How different societies regard the elderly

The older you get, the wiser you get. This is undoubtedly a continuum scale. My concern is, why do some societies treat the elderly so poorly? These humans carry a vast amount of information and knowledge. They have witnessed and experienced adversity throughout history, shaping the modern world. Some have information that we can only get through books. Wouldn’t it be more interesting to hear concrete facts and anecdotes from someone who has lived in that moment of history? What a wealth of knowledge the elderly have! They are deserving of every type of respect. The young will always be at their mercy in terms of acquiring their wisdom, knowledge, and information.

Different societies treat the elderly in different ways. For some, they are highly esteemed since they are seen as a source of wisdom. In other societies, the old or per se aging is viewed negatively and as a burden. Others consider them as storytellers with enormous knowledge to impart on the young.

The terminology of society typically reflects its respect for the elderly. In Hindi, honorific suffixes like -ji allow speakers to show further respect for notable figures, such as Mahatma Gandhi, who is frequently referred to as Gandhiji. According to Wikipedia, mzee is a phrase used by younger speakers of Kiswahili, a language spoken in various parts of Africa, to express a great level of respect for elders. The Hawaiian word kūpuna means “elders” with the additional sense of knowledge, experience, and skill. The suffix -san in Japanese, which is frequently used with elders, indicates the country’s strong respect for the elderly.

Many African societies are shaped by the ideal of the respected elder. The senior generation rules the extended family. The elderly wield power in the community because they are the closest in age to their forefathers. Older individuals have a high standing because they believe that family growth is beneficial and fortunate. People consider large families as a source of protection in times of difficulty, and they want to be remembered as ancestors by their offspring. Older people have always been seen as a positive light in Sub-Saharan Africa as reservoirs of knowledge and wisdom. After dinner, many African villages gather around a central fire to listen to the elder storytellers.

What a wealth of knowledge the elderly have…

The elderly are held in high regard in Eastern societies. A new “Elderly Rights Law” passed in China warns adult children not to “ignore or insult elderly people” and requires them to visit their elderly parents frequently, no matter how far away they live. The law also offers tools for enforcing it: Offspring who fail to make such visits to their parents risk penalties ranging from fines to jail time. As in Chinese culture, the common expectation in Korea is that once parents reach retirement age, roles reverse and it is the responsibility of an adult child to care for his or her parents.

A person’s 60th birthday is likewise a big deal in Japan. Kankrei, as the festival is known, is a rite of passage into old age. Respect is regarded as a religious obligation in Asian cultures. Respect is focused on the family and is formalized through language and gestures. The Asian idea of respect affects sentiments of duty within the family as well as how Asian patients make decisions.

When exploring western societies, we find that as people age, the younger generations tend to view them with greater contempt. In Western culture, old age is associated with forgetfulness and irrelevance. They are treated more like children who, due to superior technology, can not understand the modern world. Because the fast-changing world has left them behind, the younger generation regards them as unreliable. According to a National Center for Biotechnology Information research, this attitude may originate from westerners’ preference for personal ambitions over familial bonds.

The emphasis on qualities like autonomy and independence is typical of Western societies, which are often youth-oriented. According to anthropologist Jared Diamond, who has examined the treatment of the elderly throughout cultures, the elderly in countries such as the United Kingdom and the United States live “lonely lives apart from their children and longtime companions.” The elderly in these cultures frequently move to retirement villages, assisted living facilities, and nursing homes as their health deteriorates.

Similar to China, France also implemented an Elderly Rights Law in 2004 (Article 207 of the Civil Code) requiring persons to maintain contact with their geriatric parents. Perhaps some hope is on the way for Western societies…?

The elderly are considered the “wisdom-keepers” in tribal cultures and are held in high respect. They are regarded as the guardians of their tribes’ language and traditions. Most of these tribes, such as the Choctaw among Native Americans, have a long tradition of oral storytelling. Their stories were meant to preserve the tribe’s heritage and teach the next generation. Stories about westward migration, the birth of the world from a mound, other histories, and lessons about life or morality.

In her book, Experiencing Old Age in Ancient Rome, Dr. Karen Cokayne of the University of Reading argues that the Romans utilized their elderly and trusted their wisdom and experience, quoting Cicero as saying, “For there is definitely nothing dearer to a man than wisdom, and though age takes away all else, it undoubtedly brings us that.” However, Cokayne emphasizes that elderly people had to earn that high level of esteem by leading a virtuous life. “Wisdom had to be earned – through hard effort, study, and, most importantly, virtuous life. At all times, the elderly were expected to act with moderation and decency. It was assumed that the young learned by example, thus the old had to set a good example for them. This was deeply ingrained in Roman culture.

References

Sugirtharjah S. (1994). The notion of respect in Asian traditions. British journal of nursing (Mark Allen Publishing)3(14), 739–741. https://doi.org/10.12968/bjon.1994.3.14.739

Honorific – Wikipedia. (2009, December 1). Honorific – Wikipedia; en.wikipedia.org. https://en.wikipedia.org/wiki/Honorific

Diamond, J. (n.d.). Jared Diamond | Speaker | TED. Jared Diamond | Speaker | TED; http://www.ted.com. Retrieved August 13, 2022, from https://www.ted.com/speakers/jared_diamond

WAGSTAFF, K. (2015, January 8). In China, adults must visit their aging parents… or else | The Week. In China, Adults Must Visit Their Aging Parents… or Else; theweek.com. https://theweek.com/articles/462599/china-adults-must-visit-aging-parents-else

Storytelling and Cultural Traditions | National Geographic Society. (n.d.). Storytelling and Cultural Traditions | National Geographic Society; education.nationalgeographic.org. https://education.nationalgeographic.org/resource/storytelling-and-cultural-traditions

-. (n.d.). Elders | NCAI. Elders | NCAI; http://www.ncai.org.

Africa: Age and Aging. (n.d.). Africa: Age and Aging; geography.name. https://geography.name/age-and-aging/

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Healthcare in underdeveloped nations

In certain impoverished nations, unless you pay at the reception, you cannot see a medical professional–even if you are bleeding, there is nothing they can do other than give you a cloth to wrap and stop the bleeding and that’s if someone is kind enough. This means that you must pay out of pocket for healthcare services each time you see the doctor. In these countries, unemployment is very high, sanitation is very poor, and people are highly susceptible to illness not once or twice, but constantly, with no access to healthcare.  As a result of having to pay for these services out of their own pockets, the lack of financial security increases families’ financial strain.

“Without health care, how can children reach their full potential? And without a healthy, productive population, how can societies realize their aspirations?” said UNICEF Executive Director Anthony Lake. “Universal health coverage can help level the playing field for children today, in turn helping them break intergenerational cycles of poverty and poor health tomorrow.”

The most primary and infectious causes of death in developing nations are malaria, AIDS, and tuberculosis. In fact, these diseases can be prevented in the same manner as in industrialized nations. Tuberculosis? implying that both adults and children lack access to immunization. Immunization, seriously? Everyone should be vaccinated against these deadly diseases, which have claimed countless lives before our great-grandparents were born. In the 1700s, tuberculosis was not only referred to as the white plague due to the sufferers’ pallor, but also as the “Captain of all these men of death.” Now that it is possible to contain the disease, why not do so in every region of the world and not only in wealthy nations? 

If an outbreak occurs, it can affect people in both underdeveloped and developed countries. For example, Ebola emerged in 1976 in the DRC and South Sudan. After a period of few to no occurrences, an outbreak resurfaced between March 2014 and June 2016. This was the largest Ebola outbreak ever reported, with over 28,000 cases. This occurred not just in West Africa, but also in East Africa, Italy, Spain, the United Kingdom, and the United States. If these regions of Africa had proper healthcare, the disease may have been efficiently contained. National and international authorities collaborated to help terminate this outbreak by building prevention programs and messages, as well as implementing policies with care. Personnel from the CDC were dispatched to West Africa to aid in response activities, including surveillance, contact tracing, data management, laboratory testing, and health education. In addition, the CDC team assisted with logistics, staffing, communication, analytics, and management.

During the height of the response, the CDC trained 24,655 West African healthcare professionals in infection prevention and control methods. In addition, by the end of 2015, 24 laboratories in Guinea, Liberia, and Sierra Leone were equipped to do Ebola virus testing. If all these strategies were done not only during pandemics, we would be able to avert a great number of outbreaks. These nations and others would be able to contain an outbreak before it spreads internationally. However, we wait until a pandemic threatens our minds before implementing laboratories and educating more healthcare staff in developing nations. Why not do this in the absence of a potentially deadly disease? Why not be prepared for anything that could affect us in both developed and poor countries?

We’re not ready for the next epidemic, Bill Gates remarked during the ebola outbreak. Obviously, Covid happened, and what appeared to be a simple sentence made so much sense. He went on to explain that we require a response system with the capacity to mobilize tens of thousands of healthcare staff. During his TED talk, he mentioned that in order to combat an epidemic, we need robust health systems in developing nations– where mothers can safely give birth there, and children can receive all of their vaccinations there. However, this is also where the outbreak will appear first.

“Past experiences taught us that designing a robust health financing mechanism that protects each individual vulnerable person from financial hardship, as well as developing health care facilities and a workforce including doctors to provide necessary health services wherever people live, are critically important in achieving ‘health for all,’” said Mr. Katsunobu Kato, Minister of Health, Labour and Welfare, Japan. 

What are we waiting for to improve healthcare in developing nations? In other words, what affects individuals in developing nations is likely to impact developed nations. Why not collaborate to create not only a better national healthcare system but also a universal healthcare system? Universal health means that everyone has access to and is covered by a well-organized and well-funded health system that provides quality and comprehensive health care and protects individuals from financial ruin if they utilize these services.

Guaranteeing the right to health means eliminating all kinds of barriers to accessing services…

Dr. Carrissa F. Etienne– Director of the Pan American Health Organization

Some Key actions for Universal Health are:

  1. Expanding equitable access,- Initiating and gradually extending primary care models and comprehensive service delivery that are centered on people’s needs. Assuring the prudent utilization of medications and health technology.
  2. Increasing stewardship and governance by teaching and empowering people and communities about their health-related rights and duties and encouraging them to participate in the development of health-related policies.
  3. Increasing and enhancing finance through eliminating payments at the point of service entry, identifying sustainable means of increasing health financing, and financially protecting individuals. These are only a few examples; the list is far longer.

The enhancement of health care in developing nations will have a substantial effect on the mental health of an infinite number of individuals. Healthcare is a human right!

References

World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses. (n.d.). World Bank; http://www.worldbank.org. Retrieved June 7, 2022, from https://www.worldbank.org/en/news/press-release/2017/12/13/world-bank-who-half-world-lacks-access-to-essential-health-services-100-million-still-pushed-into-extreme-poverty-because-of-health-expenses

CDC. (2022, January 14). World TB Day History. Centers for Disease Control and Prevention; http://www.cdc.gov. https://www.cdc.gov/tb/worldtbday/history.htm

Fact sheet about malaria. (2022, April 6). Malaria; http://www.who.int. https://www.who.int/news-room/fact-sheets/detail/malaria

2014-2016 Ebola Outbreak in West Africa | History | Ebola (Ebola Virus Disease) | CDC. (2019, March 8). 2014-2016 Ebola Outbreak in West Africa | History | Ebola (Ebola Virus Disease) | CDC; http://www.cdc.gov. https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html#:~:text=The%20patient%20recovered.,hospitals%20in%20the%20United%20States.

Universal health coverage (UHC). (2021, April 1). Universal Health Coverage (UHC); http://www.who.int. https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)

Gates, B. (n.d.). Bill Gates: The next outbreak? We’re not ready | TED Talk. Bill Gates: The next Outbreak? We’re Not Ready | TED Talk; http://www.ted.com. Retrieved June 7, 2022, from https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready

What happens if Abortion rights are revoked?

Sometimes I wonder if the United States is regressing rather than progressing. The patriarchy was sitting somewhere one day, whether at a political conference, golfing, campaigning for office, or even swearing-in– you name it! And suddenly, one of them had an inch to poke the matriarchy. We are striving for equal wages, and now you are threatening to withdraw our abortion rights. Seriously, welcome to the poker game. We women are inherently multi-taskers: we shall battle for both and much more.

Fetal rights and the protection of women’s health are two of the justifications stated by opponents of abortion restrictions. For starters, if you cared about fetal rights, how about addressing this country’s appalling rate of infant mortality? In 2005, the infant mortality rate in the United States was 6.9 deaths per 1000 births. According to the Centers for Disease Control and Prevention, the United States ranks 30th in the world. The infant mortality rate in the United States is greater than in most other industrialized countries, and it appears to be worsening.” “There should be support programs for children once they are born,” says Kathryn Kolbert, a reproductive rights attorney.

Just to be clear, induced abortion is actually safer than childbirth, so if the rationale is to preserve women’s health, that’s simply not true. Among wealthy countries, the United States has the highest maternal mortality rate. The maternal mortality rate for 2020 was 23.8 deaths per 100,000 live births, a significant increase from the previous year.

One study assessed the death rates related with infants born and legal induced abortions in the United States from 1998 to 2005. Pregnancy-related mortality was 8.8 deaths per 100,000 live births among mothers who delivered live neonates. The induced abortion mortality rate was 0.6 deaths per 100,000 abortions. Prenatal complications were more likely during childbirth than during abortion in recent comparative research in the United States. A live birth has a 14-fold greater risk of death for women than an abortion-related death, according to the study. The findings, while not surprising, experts say, contradict several state regulations that claim abortions are high-risk operations.

According to Dr. Bryna Harwood, an ob-gyn at the University of Illinois in Chicago, an induced abortion, like any other medical procedure, requires informed permission from the woman. That is, women recognize and accept the dangers associated with their various options. What complicates situations, according to Harwood, is when the government intervenes and mandates doctors to provide information that isn’t always accurate or medically sound — typically exaggerating the risk of abortion.

Instead of fussing about outlawing abortion, how about focusing on lowering both the neonatal and maternity death rate? According to several studies, some factors contributing to the increase in maternal mortality rates include a shortage of maternity caregivers, particularly midwives, and a lack of access to full postpartum assistance. While other high-income countries offer paid leave to new moms, the United States does not. Maternity leave enables new mothers in adjusting to the physical and emotional demands of motherhood while also providing families with financial stability. Except for the United States, other developed countries require at least 14 weeks of paid leave. In addition, several countries offer more than a year of maternity leave.

Unlike the United States, in other developed nations, postpartum home visits are guaranteed. Postpartum care helps mothers and newborns recover physically and emotionally. Midwife or nurse home visits boost mental health, breastfeeding, and health care expenses.   Home visits allow healthcare professionals to address mental health concerns as well as analyze socioeconomic determinants of health, such as food, shelter, and financial security.

There are more pressing matters to address than poking the matriarchy with their reproductive freedom. If you truly cared about women’s health, as you claim, those must be some of your aims, or else this is just about controlling women. This is about confining women– by the time you want to outlaw the safest women’s reproductive procedure. Because if we don’t have a choice over whether, when, and with whom we have children, women will be unable to function as equal members of society.

In terms of mental health, overturning Roe v. Wade will exacerbate and destroy the lives of many girls and women. With all the psychological and economic strain that comes with having children, the mental battle will feel like a war zone where you’re sure you’re doomed. Many individuals believe that getting an abortion is mostly motivated by a desire not to have children. Most individuals are simply not prepared to care for children– by the time they are trying to care for themselves, having another human to care for is daunting, so it is postponed until they are ready psychologically and financially. This alone protects not just the people in the current circumstances, but also future generations and the society as a whole. Poverty is already one of the primary causes of death and mental illness. According to research, poverty claims the lives of 1.5 million people each year, with more than half of them being children under the age of five — that is 4000 deaths each day. Do we truly want more humans to be born in poverty?

In the United States, more than 11.5 million children live in poverty. When a child grows up in poverty, he or she may not have the opportunity to go to school, receive adequate nourishment, or receive complete healthcare.

What kind of society will we be living in? Homelessness is already one of the most serious issues in the United States. Look at all these concerns that you are already aware of, and your primary goal is to make them worse– how lovely politicians? Everything is interconnected and interdependent; therefore, putting your ego aside, you will recognize that prohibiting abortion will be the worst decision ever implemented.

Whatever a person’s race, ethnicity, gender identity, or whoever one loves, everyone deserves the freedom of choice when to become parents and the support they need to build a family and bring up their children in an environment that promotes dignity and safety for everyone.

There are more pressing matters to address than poking the matriarchy with their reproductive freedom.

References

Raymond, Elizabeth G. MD, MPH; Grimes, David A. MD The Comparative Safety of Legal Induced Abortion and Childbirth in the United States, Obstetrics & Gynecology: February 2012 – Volume 119 – Issue 2 Part 1 – p 215-219
doi: 10.1097/AOG.0b013e31823fe923

Maternal Mortality Rates in the United States, 2020. (2022, February 23). Maternal Mortality Rates in the United States, 2020; http://www.cdc.gov. https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm

Infant Mortality:How Does The US Compare? (n.d.). Infant Mortality:How Does The US Compare?; http://www.nptinternal.org. Retrieved May 25, 2022, from https://www.nptinternal.org/productions/chcv2/infant-mortality/howuscompare.html

Maternal Mortality Maternity Care US Compared 10 Other Countries | Commonwealth Fund. (2020, November 18). Maternal Mortality Maternity Care US Compared 10 Other Countries | Commonwealth Fund; http://www.commonwealthfund.org. https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries

Red Nose Day 2018 : Charity Navigator. (2018, May 21). Charity Navigator; http://www.charitynavigator.org. https://www.charitynavigator.org/index.cfm?bay=content.view&cpid=6330&c_src=WPAIDSEARCH&gclid=CjwKCAjwp7eUBhBeEiwAZbHwkbFrD3itOnol5mbiwZx0JmGvZrW9jxKFqKVQyYhLRkAgG7_zfemhYBoCvQkQAvD_BwE

Poverty Facts and Stats — Global Issues. (2013, January 7). Poverty Facts and Stats — Global Issues; http://www.globalissues.org. https://www.globalissues.org/article/26/poverty-facts-and-stats#:~:text=It%20claims%20the%20lives%20of,number%20of%20deaths%20from%20tuberculosis.

Quote of the day

Many cultures, particularly in developing countries, continue to believe brain disorders in the context of metaphysical affiliations, exorcisms, taboos, bad luck to the family, et cetera… To this day so many people suffering from mental illness are homeless and left on the streets, where they are mocked, beaten, harassed or jailed.

DMK

Quote of the day

I simply cannot fathom the fact that individuals are either overdiagnosed, underdiagnosed, or not treated at all based on their skin color. The thing is, by the time you misdiagnose someone based on their skin color, you’ve gone too far…

DMK

Healthcare should be a human right

The United States has such significant health care disparity that it is the only developed country that relies on private health insurance. Prior to the Affordable Care Act, approximately 20% of Americans had little or no health insurance. As a result, about 45,000 of those people died each year due to the expensive cost of health care.

No one should become ill and die simply because they are poor or lack access to health care. How inhumane!

The United States is one of the wealthiest countries in the world, yet its healthcare system is a disgrace. How can such a wealthy country be at the bottom of healthcare statistics given how much money it spends—research shows that the United States spends more on healthcare than any other country. In 2020, annual health expenditures were expected to exceed $4 trillion USD, with personal health care spending totaling $10,202 USD.

I’m curious where all that money goes. Our system prioritizes disease, specialty treatment, and technology over preventive care. Inpatient treatment, intensive care units, and subspecialties such as cardiology and gastroenterology are prioritized over nutrition, exercise, mental health, and primary care education. Doctors in high-tech specialties (such as anesthesiology, cardiology, or surgery) often earn far more than those in primary care.

You visit the doctor for a sunburn rush and receive a bill for approximately nine hundred dollars. Keep in mind that the time you spent with the doctor was about 2 minutes. For individuals who have health insurance, the bill will be lower or even covered. In fact, even insured Americans spend more money out of pocket for healthcare than residents in most other wealthy countries. Some people resort to buying drugs from other nations where the prices are much lower. Even though the power structure may be agreeable to healthcare insurers, pharmaceutical firms, and those healthcare professionals who benefit financially from it, our existing healthcare system is not financially sustainable. So, how much do you think individuals without insurance suffer from the consequences? This is completely ridiculous!

The most outrageous thing is that if you don’t have health insurance for a certain length of time in a year, you have to pay a fine/penalty to the IRS. In any case, health insurance is required. Even folks in the middle class who have health insurance risk devastation due to health care disparities. The rising expense of healthcare services can push people into poverty. According to a 2018 research, medical bills drove Seven million people below the federal poverty level. Medical bills have become the most profitable line of business for collection agencies. When it came to medical bankruptcy, the insured were 6% more likely than the uninsured to have declared bankruptcy in the past. They had not budgeted for unanticipated deductible and coinsurance fees. Almost two-thirds were unaware that their hospital was not included in their plan. Approximately 25% had their insurance claims dismissed. Every year, around 530,000 people file for medical bankruptcy. Health insurance providers have been raising patients’ medical expenditures by raising deductibles, which more than doubled between 2007 and 2017. At the same time, employers’ share has decreased. The average deductible in employer-sponsored health plans increased by 255 % between 2006 and 2018. Even those on Medicare are at risk. During retirement, the average 65-year-old couple anticipates $295,000 in medical expenditures. Most of them haven’t saved enough to cover these expenses without jeopardizing their retirement plans.

Is the purpose of our healthcare system to serve the public or to generate profit? A woman in labor was turned away from a private hospital in Alameda County because the hospital’s computer indicated that she did not have insurance. In a county hospital hours later, she gave birth to a stillborn infant. A hospital surgeon in San Bernardino sent a patient who had been attacked and stabbed in the heart to a county medical center after determining that his condition was stable. The patient arrived at the county medical facility in a comatose state, suffered a heart arrest, and subsequently died. These two hospitals transferred these patients to county facilities for economic, not medical, reasons — the receiving hospitals feared they would not be reimbursed for treating the patient. These patients were simply “bad business.”

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.

Dr Tedros Adhanom Ghebreyesus
Director-General, World Health Organization
WHO

Everyone should have access to the health treatments they require, when and where they need them, without experiencing financial hardship. When individuals experience marginalization, stigma, or prejudice, their physical and mental health deteriorates. Given the complex and confounding variables that accompany health care in the United States, even contemplating it is a source of stress. But when individuals are given the opportunity to be active participants in their own treatment, rather than passive recipients, and their human rights are respected, the outcomes improve and health systems become more efficient.

We must all work together to eliminate disparities and discriminatory actions so that everyone, regardless of age, gender, ethnicity, religion, health status, disability, sexual orientation, gender identity, or migration status, can experience the benefits of good health.

Healthcare should be a human right!

References

Topic: Health expenditures in the U.S. (n.d.). Statista; http://www.statista.com. Retrieved May 11, 2022, from https://www.statista.com/topics/6701/health-expenditures-in-the-us/#topicHeader__wrapper

Health is a fundamental human right. (2017, December 10). Health Is a Fundamental Human Right; http://www.who.int. https://www.who.int/news-room/commentaries/detail/health-is-a-fundamental-human-right

Is our healthcare system broken? – Harvard Health. (2021, July 13). Harvard Health; http://www.health.harvard.edu. https://www.health.harvard.edu/blog/is-our-healthcare-system-broken-202107132542

How to plan for rising health care costs | Fidelity. (2021, August 31). How to Plan for Rising Health Care Costs | Fidelity; http://www.fidelity.com. https://www.fidelity.com/viewpoints/personal-finance/plan-for-rising-health-care-costs

Health Costs | KFF. (2019, September 25). KFF; http://www.kff.org. https://www.kff.org/health-costs/

2021 Employer Health Benefits Survey. (2021, November 10). KFF; http://www.kff.org. https://www.kff.org/health-costs/report/2021-employer-health-benefits-survey/

The Effects of Household Medical Expenditures on Income Inequality in the United States | AJPH | Vol. 108 Issue 3. (2017, October 24). American Journal of Public Health; ajph.aphapublications.org. https://ajph.aphapublications.org/doi/10.2105/AJPH.2017.304213

Health Care for Profit or People? (n.d.). Health Care for Profit or People?; http://www.scu.edu. Retrieved May 11, 2022, from https://www.scu.edu/mcae/publications/iie/v1n4/healthy.html