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Some thoughts from Tara and Henry…

The economic benefit of sunshine

Cloudy skyA recent news story got me all riled up.  It was a news story about the ontario government canceling vitamin d testing.

This short sighted move got me thinking.
What is the economic benefit of sunshine?

As we approach the end of summer and the days are getting shorter our level of sun exposure is decreasing.  With the change in the season and because of the angle of the sun the intensity of UVB light drops dramatically.

Why does that matter?  It matters because of a little something called vitamin d.

Now if you haven’t heard of vitamin d especially over the last couple of years you may have been living in a cave, under a rock or perhaps been on a media fast.

Lately vitamin d is the hottest vitamin.

So let me give you a bit of background on vitamin d or as it is know the sunshine vitamin.
Vitamin d is actually not a vitamin but a hormone and humans are actually designed to make vitamin d when our skin is exposed to the UVB rays of sunshine.

In fact our body can make 20,000 units of vitamin d after just 20 minutes of summer sun exposure.  That is of course without wearing sunscreen or clothes.

Before the industrial revolution there was very little vitamin d deficiency.  We used to spend much more time outside – hunting and farming and there was no sunscreen.

Now days that has all changed.  Many people spend most of their days working inside.  Perhaps sitting in their corner office basking in the sun coming through the large glass windows. But I hate to tell you but UVB can’t penetrate glass.  No natural vitamin d production.

Other things that block UVB rays things like air pollution, cloud cover, darker skin colour and obviously sunscreen.

What makes it worse is that if you live anywhere north of the 35 parallel little or no vitamin d is made by our bodies from sunlight during the fall and winter months.  That is approximately 6 months of the year.

For those whose geography knowledge may be like mine – Flagstaff AZ is at the 35 parallel.  NYC is at the 40th and Aurora is at the 44th.  North of the 35th parallel includes all of Canada and 2/3 of the US.

Studies have shown that between 70 and 97% of the canadian population has inadequate vitamin d status.  In fact the average blood value is 67 nmol/L.  The normal reference range is between 75 and 250 and ideal levels are between 100 and 150.
The majority of canadians are vitamin d deficient.  Many much more than others.

Which brings us back to the question what does this all matter?

Vitamin d was at one point thought to be primarily involved in bone health.  More recently there has been an explosion of research exploring its role in many different diseases.  It plays a role in 17 varieties of cancer including breast and colon, diabetes, cardiovascular disease, depression and the flu just to name a handful.

Let’s talk about the flu for a moment as we are heading into that season.

Vitamin d deficiency seems to play quite an important role in both the development of the flu and in secondary infections like pneumonia.  So much of a role that there is compelling evidence indicating that the change in sun exposure and vitamin d production is actually the reason why the flu season starts in the fall.

People who have insufficient vitamin d are much more susceptible to respiratory infections and research shows that when those levels are optimized the incidence decreases.

So vitamin d plays a very important role in health and in disease prevention.

Okay so we know most Canadians are deficient in vitamin d and we know it is very important in disease prevention but what is the economic benefit of increasing canadians vitamin d status?

A recent paper published in 2010 looked at the estimated benefits of disease reduction based on increasing vitamin d levels to 105. It was found that the estimated decrease in economic burden of disease was $14.4 billion dollars.  That is a huge decrease from a very simple, low risk intervention of optimizing vitamin d levels.

A bottle of vitamin d is very inexpensive to buy.  Generally ranging from $10 to 15 which in turn can last from 3 to 6 months. The issue is how much do you need to optimize your levels?  Currently most medical doctors will recommend 1000 IU but is that enough?  Ideally you should have your blood levels checked especially if you are in a higher risk category.  Someone who is overweight, pregnant, darker skinned or avoid the sun, never mind the numerous health concerns.  If your blood levels start at 50 the addition of 1000 IU will only raise that number by between 10 to 25 points.  So the end result would still not be optimal (better but not optimal).

Now on the point of blood testing. As of August the ontario government will no longer pay for vitamin d testing.  The reason given is that the cost to the province of testing has skyrocketed to $66 million per year.  It is just too expensive – despite the great long term economic benefit the short-term cost is too expensive.  This health strategy adopted by the ontario government is extremely short-sighted.  The current cost of the test will be much less than the savings realized on the long term decrease in economic burden of illness.

Just to put things in perspective this is the same government who will fund a $40 million seasonal flu campaign which results in a savings of $7.8 million of our health care dollars.  That is a loss of $32.2 million… and that is considered a cost effective program.

I ask you to consider your future. With the majority of Canadians deficient in vitamin d work to optimize your levels.  It will not only improve your health and prevent illness it will also decrease the overall economic burden of illness. Also contact the ministry of health and let them know you want vitamin d testing to be covered.  It would benefit us all.

Responses are being invited by the Ministry until September 27, 2010 at http://www.ontariocanada.com/registry/view.do?postingId=3902&language=en

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