It Should Be Very Simple

The idea didn't just come, but like most tantalizing ideas it was a Michelin - quality dish that started out using ingredients in my everyday cupboard. Years ago, I attended an American Speech - Language - Hearing (ASHA) national convention, and heard papers on "prevention" by Marge, Lubker, Antoniadis and others. Radical indeed: doing our best to make sure that we SLP's may not have customers! I loved the idea, and looked for a way to incorporate this widget for our profession into the daily slog. Over the years I wondered: were many people approaching speech-language pathology from this perspective??

A few papers appeared, on decreasing risk for child language impairments, as well as for increasing success in literacy and speech fluency. There's also been continued attention to screening the public for signs of impairments. Audiology, in addition, has devoted growth among its numbers for the study and practice of population health - which includes the idea of "primary prevention", or avoiding/lessening risk altogether. Now THAT, other than in the practice domains I've already named above, seems rare in SLP now. It takes too much time during training of master's students, I've heard. In the real world of patient care, how would you do it? Who would want to buy that kind of prevention, from a "speech therapist"? And, above all, who's going to pay you for that?

But, but, but - there's such a need! The 2023 report by the CDC on mortality in the US, reported that for 10 top causes of death, cardiovascular disease was (in)directly connected to 50% of them. Among the world's top seven industrialized nations, another report lists three of them as of 2021 as having cardiovascular disease the leading cause of death (US, Germany, Italy). Though Canada, France, Japan and the UK also listed cardiovascular disease as their leading cause of death in 1980, by 2021 the leading cause was cancer in all those nations. There is evidence that a government's change in public health policy might bring about significant improvement in citizens' wellness. For clinicians, researchers and institutional leaders in the communication sciences and disorders (CSD) professions, there's an opportunity to help the nation move the needle on cardiovascular risk in a positive direction.

As well - trained professionals with varying levels of experience in the healthcare system, we see the evidence of health behaviors that may lead to higher cardiovascular risk, after the fact. I've reviewed the variables encompassed in the "Life's Essential Eight" https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8 many times in this blog, so readers will have had some orientation to a framework for wellness that appears accepted by the medical establishment. Not only is this framework a guide to managing cardiovascular risk, but clinicians working in cancer treatment will also recognize these variables for better health. How can the CSD professionals relate to these data points, when what they do day - to - day is so far removed?

I can only defend my own actions, and advocate for this approach to primary prevention; in this case, I want to do primary prevention of cardiovascular disease, through addressing consumers' diet. The operative question is then - can well adults, not presenting with a referral to speech - language pathology for evaluation/treatment of a problem swallowing, learn and implement strategies for eating a diet for themselves?