces curvature variations (geometry) of the gravity field and creates the experience of dark energy and dark matter. 

9. The stepwise increase of micro-dimensional frequencies corresponds to the age of particles and formulates a time progression of space. 

10. Aging uses up the macro-dimensions; dimensional loss in the high entropy black holes formulates information firewalls. 

11. Landauer’s principle shows that information accumulation corresponds to heat, whereas erasing information cools temperature. 

12. The principle of static time necessitates that erasing information produces contrasting dimensionality change to black holes. Expanding macro-dimensions increase in dimensionality: cosmic voids might harbor four-dimensional white holes, which expand space.

13. The near Euclidean regions of the universe are three dimensional, gravity is an extremely weak force here, which permits low entropy instability.

14. The large value of vacuum energy expands space into the fourth dimensions, thus eliminating the cosmological problem. 

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Interview with Dr. Matthew Welsh J.D., Ph.D, of Spiritual Media Blog

The best consciousness blogs on the internet approach their subject from a variety of angles.  However, it is surprising how often wisdom springs from difficulty. Their story becomes relevant as an example of a mental transformation to achieve better living. I have interviewed psychologist Dr. Matthew Welsh, founder of Spiritual Media Blog to share his motivation and experience about his work in this field. 

1. What inspired you to start your spiritual journey and what inspires you

to continue to serve with your work? 

In college, I experienced a spiritual awakening to listen and trust my intuition. At the time, I was logical, practical, and externally focused on success, and also very stressed out. But, I felt this inner calling to begin to trust my Spirit or whatever you want to call it. This has not always been easy or a struggle-free spiritual journey. For example, after college, I went to law school and then worked for an entertainment agency in Hollywood and then as a trial lawyer for the Department of Child Services in Indiana. However, I was miserable. I woke up most days feeling anxious driving to work in the morning and left work feeling depressed at night. Working as a lawyer just felt so out of alignment with my personality, values, and deeper inner calling for my life.

I felt so lost and unsure professionally that I sought counseling. Counseling helped me reconnect with my authentic Self and better understand my values. I started giving motivational talks on how to find a meaningful career at colleges and non-profits. I began providing career coaching at night and Saturday mornings. Career coaching made me feel so alive, inspired because I was making a real difference in other people's lives.

The combination of the counseling and the joy of career coaching inspired me to quit my job as a lawyer and get my Ph.D. in psychology. I believe providing therapy and counseling is my true calling. I now provide therapy to veterans who have an addiction and PTSD. Helping other people better cope with challenges in their lives, reconnect with their authentic selves, and pursue their deeper purposes in life inspires me to continue to serve in my work. Every day I feel a sense of purpose, contentment, and peace. 

2, What was the most important learning experience of your life?

The most important learning experience for me is the challenges and problems in my life. For the past 15 years, I meditated daily, followed my intuition, gone to psychotherapy and spiritual life coaches, and attended numerous self-help workshops. When I first began, I thought that if I pursued enough self-improvement or 'achieved' enough spiritual growth, then I would always be happy and never have any problems or challenge. I think this is a potentially problematic line of thinking by many spiritual seekers, because of the belief that having positive thoughts and avoiding negative emotions such as anger or sadness, will only attract good things in life. However, it is normal to feel sad, anxious, angry, and have problems. What important is to manage negative emotions and handle life issues in a more healthy and solution-focused way.

3, How do you find people that can help you expand your circle of competence?

I have tried to adopt the attitude that I will never stop learning or growing. So, I try to be open to the possibility that there will always be someone who can help me with whatever I am working on, whether that is through listening to a podcast, reading a book, seeking out professional help, or being receptive to my family, friends, and coworkers. I have also worked with a spiritual life coach on and off for the past 10 years and had about 4 years of professional therapy.

4, How do you find your purpose?

I find purpose by trying to pay attention to what brings me joy in life, makes me feel alive and focusing on living my internal values. There was a time in my life when I was unemployed when I was a lawyer. At that time, I really had no idea what sort of work or career I wanted to do. I just knew that I was unhappy as a lawyer. I felt lost and did not know what my purpose in life was. During that time I began to focus more on identifying and living my internal values. I literally woke up each morning and said the following phrase:

"Who I am is the possibility of being __________"

Then, I would fill in the phrase with whatever internal value I felt like would give me purpose that day. The 2 values that I found myself repeating over and over again were inspiration and authenticity. I tried to create meaning by living those values even though I was not working at the time. This is a powerful exercise because we can not necessarily control our external environments such as our job, relationship status, or physical body. However, we can control whether we are living our internal values. For example, regardless of our external circumstances, we can choose to be authentic, inspiring, honest, kind, discipline or whatever internal value is important to you. This exercise helps us become greater than our external circumstances. Today, each day I wake up, I pick one value that gives me purpose and try to live that value during that day.

5, How do you maintain your focus on things that matter?

Maintaining focus can be difficult when we are faced with stress, pressures, and responsibilities of daily life. However, one thing that really helps me is to have a morning and evening routine where I reconnect with my Spirit or things that really matter. For example, each morning, I meditate for 10 minutes, try to read or listen to something that is inspirational; and while I take a shower, I reflect on what I am grateful for, proud of, or how I experience Spirit. Then I focus on one value I want to live that day. I also have an evening routine where I do some relaxed and restorative yoga for about 20 minutes and then meditate for about 10 minutes. I also am a big believer in discipline and grit. Sometimes, it takes all of the strength you have to put one leg in front of the other, but just focusing on taking that next step or accomplishing that next task right in front of you. No matter how big or small, it can also help your focus to accomplish greater goals in the long run.

6, What is the most common mistake you see in your practice that people

make?

People demonize, deny, or repress negative emotions such as stress, sadness, or anger instead of finding healthy and authentic ways to understand, manage, and express them. For example, some people have been taught that anger is a bad emotion. So, they deny they are angry and repress it. Then, they often let it build up and explode later or act out aggressively and say or do something they regret or feel guilty about. Other people may use alcohol or drugs to cope with their negative emotions. One possible healthy alternative would be to express the anger or sadness constructively by accepting that it is normal to experience those emotions and then talking about those emotions calmly and directly to someone who will listen to you with empathy and compassion.

7, What is the most important message you have learned from other spiritual

teachers?

We all have a still quiet voice that is capable of guiding us to a meaningful life. Some people call this our instincts, intuition, or an inner knowing. It may not always make sense, and we may experience problems and challenges throughout our life if we follow it. But, this inner knowing can and does help provide us with a peace that passes understanding and greater purpose throughout our life.

8, Do you see social changes pointing toward the betterment of humanity or

toward chaos?

I see social changes pointing toward the betterment of humanity. If you look at the increased social acceptance in America of yoga, meditation, mindfulness, and even psychotherapy over the past 50 years, I believe these practices will continue to help bring about a betterment of humanity. Yoga, meditation, and mindfulness used to be considered "woo-woo" over 50 years ago or rarely practiced. Now, they are regularly featured on the cover of major news outlets, used by VAs and the military to treat PTSD, and can be found in pretty much every city in America. That is a significant increase in just 50 years. Additionally, the #Metoo movement is bringing greater awareness to injustice and abuse of power and also helping to empower people to speak out against injustice and abuse of power. I believe the social acceptance of all these practices will continue to lead to a betterment of humanity. 

 Dr. Matthew Welsh J.D., Ph.D. is the founder of Spiritual Media Blog, a website that features guest posts, articles, interviews, and reviews about spirituality, psychology, and inspirational entertainment. 

After graduating from law school, Dr. Welsh created Spiritual Media Blog to be a source of inspirational content, media, and entertainment. He began his career in Hollywood working for an entertainment agency, the William Morris Agency, and then as a trial lawyer for the Department of Child Services in Indiana. He was not happy working as a lawyer. So, he quit his job as a lawyer to pursue his calling to become a psychologist and obtained his Ph.D. in Psychology. He now works as a full-time psychologist. Spiritual Media Blog is a creative outlet for his passions related to psychology, spirituality, and inspirational entertainment. His hope for Spiritual Media Blog is that it provides you with content that is practical, inspirational, and entertaining.

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