A woman is on a business trip and she is waiting for her flight to board at a busy airport. She goes into a gift shop and indulges herself by purchasing a very expensive box of a half dozen gourmet cookies. She sits down on a bench and waits for her flight to board.

The Cookie Story

After a while she looks on the bench at the gourmet cookies and decides to go ahead and have some. She opens the box and gets out a cookie. The man next to her stares at her when she does this, then afterwards smiles and reaches into the box of cookies to take a cookie! She is surprised and does not know how to respond. She puzzles over this strange event as she eats her cookie. A few moments later the man reaches into the box and takes a second cookie. She looks at the man with a shocked expression and pulls the box a little closer to her and takes a second cookie of her own. The man just smiles broadly at her.

After five minutes the man reaches into the box taking a third cookie then lifts the box offering her the last one with a smile. She is amazed by his boldness but does not want to cause a scene. She scowls at him as the flight she is waiting for is called to board. She gets on her flight and is glad to see that the man was not waiting to board the same flight. She finds a seat and shuffles through her bag to get her phone.

She can not wait to tell her sister about this crazy man. As she opens her bag she is surprised to find her box of cookies unopened!

This story illustrates a paradigm shift.

A paradigm shift is a new way of looking at a situation and/or problem that is completely different from the way you viewed it in the past. How are we experiencing a major paradigm shift in health today?

In the 1800s and early 1900s infectious (communicable) diseases such as influenza, tuberculosis, and diphtheria were the leading causes of death.

In the 20th century these have been replaced

with the chronic (lifestyle) diseases; accidents, suicide, heart disease, cancer

(malignant neoplasms), and stroke.

When infectious diseases were the leading causes of death, health care was more of a mechanistic model.

Mechanistic means that you basically live your life until

something breaks down and then go see a doctor

and get it fixed.

Now that the leading causes of death are lifestyle diseases, a preventative model is more critical.

suggests that health is a culmination of

your lifestyle choices.

What do you think is the leading cause of death

among teenagers?

Soooooo…

In 2009, about 3,000 teens in the United States aged 15–19 were killed and  more than 350,000

were treated in emergency departments for injuries suffered in motor-vehicle crashes.1,2  

Young people ages 15-24 represent only 14% of the U.S. population. However, they account for 30% ($19 billion) of the total costs of motor vehicle

injuries among males and 28% ($7 billion) of the total costs of motor vehicle injuries among

females.3

#1 Motor Vehicle Accidents

Cause of Death No of Deaths Percent

Unintentional Injury 7137 51.67%* Motor Vehicle Traffic 5522 39.98%* Poisoning 486 3.52%* Drowning 320 2.32%* Firearm 107 0.77%* Other Land Transport 100 0.72%* Fire/burn 86 0.62%* Fall 83 0.60%* Unspecified 79 0.57%* Other Transport 69 0.50%* Pedestrian, Other 68 0.49%* Suffocation 68 0.49%* Other Spec., classifiable 56 0.41%

* Natural/ Environment 30 0.22%* Struck by or Against 30 0.22%* Machinery 11 0.08%* Other Spec., NEC 11 0.08%* Pedal cyclist, Other 7 0.05%* Cut/pierce 4 0.03%

While unintentionalinjury is listed as the #1 cause of death with 7137 deaths, of those deaths 5522 are frommotor vehicle accidentsso we consider motor vehicle accidents as the #1 cause of death among 15 – 19 yr. olds.

Although other teens are responsible for many of the homicides of teens below age 18, two-thirds of the murderers are eighteen or older.4   Gang

involvement has been associated with many teen murders; in 2002, nearly three-quarters of homicides of teens were attributed to gang

violence.5  Although school-related homicides receive substantial attention, in the 2006-07 school year they accounted for less than two

percent of all child homicides.6

# 2 Homicide

In 2006, 1,771 children and teens between the ages of 10 and 19 committed suicide in the U.S. Teenage boys were four times as likely as teenage girls to die by suicide and they were also more likely to use guns

and suffocation to kill themselves. Girls were more likely than boys to use pills.

#3 Suicide

Malignant neoplasm implies a lesion that can invade and destroy the adjacent tissues and spread to the distant sites(Metastasize) and cause death, Malignant tumor are

also called CANCER

#4 Malignant Neoplasms(cancer)

#5 Heart DiseaseMost of the risk factors that affect children can be controlled early in life, lowering the risk of heart disease later in life. Other risk factors are usually passed down through family members (they are

hereditary) or they are the result of another illness or disease. These risk factors usually can be controlled. Congenital heart disease (heart defects you are born

with) cannot be changed, but better tests and treatments are now available for children with these

types of heart problems.