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JAMA recommends ways to survive next century  Editor's note: The Journal of the American Medical Association (JAMA) advises Americans on how to survive the next century, medically and physically. As we count down to the Year 2000, the physicians of America know that the new millennium will bring tremendous challenges and opportunities in preventing illness and disease. New technology, tests and treatments will result in more accurate diagnoses and better outcomes for patients. Great strides will be made in biogenetic engineering and clinical research. Some infectious diseases will be uncovered, while cures for existing diseases will be discovered.  Despite all of the developments we foresee, Americans have to take many of the same precautions against poor health and disease in the next millennium that we have in this one. For those people who haven’t been taking those precautions, there is no better time to start than now.  The best way for individuals to begin improving their health in the Year 2000—and beyond—is by establishing a partnership with your physician to help you take charge of your health. To get everyone started, the physicians of the American Medical Association would like to offer several recommendations on maintaining good health in the new millennium—for people of all ages.  Children and Adolescents Make your child’s world a safe one. It is important to create a safe environment for our children— both inside and outside of the home. Here are some suggestions on how to do that:  Avoid smoking or using tobacco products around your children  Lock firearms away and out of children’s reach.  Keep toxic poisons stored where small children can’t find them.  Place sleeping babies on their backs to prevent Sudden Infant Death Syndrome (SIDS).  Make sure your children are buckled up in the car at all times—and that small children are buckled into car seats that have been properly installed.  Open up a dialogue. It’s never too early to talk to your children about growing up healthy—and about the dangers of smoking, drinking alcohol and using drugs. Remember, the average age that children start drinking and smoking is 12 years old. And the average age they start smoking marijuana is 14. These are only averages—many children begin these unhealthy habits even earlier.  One of the most important things parents can do to help their children remain substance free is discuss these issues with them—and be directly involved in their lives. For our children, growing up healthy involves more than just making good choices. As parents, you should be active in your children’s lives—get to know their friends, eat meals with your children, and most importantly—have fun with them.  Protect your kids from infection. Immunize! Immunization is the best way to protect children against many infectious diseases. It’s important to make sure that your children are immunized at the correct ages. See a recommended immunization schedule online or obtain one from your pediatrician.  Adults  Begin the new millennium as a non-smoker, and stay that way. Unfortunately, none of the new technology or medical treatments that we anticipate will reduce the harm nicotine causes the human body. Tobacco use remains the leading preventable cause of death in America—causing more than 400,000 deaths each year and resulting in an annual cost of more than $65 billion in direct medical costs. Every year, smoking kills more people than AIDS, alcohol, drug abuse, car crashes, murders, suicides, and fires combined.    Eat right and keep the pounds off. Your health depends on it. Obesity and lack of exercise are becoming serious health problems in this country and will become worse in 2000. According to the U.S. Surgeon General, 60 percent of American adults are not physically active on a regular basis—and 25 percent of them aren’t active at all. A combination of good nutrition and good exercise can not only prevent obesity, but it can reduce the risk of a number of diseases. Most importantly, it reduces the risk of early death also. Talk to your physician about healthy eating habits and exercise.  Be a cautious Internet user. We receive a great deal of information on the Internet—some of it is accurate—but much of it is not. When it comes to health information, your most trusted source is your physician. Talk to your doctor about any information you get from the Internet—especially information about medication, treatments or surgeries. The Internet can be a good information resource, but don’t make a final decision on a health issue based on something you’ve read on a website. Here are some tips for Internet users: Check the website’s source and funding. Be wary of sites that tout “miracle cures” or push treatments that sound too good to be true.  Beware of information posted anonymously.  Check how often the information is updated, when it was last updated and who reviews it. The authors’ affiliation and credentials should be provided.  Seniors (65 +) Remember: Good health equals successful aging. Today’s “new age” seniors, who anticipate 15-20 more years of active involvement in our society, are quickly adopting a regimen of strategic wellness. Here are some important lifestyle practices:  Participate in a regular exercise program for a healthy heart and healthy bones.  Manage disorders of cholesterol, triglycerides and lipoprotein metabolism through diet and medication.  Eat a heart healthy diet that is high in fiber and low in fats and sugars.  Recognize and seek proper treatment for depression that often accompanies this definitive period of life.  Take your medication properly and as prescribed If you don’t understand your physicians’ instructions, ask for clarification—after all it’s your life!  Elderly adults and their caregivers Protect your quality of life by taking precautions. As we grow older, failing vision, loss of hearing and limited mobility become inevitable conditions. Given the problems that develop with age, the elderly must take particular health precautions. As activities of daily living become a challenge, caring for the frail elderly involves careful prevention of mishaps. Here are some examples of how to do that: Help prevent dangerous falls by tacking down scatter rugs, making sure stairwells are well lit, and removing small objects (such as toys and magazines) from their path.  Learn to recognize the signs of elder abuse, including yelling, pushing, pinching and hitting - and report them to the authorities.  Avoid hot water scalds by making sure hot and cold water faucets are color-coded and that handles are easy to turn. Provide the elderly with easy grip cooking utensils.  Look for signs of withdrawal and depression in elderly people who have suffered the loss of family members, friends and profession. These feelings may lead to thoughts of suicide, which is largely preventable through proper intervention.  As the world progresses, so should our health concerns. And as they do, the relationship between patient and physicians becomes even more critical. When it comes to good health, your physician is your best ally. Let’s all work together to have the healthiest America possible—in the Year 2000 and beyond.