Archives December 2023

Don’t worry. It’s good advice if you can take it. Of course that’s not always easy, especially for health concerns.

The truth is: it’s impossible (and ill-advised) to never worry about your health. But are you worrying about the right things? Let’s compare a sampling of common worries to the most common conditions that actually shorten lives. Then we can think about preventing the biggest health threats.

Dangerous but rare health threats

The comedian John Mulaney says the cartoons he watched as a child gave him the impression that quicksand, anvils falling from the sky, and lit sticks of dynamite represented major health risks. For him (as is true for most of us), none of these turned out to be worth worrying about.

While harm can befall us in many ways, some of our worries are not very likely to occur:

• Harm by lightning: In the US, lightning strikes kill about 25 people each year. Annually, the risk for the average person less than one in a million. There are also several hundred injuries due to nonfatal lightning strikes. Even though lightning strikes the earth millions of times each year, the chances you’ll be struck are quite low.
• Dying in a plane crash: The yearly risk of being killed in a plane crash for the average American is about one in 11 million. Of course, the risk is even lower if you never fly, and higher if you regularly fly on small planes in bad weather with inexperienced pilots. By comparison, the average yearly risk of dying in a car accident is approximately 1 in 5,000.
• Snakebite injuries and deaths: According to the Centers for Disease Control and Prevention, an estimated 7,000 to 8,000 people are bit by poisonous snakes each year in the US. Lasting injuries are uncommon, and deaths are quite rare (about five per year). In parts of the country where no poisonous snakes live, the risk is essentially zero.
• Shark attacks: As long as people aren’t initiating contact with sharks, attacks are fairly uncommon. Worldwide, about 70 unprovoked shark attacks occur in an average year, six of which are fatal. In 2022, 41 attacks occurred in the US, two of which were fatal.
• Public toilet seats: They may appear unclean (or even filthy), but they pose little or no health risk to the average person. While it’s reasonable to clean off the seat and line it with paper before touching down, health fears should not discourage you from using a public toilet.

I’m not suggesting that these pose no danger, especially if you’re in situations of increased risk. If you’re on a beach where sharks have been sighted and seals are nearby, it’s best not to swim there. When in doubt, it’s a good idea to apply common sense and err on the side of safety.

What do Google and TikTok tell us about health concerns?

Analyzing online search topics can tell us a lot about our health worries.

The top Google health searches in 2023 were:

• How long is strep throat contagious?
• How contagious is strep throat?
• How to lower cholesterol?
• What helps with bloating?
• What causes low blood pressure?

Really? Cancer, heart disease and stroke, or COVID didn’t reach the top five? High blood pressure didn’t make the list, but low blood pressure did?

Meanwhile, on TikTok the most common topics searched were exercise, diet, and sexual health, according to one study. Again, no top-of-the-list searches on the most common and deadly diseases.

How do our worries compare with the top causes of death?

In the US, these five conditions took the greatest number of lives in 2022:

• heart disease
• cancer
• unintentional injury (including motor vehicle accidents, drug overdoses, and falls)
• COVID-19
• stroke.

This list varies by age. For example, guns are the leading cause of death among children and teenagers (ages 1 to 19). For older teens (ages 15 to 19), the top three causes of death were accidents, homicide, and suicide.

Perhaps the lack of overlap between leading causes of death and most common online health-related searches isn’t surprising. Younger folks drive more searches and may not have heart disease, cancer, or stroke at top of mind. In addition, online searches might reflect day-to-day concerns (how soon can my child return to school after having strep throat?) rather than long-term conditions, such as heart disease or cancer. And death may not be the most immediate health outcome of interest.

But the disconnect suggests to me that we may be worrying about the wrong things — and focusing too little on the biggest health threats.

Transforming worry into action

Most of us can safely worry less about catching something from a toilet seat or shark attacks. Instead, take steps to reduce the risks you face from our biggest health threats. Chipping away at these five goals could help you live longer and better while easing unnecessary worry:

• Choose a heart-healthy diet.
• Get routinely recommended health care, including blood pressure checks and cancer screens, such as screening for colorectal cancer.
• Drive more safely. Obey the speed limit, drive defensively, always wear a seatbelt, and don’t drive if you’ve been drinking.
• Don’t smoke. If you need to quit, find help.
• Get regular exercise.

The bottom line

Try not to focus too much on health risks that are unlikely to affect you. Instead, think about common causes of poor health. Then take measures to reduce your risk. Moving more and adding healthy foods to your meals is a great start.

And in case you’re curious, the average number of annual deaths due to quicksand is zero in the US. Still a bit worried? Fine, here’s a video that shows you how to save yourself from quicksand even though you’ll almost certainly never need it.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

It’s easy to say you simply don’t have time to be mindful. With so much going on in daily life, who has time to stop and be present? But everyone has at least 10 minutes to spare to practice mindfulness.

The point of these brief, daily reflections is to help you tap into calmness whenever life gets too hairy. Practicing everyday mindfulness can also improve your memory and concentration skills and help you feel less distracted and better able to manage stress . And mindfulness tools have been successfully incorporated into treatments for anxiety and depression.

There is more than one way to practice mindfulness. Still, any mindfulness technique aims to achieve a state of alert, focused, relaxed consciousness by deliberately paying attention to thoughts and sensations without passing judgment on them. This allows the mind to focus on the present moment with an attitude of acceptance.

Three easy mindfulness exercises to try

Here are three simple exercises you can try whenever you need a mental break, emotional lift, or just want to pause and appreciate everything around you. Devote 10 minutes a day to them and see how the experience changes your outlook. It’s time well spent.

Simple meditation

A quick and easy meditation is an excellent place to begin practicing mindfulness.

• Sit on a straight-backed chair or cross-legged on the floor.
• Focus on an aspect of your breathing, such as the sensations of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.
• Once you’ve narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and ideas. Embrace and consider each without judgment.
• If your mind starts to race, return your focus to your breathing. Then expand your awareness again.
• Take as much time as you like: one minute, or five, or 10 — whatever you’re comfortable with. Experts in mindfulness meditation note that the practice is most helpful if you commit to a regular meditation schedule.

Open awareness

Another approach to mindfulness is “open awareness,” which helps you stay in the present and truly participate in specific moments in life. You can choose any task or moment to practice open awareness, such as eating, taking a walk, showering, cooking a meal, or working in the garden. When you are engaged in these and other similar routine activities, follow these steps.

• Bring your attention to the sensations in your body, both physical and emotional.
• Breathe in through your nose, allowing the air to fill your lungs. Let your abdomen expand fully. Then breathe out slowly through your mouth.
• Carry on with the task at hand, slowly and with deliberation.
• Engage each of your senses, paying close attention to what you can see, hear, feel, smell, and taste.
• Try “single-tasking,” bringing your attention as fully as possible to what you’re doing.
• Allow any thoughts or emotions that arise to come and go, like clouds passing through the sky.
• If your mind wanders away from your current task, gently refocus your attention back to the sensation of the moment.

Body awareness

Another way to practice mindfulness is to focus your attention on other thoughts, objects, and sensations. While sitting quietly with your eyes closed, channel your awareness toward each of the following:

• Sensations: Notice subtle feelings such as an itch or tingling without judgment, and let them pass. Notice each part of your body in succession from head to toe.
• Sights and sounds: Notice sights, sounds, smells, tastes, and touches. Name them “sight,” “sound,” “smell,” “taste,” or “touch” without judgment and let them go.
• Emotions: Allow emotions to be present without judging them. Practice a steady and relaxed naming of emotions: “joy,” “anger,” “frustration.”
• Urges: When you feel a craving or an urge (for instance, to eat excess food or practice an unwanted behavior), acknowledge the desire and understand that it will pass. Notice how your body feels as the craving enters. Replace the wish for the craving to go away with the specific knowledge that it will subside.

About the Author

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio View all posts by Matthew Solan

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

Do you follow certain social media creators, music artists, actors, athletes, or other famous people? Are you a huge fan of particular fictional characters from a book, TV show, or movie? Perhaps you check in with them daily because you feel a connection, care about them, or just love keeping up with the minutiae of their lives.

These one-sided emotional ties to people you don't actually know (or those who don't actually exist) are called parasocial relationships. Like all relationships, they come with risks and benefits, says Arthur C. Brooks, a social scientist, best-selling author, and professor at both the Harvard Kennedy School and the Harvard Business School.

Why do we develop parasocial relationships?

Parasocial relationships tend to occur because of our natural tendency to link to others.

"Humans have evolved to thrive in groups, probably because 250,000 years ago you needed to rely on other people to survive by building social relationships. And so we become attracted to and care about people if we have a regular enough exposure to them," says Brooks.

We are all exposed regularly to tiny details about celebrities and fictional characters, watching their days unfold on social media or learning about them from a TV show or book. What hooks us is the emotional connection, especially if the person is exciting or compelling.

"That's the secret to the success of the Harry Potter book series and the TV show Breaking Bad. The writing is supposed to engage you emotionally," Brooks says. "People can form a bond even if the characters are psychopaths."

The upsides of parasocial relationships

Parasocial relationships can be a nice complement to your life. They might entertain you, inspire you, educate you, or bring you comfort. You might feel less lonely or like you're part of a tight group or a cultural moment, a feeling the shows Friends and Game of Thrones fostered for many people.

Bonding emotionally with famous or fictional people might also shape people's values. For example, children might learn lessons about right and wrong from characters they connect with on shows such as Sesame Street or Bluey. Teens or adults might feel moved to work harder if they're attached to champion athletes, or do good deeds if they admire selfless leaders.

One study of more than 300 people ages 18 to 35 even found that parasocial relationships might help reduce the stigma of mental health conditions. All participants watched one video of someone who shared personal information aimed at creating a social bond. Then, some participants also watched a video of the content creator sharing his challenges with bipolar disorder. Those who saw both videos scored lower on measures of prejudice about mental health conditions than those who only saw the first video.

The downsides of parasocial relationships

While parasocial relationships can enrich your life, these one-sided affairs can also hurt you.

• They won't love you back. "They're like fake food. They taste good, but they have no nutritional content and won't meet your needs. You need to love and be loved in return to thrive," Brooks says.
• They might contribute to loneliness and isolation if you rely on them too much. Loneliness and isolation are linked to increased risks of many chronic health problems such as depression, anxiety, dementia, and heart disease, and even premature death.
• They might have a negative influence on you. Are you picking up unhealthy ideas from the people you follow? Brooks says this should be a special concern for parents whose kids have parasocial relationships: The messages kids glean might be at odds with your values — perhaps because they are controversial political or adult themes.

Navigating parasocial relationships

A dollop of parasocial relationships in your life is fine as long as they don't crowd out real-life bonds or warp your thinking and values. But how would you know if this was becoming an issue?

Two red alerts:

• Ask yourself if you're too attached. For example, are you skipping dinner with friends because you prefer watching a TV show with a character you care about and want to connect with?
• Be wary. "If someone is trying to brainwash you, saying, 'I'm your friend, you can trust me,' that person is using a personal social bond to get you to do something — like vote a certain way," Brooks says. He points out that social media stars try to establish parasocial relationships with followers to get more clicks and make money. "That's what the new economy is all about — monetizing parasocial relationships on a mass scale," Brooks says.

Shifting from parasocial relationship to deeper connections

Parasocial relationships fill a need. Social scrolling, streaming shows, or following celebs may tamp down loneliness or offer curated moments of joy and connection. But if you're leaning too hard on these one-sided relationships, Brooks advises taking a hard look at what's missing from your life.

Forging warm connections in real life is worthwhile, though it isn't always easy. "It's a tall order for people who are shut-ins or introverted or don't have social skills, but you can start small. Have dinner with a friend. Spend more time with your family. Get more human eye contact. Touch, such as a hug, releases the bonding hormone oxytocin in the brain," Brooks suggests. "You'll care less about the characters and get what you really need."

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD