A blog covering the health/care ecosystem and people.

It’s February 1st, which marks the first of 28 days of American Heart  Month – a time to get real, embrace, learn about, and engage with heart health. Heart disease kills 610,000 people in the U.S. every year, equal to 1 in 4 deaths in America. It’s the leading cause of death for both men and women in the U.S. Knowing your blood pressure is an important step for managing the risks of heart disease. That hasn’t yet been available to those of us who quantify our steps, weight, sleep, food intake, and other health metrics. In 2017, Hugh Langley

Connecting Life’s Dots, the organization Living in Digital Times partners with CES to deliver conference content during the show. At CES 2018, LIDT is connecting a lot of dots to help make health streamline into daily living. Robin Raskin, founder, kicked off LIDT’s press conference setting the context for how technology is changing lifestyles. Her Holy Grail is to help make tech fun for everybody, inclusive for everybody, and loved by everybody, she enthused. LIDT has been a presence at CES for many years, conceiving the contest the Last Gadget Standing, hosting  tech-fashion shows with robots, and supporting a young innovators

As I am finalizing my schedule for meet-ups at CES in Las Vegas for early January 2018, I’m thinking about digital devices and wearable tech, connected cars, smart homes, and the Internet of Things through my all-health, all-the-time lens. My friends at TrendWatching write today about the automaker, Volkswagen, which has a division called MOIA started in 2016. VW, like most car manufacturers, is working on strategies to avoid being disrupted and made irrelevant as tectonic forces like autonomous cars and shared rides innovate and re-define the nature of personal transportation. MOIA is a brand and a self-described “social movement.”

Above the economy, trust in government, crime, war, terrorism, and taxes, health care is the top cause of stress in America. For ten years, the American Psychological Association has gauged Americans’ collective mood in their ongoing study, Stress in America. The latest report is The State of Our Nation, published this month, finding that we’re at the “lowest point in our nation’s history” according to 59% of Americans. The 2016 national election in the U.S. raised the stress-stakes, when APA released a stress study we discussed here in Health Populi. The election season was a source of stress for 52%

Just a few days since CVS Health announced the company would be working with mega-health insurer Anthem on a prescription drug management program, the pharmacy chain today is reportedly in talks to buy Aetna, the national health insurance company, according to CNBC and other credible news outlets like the Wall Street Journal. Remember that Aetna’s bid to acquire Humana was scuttled earlier this year after many months of negotiation and positioning, along with FTC scrutiny about antitrust. That insurance merger “died” on one day in February 2017 along with an Anthem-CIGNA deal, covered here by CNN. A deal between CVS

THINK: money and love. To find health, working-aged people seek financial stability and good relationships, according to the Consumer Health POV Report from Welltok, meQuilibrium, and Zipongo, featured in their webinar broadcast today. The online consumer survey was conducted among 2,000 full-time working U.S. adults in August 2017, segmented roughly into thirds by Boomers (37%), Gen Xers (32%), and Millennials (31%). Much lower down the priority list for healthy living are managing food, sleep, and stress based on the poll. Feeling stress is universal across most consumers in each of the three generational cohorts, especially related to work and finance.

Obesity, conflict, and mental illness contribute most to the ill health and mortality of the world’s population – especially in the U.S., according to the annual Global Burden of Disease study published this month in The Lancet and funded by The Bill & Melinda Gates Foundation. There’s good news and bad news in this research: on the upside, people are living longer. On the downside, there’s a lot of morbidity – that is, sub-optimal health – in those years. The study examines both YLLs (years of life lost) and YLDs (years lived with disability). “Death is a powerful motivator, both

    The Affordable Care Act (ACT) was implemented in 2010. Since the inception of the ACA, the proportion of uninsured women in the U.S. fell by nearly one-half, from 19 million in 2010 to 11 million in 2016. The Commonwealth Fund has documented the healthcare gains that American women made since the ACA launch in their issue brief, How the Affordable Care Act Has Helped Women Gain Insurance and Improved Their Ability to Get Health Care, published earlier this month. The first chart talks about insurance: health care plan coverage, which is the prime raison d’être of the ACA. It’s

I quote directly from the Twitter feed of Anthony Scaramucci, @scaramucci: “@dhank2525 agree. We already have Univ Health Care, we made decision long ago to treat everyone that enters an emergency room.” Mr. Scaramucci is President Trump’s Communications Chief, replacing Sean Spicer. Mr. Scaramucci is neither veteran journalist nor healthcare policy wonk. He’s a successful businessman, which I respect for his savvy and ability to build a fund, attract investors, and create a media persona which he has telegenically broadcast on CNBC and elsewhere over the past decade. He’s got a engaging public personality, and goes by the moniker, “Mooch.” But

Wellness is at the grocery store, the vast majority of U.S. health citizens say. 8 in 10 U.S. shoppers are concerned about the nutritional content in the food they eat. As grocery shoppers look for more fresh and less processed foods, grocery stores are seen as trusted allies for meeting wellness needs. Grocers are coupling the growth of more healthy packaged foods in the middle of the store with more fresh and prepared food options that consumers see as healthier than restaurant meals, according to U.S. Grocery Shopper Trends 2017 from FMI (the Food Marketing Institute) and Hartman Group. While

Forget about the 80/20 Rule. Welcome to the 41/12 Metric: 12% of U.S. adults account for 41% of healthcare spending in America, calculated by RAND Corporation in their new report, Multiple Chronic Conditions in the United States. RAND’s report quantifies the growing chronic care landscape in America that will be a burdensome legacy for younger Americans in terms of financial and social costs. First, a definition: RAND defines a chronic condition as a physical or mental health issue that lasts more than one year and causes functional restrictions or requires ongoing monitoring or treatment. Older adults are more likely to

Americans are overwhelmingly keen to use food for their health, and overwhelmed by the amount of nutrition information they face to make good shopping and eating decisions. Welcome to “food confusion,” a phenomenon gleaned from the 12th Annual Food and Health Survey conducted by the International Food Information Council Foundation (IFIC). This 12th annual survey from IFIC finds that most Americans take many steps to be healthy. In the past year, the most popular health-steps include drinking more for hydration, making small changes to achieve a healthier diet, consuming smaller portions, eating more fruits and vegetables, and eating more whole grains.

The top healthiest eating communities tend to circle the perimeter of the map of the lower 48 U.S. states. In these towns, more than 72% of health citizens report healthy eating. These areas are located in California, Florida, and Massachusetts, among others. Areas with the lowest rates of healthy eating are concentrated generally south of the Mason-Dixon Line, in places like Arkansas, Kentucky, and Mississippi, and other states. In these places, fewer than 57% of people eat healthy. Eating healthy foods in moderation is a mighty contributor to personal and public health, discussed in the report, State of American Well-Being

CNN called it, “the ancient perfume store you never heard of,” but the Officina Profumo-Farmaceutica di Santa Maria Novella had its literal roots in medicinal herbs. With scents wafting onto a 13th century Florence piazza, the Farmacia now operates as a pharmacy storefront for homeopathic and herbal supplements, along with perfumes and home scents. A visit to the pharmacy today is a journey into medicinal time-travel, back to the year 1221. I spent time in the pharmacy today to learn about the literal roots of the shop in medicinal herbs cultivated in a monastery garden and reformulated by monks into

We make our health across many dimensions: via nutrition, safe physical/built environments, financial wellness, education, and the environment among them. In this last category, the environment, new research finds that climate change has a significant impact on health. The report, Mental Health and Our Changing Climate: Impacts, Implications, and Guidance, was sponsored by the American Psychological Association in conjunction with Climate for Health and ecoAmerica. “Climate change-induced severe weather and other natural disasters have the most immediate effects on mental health in the form of the trauma and shock due to personal injuries, loss of a loved one, damage to

The future of wellness combines: Connected (you) Social IRL (in-real-life) Banishing bad (de-tabooing what’s traditionally seen as “bad”) Humanizing data, and The end of experts. These insights come from adidas, whose team developed a forecast of the future of fit, announced at the 2017 South-by-Southwest Festival in Austin this weekend. I had the honor of participating in this forecast and shepherding the SXSW panel on The End of Experts: Crowdsourcing Your Wellness at the adidas meet-up held over the weekend. The future of fit and wellness is Connected, because we are growing to understand that balancing many elements in our daily

Geography is destiny, Napoleon is thought to have first said. More recently, the brilliant physician Dr. Abraham Verghese has spoken about “geography as destiny” in his speeches, such as “Two Souls Intertwined,” The Tanner Lecture he delivered at the University of Utah in 2012. Geography is destiny for all of us when it comes to our health and well-being, once again proven by Gallup-Healthways in The State of American Well-Being 2016 Community Well-Being Rankings. The darkest blue circles in the U.S. map indicate the metro areas in the highest-quintile of well-being. The index of well-being is based on five metrics, of consumer self-ranking

Health and money are the two issues about which Americans have set New Year’s resolutions, according to the Harris Poll, Americans Look to Get Their Bodies and Wallets in Shape with New Year’s Resolutions. The top goals U.S. consumers have set for 2017 are to: Eat healthier, 29% of all U.S. adults Save more money, 25% Lose weight, 24% Drink more water, 21% Pay down debt, 17% Spend more time with family and friends, 15% Get organized, 15% Travel more, 15% Read more, 14% Improve relationships, 14%. There are some marked differences between American men versus women across these resolutions;

For the first time since 1993, expanding life expectancy in the United States has reversed, based on the latest report from the Centers for Disease Control, Mortality in the United States, 2015. “The last time U.S. life expectancy at birth declined was in 1993, when it dropped from 75.6 to 75.4, according to World Bank data,” as quoted in the Washington Post. Life expectancy at birth in 2015 was 78.8 years, a slight fall from 2014 at 78.9 years. The larger decline fell among men, from 76.5 to 76.3 years. For women, life expectancy at birth in 2015 was 81.2,

This post was written to support the upcoming meeting of the PCHA, the Personal Connected Health Alliance, to be held 11-14 December 2016 at the Gaylord Hotel in greater Washington, DC. You can follow the events and social content via Twitter using the hashtag #Connect2Health. Have you visited your local Big Box, discount or consumer electronics store lately? You’ll find expanding shelf space for digital health technologies aimed squarely at consumers. 2017 promises even more of them, aimed at helping people accomplish health tasks once  performed in hospitals and by healthcare providers, or tasks not yet delivered in today’s healthcare

If you need more proof that mainstream consumers are seeking health through the food they buy, look no further than this announcement about the new Good Housekeeping nutrition lab and launch of the new emblem:  “nutritionist approved.” The effort is underpinned by the Good Housekeeping Food and Nutrition Brand Lab Incubator, located in the GH Institute in New York City. The goal of the program is to empower consumers to “confidently navigate crowded supermarket shelves and make healthier purchases.” Ultimately, GH hopes to inspire people to make healthier food choices, and to inform food manufacturers with healthy product development and brand

Technology is high on U.S. consumers’ holiday shopping lists for the 2016 holiday season, according to the CTA (Consumer Technology Association). And wearable activity trackers are a fast-growing segment of consumer technology purchases expected in shoppers’ carts (both physical and online virtual) this fourth quarter of 2016, CTA notes in its 23rd Annual Holiday Outlook consumer survey research. The line graph illustrates the hot categories in this year’s holiday gift mix, led by smart phones (in red), tablets, laptops, and video game systems. But the proportion of people intending to purchase smartwatches now ties with video game system sales, closely followed

  1 in 3 consumers track health or fitness via an app, wearable technology, or smartwatch, according to GfK’s global survey on Health and fitness tracking published in September 2016. The key reasons people monitor health or fitness are to maintain or improve physical condition/fitness (for 55%) and to motivate oneself to exercise (for 50%), across the 16 countries GfK surveyed. Improving energy level, feeling motivated to eat and drink more healthfully, improving sleep, making tracking part of a daily routine, losing weight, and being more productive were cited as reasons to health-track by at least one-fourth of health citizens

Walmart is already in the healthcare business, serving 140 million customer visits weekly, millions of whom fill prescriptions at the store pharmacy, seek personal care in the health and beauty aisles, track blood pressure using a Higi health kiosk, and shop for healthier foods in the grocery aisles. The world’s largest company on the Global Fortune 500 list hosted a Retail Health Summit in June, the details of which have been published in . The Summit, produced by Dan Mack’s Mack Elevation Forum and , convened stakeholders from across the retail health landscape: including over-the-counter medicines, personal care, aging-at-home, caregiving, genomics, disease

There are many signposts in the marketplace pointing the way toward the new retail health/care for consumers. They include: Food and exercise as the new medicine Loneliness as the new smoking as a health risk Prevention as the new sustainability Home as the new long-term care locus Balancing humanity and technology, the analog and the digital, and Retail as a center of the new healthcare ecosystem. Read more about the 7 Signs of the Retail Health Revolution,  published by Drug Store News. This graphic-rich publication was based on a speech I gave at a recent retail health summit convened with healthcare’s

As consumers gain more financial skin in the game of paying for health care, we look for more retail-like experiences that reflect the Burger King approach to consuming: having it our way. For health are, that means access, convenience, transparency and fair costs, respect for our time, and a clear value proposition for services rendered. That doesn’t happen so much in the legacy health care system — in hospitals and doctors’ offices. It has already begun to happen in retail health settings and, especially, in the changing nature of pharmacies. Retail Health 2027, a special supplement to Drug Store News

The bad news: mortality rates haven’t improved much and obesity rates rose in one-third of communities. The good news: public health gains can be made in resource-poor communities with the right health policies, based on research from The Commonwealth Fund, Rising to the Challenge, the Fund’s Scorecard on local health system performance for 2016. The top-line of this benchmark report is that health care in the U.S. has, overall, improved more than it’s declined. Among the big levers driving health care improvement in the past year have been the further expansion of health citizens covered with insurance through the Affordable

Technology alone won’t improve health care in America, especially in people with chronic health problems don’t want to use it. Furthermore, too many clinicians who have invested in digital health technologies (namely, electronic health records systems), aren’t fully taking advantage of what they have. This and other health care realities are explored in Better Together: Patient Expectations and the Accountability Gap, based on a consumer survey conducted by Nielsen Strategic Health Perspectives for the Council of Accountable Physician Practices, an affiliate of the American Medical Group Foundation. The survey polled 30,007 consumers in March 2016, and combined physician data culled from Nielsen’s

Hippocrates is often quoted as saying, “Let food be thy medicine and medicine be thy food.” While some researchers argue that Hippocrates knew the difference between ‘real’ medicine and clinical therapy, there’s no doubt he appreciated the social determinant of health and wellness that food was 1,000 years ago and continues to be today. Taking a page, or prescription note, from the good doctor’s Rx pad, food retailers, healthcare providers, local food banks, and State healthcare programs are working the food-as-medicine connection to bolster public health. One approach to food-as-medicine is promoting the purchase of fresh fruits and vegetables — the

There’s growing recognition of the role of food in health, on both the supply side of grocers, food growers and consumer marketers; and, among consumers who are, increasingly, shopping for food with health on their minds. 8 in 10 consumers in the U.S. enter a grocery store thinking about the health attributes of what they’re about to choose from the aisles that are stocked with more gluten-free, GMO-labelled, and organic products, according to the 2015 Deloitte Pantry Study. Our physicians have begun to “prescribe” food, especially as the collective BMI of Americans has reached medically catastrophic levels. See this forecast from

Nearly 1 in 2 people own at least one wearable device, up from 21% in 2014; one-third of people own more than one such device that tracks some aspect of everyday life, according to PwC’s latest research on the topic, The Wearable Life 2.0 – Connected living in a wearable world, from PwC. Wearable technology in this report is defined as accessories and clothing incorporating computer and advanced electronic technologies, such as fitness trackers, smart glasses (e.g., Google Glass), smartwatches, and smart clothing. Specifically, 45% of people own a fitness band, such as a Fitbit, the most popular device in this

The first health news I read this morning in my Google Alerts was a press release explaining that Nokia planned to acquire Withings for EU170 (about $190mm). As an early adopter and devoted user of the Withings Smart Body Analyzer, I took this news quite personally. “What will Nokia be doing with my beloved Withings?” I asked myself via Twitter early this morning. As if on cue, a public relations pro with whom I’ve been collegial for many years contacted me to see if I’d like to talk with the Founder and CEO of Withings, Cédric Hutchings, and Ramzi Haidamus,

How can digital technologies enable self-healthcare in novel ways? This was the theme of a meeting sponsored by Pfizer Consumer Healthcare and hosted by Google, with the title, “Advancing Consumer Health through New Technology and Next Generation OTC Healthcare” held on 12th April 2016 at Google offices in Manhattan’s Chelsea neighborhood. Pharmaceutical brand drugs switching to over-the-counter packaged goods, the Cellscope Otoscope used by parents checking their young children’s earaches, connected shoes and earbuds for athletic enhancement, and omni-channel retail shopping….these are a few of the signals we see emerging to enable consumers’ to drive healthy behaviors, wellness and self-healthcare. Speakers

In the growing era of consumer-driven health, a growing list of options for receiving care are available to consumers. And people are liking new-new sites of care that are more convenient, cheaper, price-transparent, and digitally-enabled. Think of these new-new sites as “new front doors,” according to Oliver Wyman in their report, The New Front Door to Healthcare is Here. The traditional “doors” to primary and urgent care have been the doctor’s office, hospital ambulatory clinics, and the emergency room. Today, the growing locations for retail clinics and urgent care centers are giving consumers more visible and convenient choices for seeking

Today is International Women’s Day. Being a woman is a social determinant of health (for the worse). To mark the occasion of the Day, The International Labour Organization (ILO) published a report on women and work yesterday, finding that in the 178 countries studied, inequality between women and men persists across labor markets. And while there’s been progress in women’s education over the past twenty years, this hasn’t resulted in women advancing career paths and wage equality. It struck me this morning, reading both (paper versions of) the Wall Street Journal and the Financial Times that the latter had two FT-sponsored ads marking

One in 2 hospitals currently use three or more connected health technologies, according to the 2016 HIMSS Connected Health Survey released today at the annual HIMSS conference. The most commonly used connected health applications cited were: Patient portals, among 58% of providers Apps for patient education and engagement 48% Remote health monitoring, 37% Telehealth via fee-for-service, 34% SMS texting, 33% Patient-generated data, 32% Telehealth via concierge, 26%. 47% of health care providers plan to expand use of connected health technologies, especially for telehealth via concierge, patient-generated data, and SMS texting. HIMSS worked with the Personal Connected Health Alliance (PCHA) to

As consumers’ growing financial skin in the health care game compels them to seek care in lower-cost settings, the pharmacy business recognizes the opportunity to provide healthcare services beyond the core business of filling prescriptions. This month, Drug Store News (DSN) published a special section called which profiles several pharmacy companies’ expanding reach into retail health – in particular, re-defining the concept of the “health fair.” A health fair is “an educational and interactive event designed for outreach to provide basic prevention and medical screening to people in the community,” according to the latest Wikipedia definition. But the health fairs described

All over the world, people define their health and wellness across many dimensions…physical, mental, financial, and appearance. In Florence, Italy, I happened upon a riff on this last component on “look good, feel good” at the Coin Department store located on Via Del Calzaiuoli in central Firenze. Welcome to Coin’s Health&Beauty Store. The two photos tell a story about health, where we live, work, play, and shop, the mantra for public health focused on the social determinants of health beyond healthcare. Here at Coin, adjacent to the holistic brands of Clarins and other luxury labels, is a pharmacy along with

9 in 10 people in the U.S. believe working with their health clinician as a partner will help them better manage their overall health, according to a survey conducted for The Society for Participatory Medicine. Consumers’ majority call-out for shared decision-making with health care professionals also extends to their self-tracking health data — for example, via activity trackers, digital glucometers for blood sugar, technologies for blood pressure, and food logging apps. 84% of people said that sharing their personal self-tracking health data with clinicians between visits would also help people manage health. That clinician’s involvement is very important to health

9 in 10 adults in the U.S. have visited a doctor’s office in the past year, and over half of these patients have been very satisfied with the visit; 35% have been “somewhat” satisfied. Being a highly-satisfied patient depends on how old you are: if you’re 70 or older, two-thirds of people are the most satisfied. Millennial or Gen X? Less than half. What underlies patient satisfaction across generations is the fact that younger people tend to compare their health care experience to other retail experiences, like visiting a bank, staying at a hotel, or shopping in a department store.

Sleeplessness and chronic pain are two epidemics that are mutually-enforcing, as the chart shows. The 2015 Sleep in America Poll found that pain is a key factor in Americans’ “sleep debt:” 21% of people have experienced chronic pain and lose 42 minutes of sleep due to it; 36% have experience acute pain, resulting in 14 minutes of lost sleep each night. People dealing with both conditions project-manage their health in numerous ways, multitasking with over-the-counter meds, prescription drugs (from “lite” to narcotic), meditation, yoga, homeopathic remedies, aural relaxation, Mozart, and more. There are a growing number of digital health tools now

As we concluded our panel on The Wizards of Maternal Health kicking off today’s launch of the 2016 Digital Health Summit, co-located with the 2016 CES (Consumer Electronics Show) in Las Vegas, our diverse team concurred that there’s more than enough “technology” on the convention floor. The challenge now for health is to make connections between the islands of devices, and generate meaningful data and culturally contextual information and support for consumers (patients, caregivers, people) and health providers. Here at the CES, it’s all about the supply side of the equation – for health, that means digital health tools, wearables,

It’s time to get the tea leaves out and mash up trends in my world of health, health care, technology, policy and people for 2016. We’ll start with the central player: people, consumers, patients, caregivers all. Health consumerism on the rise.  People – call us patients, consumers, caregivers – will take on even more financial and clinical decision making risk in 2016. Growing penetration of high-deductible and consumer-driven health plans will push (not just nudge) people into the role of health care consumers, and the emerging businesses and programs serving the transparency market for price and quality will gain traction

It’s Christmastime, so I’m thinking about connections. “Connectivity” can be social (offline and online), which is indeed a health factor (see Christakis and Fowler on being Connected). But the kind of connectivity to which I’m referring is broadband, WiFi, the kind most often associated with data plans, cable to the home, and free WiFi at your favorite coffee or fast food joint. That kind of connectivity is also a social determinant of health, and is increasingly becoming so for all people. Yet as peoples’ need for internet connectivity is fast growing, especially for health, home broadband connectivity has reached a

Among TIME magazine’s 25 best inventions of 2015, most relate directly or adjacently to health and health care. Among the 25 are: The EKO Stethoscope A gluten-sniffing sensor, the 6SensorLabs Nima The Sproutling baby monitor Nike Flyease 8 shoes, that you can tie with one hand Cogni-Toys Dino, the toy that talks back A smart refrigerator that can fix you a glass of nutrient-enriched water The TZOA environmental tracker for personal pollution sensing, measuring atmosphere in a specific area (e.g., temperature, particulates such as dust, pollen, mold, and car exhaust), and UV ­exposure Doppler Labs Here Active Listening earbuds The

The 2015 holiday shopper can find activity trackers for gifting discounted as much as 50% and more over Thanksgiving weekend. In greater Philadelphia, the Thursday print newspaper ads were chock full of examples from Best Buy, Dick’s Sporting Goods, Kohl’s, Target, and Walmart, among others. Among the many “Doorbusters” and deep discounts were a Misfit Flash tracker for $14.99 at Best Buy (a 50% discount), a Fitbit Zip at both Kohl’s and Walmart for $39 ($20 off the manufacturers’ suggested retail price), and a Fitbit Flex at Dick’s Sporting Goods for $49.95 — 50% off full retail. That trackers are

The factors of where people are born, live, work and age — social determinants — shape human health more than health care. Yet in the U.S. much more resource per capita is funneled into healthcare services than into social ones. Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity was published by The Kaiser Commission on Medicaid and the Uninsured in November 2015, calling attention to the opportunity and wisdom of baking health into all public policy. The social determinants of health (SDOH) include economic stability, the physical environment and neighborhood, education, food, community and

By shifting primary care visits by 5 minutes, moving some administrative tasks and self-care duties to patients, the U.S. could conserve billions of dollars which could extend primary care to underserved people and regions, hire more PCPs, and drive quality and patient satisfaction. Accenture’s report, Virtual Health: The Untapped Opportunity to Get the Most out of Healthcare, highlights the $10 bn opportunity which translates into conserving thousands of primary care providers. PCPs are in short supply, so virtual care represents a way to conserve precious primary care resources and re-deploy them to their highest-and-best-use. The analysis looks at three scenarios

American workers are working to pay for health care costs, having traded off wage increases for health premiums, out-of-pocket costs and growing high deductibles. Welcome to the 2015 Employer Health Benefits survey conducted annually by the Kaiser Family Foundation (KFF) and Health Research & Educational Trust (HRET). Premiums are growing seven times faster than wages.  The report calculates that high-deductibles for health insurance have grown 67% from 2010 to 2015. In the same period, wages grew a paltry 10%, while the Consumer Price Index rose 9%. The first chart illustrates that growing gap between relatively flat wages and spirally health