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List of chronic diseases that are concern in US
- heart disease
Goals of CDC for chronic disease prevention
- a. Prevent, delay, detect, and control chronic diseases.
- b. Contribute to chronic disease research and apply that research to put practical and effective intervention strategies into practice.
- c. Achieve equity in health by eliminating racial and ethnic disparities and achieving optimal health for all Americans.
Greatest lifestyle risk factors that need to be reduced/modified to see a reduction in chronic diseases
- physical activity
How can you incorporate the levels of prevention with chronic disease programming?
- The three levels are:
- 1. Primary: Actions designed to identify risks and reduce susceptibility prior to disease onset. For example: health promotion efforts, education, accident prevention, immunization
- 2. Secondary: Detect and treat disease in early stages to prevent progress, duration, severity, or recurrence. For example: Immediate Correction, or multidimensional screening
- 3. Tertiary: Alleviate the effects of Disease/Injury, optimal management, accommodation of those with irreversible disease
What are some of the barriers to controlling chronic diseases?
- • Inadequate intensity of treatment and failure of providers to follow evidence-based guidelines
- • Failure to adhere to treatment
- • Lack of Family support
- • Lack of Support for Self-Management
- • Lack of Access to Care; being uninsured
- • General Expenses (transport, etc)
- • Different Cultural Perspectives on Health
- • Complexity of treatment
- • Insufficient focus in the US on prevention and on support from social and health care systems
What is quality of life (QOL) and how is it usually measured?
- • The ability to lead a normal life through fulfilment of personal goals and self-actualization. WHO defines it as the individual’s perceptions of their positions in life, in the context of the cultural and value systems in which they live, and in relation to their goals, expectations, standards and concerns.
- o It is measured by the WHOQOL-BREF and SF-36.
What is Health Related Quality of Life and how is it usually measured?
- • HR-QOL: An assessment of how an individual’s well-being may be affected over time by a disease, disability or disorder. It looks at how these things affect QOL
- • It is measured by PROMIS: Patient Reported Outcomes Measurement Information System Global Health Measure (questionnaire)
- • Also it is measured by: Well Being Measures and Participation Measures
What is Healthy People 2020?
A set of goals with 10 year targets designed to guide national health promotion and disease prevention efforts to improve health in the US. Directed by the Department of Health and Human Services, it is science-based and motivated people. It measures progress and plans for the future.
What are the 10 leading health indicators? (there are 12)
- 1) Physical Activity
- 2) Overweight and Obesity
- 3) Tobacco use
- 4) Substance Abuse
- 5) Responsible Sexual Behavior
- 6) Mental Health
- 7) Injury and Violence
- 8) Environmental Quality
- 9) Immunization
- 10) Access to Health Care
What are the 3 overarching goals of Healthy People 2020? (There are 4)
- 1) Attain high quality, longer lives free of preventable disease, disability, injury and premature death
- 2) Achieve high equity, eliminate disparities and improve the health of all groups
- 3) Create social and physical environments that promote good health for all
- 4) Promote quality of life, healthy development and healthy behaviors across all stages of life
Who is involved with Healthy People?
Led by the Department of Health and Human Services as well as experts in all of the different fields.
What measures are being used to track the nation’s progress? How well are we doing in compared to other countries--------stay focused on QoL and HrQoL
- 1) Life expectancy (at birth and at age 65). US is ranked 27th (men) and 26th (women)
- 2) Healthy Life Expectancy (Expected Life in Good or better Health, Expected life free of limitation activity, or expected life free of chronic diseases)
- 3) Years of Potential Life Lost (US not doing good compared to other countries, even those which are less wealthy)
- 4) Physically and Mentally Unhealthy Days (in the last 30)
- 5) Self-Assessed health Status
- 6) Limitation of Activity (ADLs & IADLs)
- 7) Chronic Disease Prevalence (Leading cause of Death in US)
What are the determinants of health? Describe the determinants as a system
- • Policy Making
- • Social Factors
- • Health Services
- • Individual Behavior
- • Biology and Genetics
What is a health disparity? What health disparities exist in the US? What do we need to do as therapists to begin to reduce health disparities?
- a. Healthy People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage
- b. health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion
- c. The greatest way to reduce disparities is to empower individuals to make informed health care decisions & promote community wide safety, education, & access to health care