600 Exam 3: Chronic Diseases

Protecting the Natural Environments:

"We are strongly persuaded that access to good quality green space provides an effective, population-wide strategy for the promotion of good health, well-being and quality of life... we are convinced that the evidence is sufficiently strong to warrant amending planning guidance to recognise the health benefits of green space and to build green space into new and existing developments"

Nearly ___ in ____ adults live with at least 1 chronic illness.

1 in 2

Approximately ______ of persons living with a chronic illness experience significant limitations in daily activities:

1/4

CDC estimates up to _______% of cancer could be prevented.

40%

What % of cancer can be prevented?

40%

Chronic Disease deaths worldwide:

6 in 10

Chronic Disease deaths in US:

7 in 10

The percentage of U.S. children and adolescents with a chronic health condition has increased from 1.8% to:

7%

Money spent on chronic disease vs. Money spent on prevention:

75% of health care budget is spent on chronic disease; 5% of budget is spent on prevention

CDC estimates up to __________% of heart disease & stroke could be prevented.

80%

CDC estimates up to __________% of type 2 Diabetes could be prevented.

80%

What % of heart disease, stroke, and type 2 diabetes can be prevented:

80%

Healthy People 2020: vision:

A society in which all people live long, healthy lives.

Recommendation of cancer prevention: Dietary Supplements:

Aim to meet nutritional needs through diet alone

Healthy People 2020 overarching goals:

Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. 2. Achieve health 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 life stages.

Recommendation of cancer prevention: body fatness:

Be as lean as possible within the normal range of body weight.

Recommendation of cancer prevention: Physical activity:

Be as physically active as part of everyday life.

Health risk behaviors are unhealthy behaviors that:

Can be changed

Misunderstanding: Chronic diseases affect primarily men

Chronic disease affect men & women almost equally

Misunderstanding: Chronic diseases mainly affect rich people:

Chronic diseases are concentrated among the poor

Management of chronic diseases could also be significantly improved:

Chronically ill patients receive only 56% of the clinically recommended preventive health care services

Using Community-Based Interventions to increase health promotions:

Community-basedinterventionscanbeusedtoencourageand support healthy lifestyle choices. • Theyareusuallyaimedatchangingtheknowledge,attitudes or beliefs of specific population groups and focus on preventing or reducing risk factors while working to help local communities to support the desired behavior change (Altman 1995; Brenner 2002). • Behaviorssuchasphysicalactivity,dietandalcoholmisuse are commonly targeted.

Top 3 Deaths due to CVD:

Coronary heart Disease Stroke Other

WHO's 4 Strategic directions: Healthy & Safe community Environments:

Create, sustain, and recognize communities that promote health and wellness through prevention.

Recommendation of cancer prevention: Plant foods:

Eat mostly foods of plant origin

Chronic Diseases are unequally distributed: Burden is associated with:

Education/income. Race/ethnicity Geography Examples: Stroke death rates highest in Southeast. • Smoking prevalence highest among some American Indian tribes. • Cardiovascular disease death rates highest among African Americans. • Obesity rates highest among those with low education or low income

WHO's 4 Strategic directions: Elimination of Health Disparities

Eliminate disparities, improving the quality of life for all Americans.

Healthy People 2020 works to benchmark and monitor progress over time in order to:

Encourage collaborations across communities and sectors. Empower individuals toward making informed health decisions. Measure the impact of prevention activities.

WHO's 4 Strategic directions: Clinical and Community Preventative Services:

Ensure that prevention- focused health care and community prevention efforts are available, integrated, and mutually reinforcing.

Recommendation for cancer survivors:

Follow the recommendations for cancer prevention

Top 3 killer chronic diseases:

Heart disease, cancer, chronic lower respiratory disease

Risk factors responsible for global trends:

High blood pressure • Tobacco smoking and secondhand smoke exposure • High body mass index • Physical inactivity • Alcohol use • Diets low in fruits and vegetables and high in sodium and saturated fats (including artificial trans fats)

Using Laws and Regulations to improve health promotion: examples:

Historical use worldwide to great advantage in health promotion activities. • e.g., Tobacco control laws have regulated businesses to provide smoke-free environments as well as enforced advertising restrictions, warning labels and point-of-sale controls. • The law can be used to mandate informing or disclosing information to the public. • e.g., food labeling laws • Improve the built environment, provide taxation and price incentives, and can also be used to regulate the marketing of products

Healthy People 2020: Mission:

Identify nationwide health improvement priorities. • Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress. • Provide measurable objectives and goals that are applicable at the national, State, and local levels. • Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge. • Identify critical research, evaluation, and data collection needs.

National Prevention Strategy: America's Plan for Better Health & Wellness: Includes things such as:

Increase the number of Americans who are healthy at every stage of life; Elimination of Health Disparities; Empowered People; Healthy and safe community environments; Clinical and Community Preventative Services Mental & Emotional well-being; active living; Reproductive and sexual health; Injury and violence free living; tobacco free living; Preventing drug & abuse and excessive alcohol use; Healthy Eating; Active living

4 behaviors that cause much of the illness, suffering, and early death related to chronic diseases and conditions:

Lack of exercise or physical activity. Poor nutrition. Tobacco use. Drinking too much alcohol.

Recommendation of cancer prevention: Alcoholic drinks

Limit alcoholic drinks

Recommendation of cancer prevention: Foods & Drinks that promote weight gain

Limit consumption of energy-dense foods & Avoid sugary drinks

Recommendation of cancer prevention: Preservation, processing, preparation:

Limit consumption of salt, avoid mouldy cereals (grains) or pulses (legumes)

Recommendation of cancer prevention: Animal foods:

Limit intake of red meat & avoid processed meat

Top 3 cancer killers for women:

Lung & bronchus Breast Colon & Rectum

Top 3 cancer killers for men:

Lung & bronchus Prostate Colon & Rectum

Health costs due to chronic conditions:

More than 75%

Recommendation of cancer prevention: Breastfeeding:

Mothers to breastfeed; children to be breastfed

Top 3 Types of Cancer to survive from:

Prostate, Breast, Uterine

WHO "best buys" in population intervention:

Protecting people from tobacco smoke and banning smoking in public places. Warning about the dangers of tobacco use. Enforcing bans on tobacco advertising, promotion and sponsorship. Raising taxes on tobacco. Restricting access to retailed alcohol. Enforcing bans on alcohol advertising. Raising taxes on alcohol. Reduce salt intake and salt content of food. Replacing trans-fat in food with polyunsaturated fat. Promoting public awareness about diet and physical activity, including through mass media.

Using Public Awareness Campaigns to increase health promotions:

Public awareness campaigns to prevent or reduce risk factors provide a target audience with information that can influence their behavior. • Have been extensively used in many areas of health promotion, particularly for risk factors for chronic disease. • May be aimed at individuals, but also at professionals, organizations and policy makers (Gordon et al. 2006). • Usually target behavioral risk factors such as alcohol, smoking, physical activity, and nutrition

Misunderstanding: Chronic diseases mainly affect high income counties:

Reality: 80% of chronic disease deaths occur in low & middle income countries

Misunderstanding: Chronic Diseases can't be prevented:

Reality: 80% of premature heart disease, stroke, and type 2 diabetes is preventable, 40% of cancer is preventable.

Misunderstanding: Low & middle income countries should control infectious disease before chronic diseases:

Reality: Double burden = double response

Misunderstanding: Chronic Disease prevention and control is too expensive:

Reality: Inexpensive and cost-effective interventions exist

Misunderstanding: Chronic diseases are the result of unhealthy "lifestyles"

Reality: Poor and children have limited choice

Misunderstanding: My grandfather smoked and was overweight - and he lived to 96

Reality: These people are the rare exceptions

Misunderstanding: Chronic disease mainly affect old people:

Reality: almost half of people under age 70

Misunderstanding: Everyone has to die of something

Reality: death is inevitable, but does not need to be slow, painful or premature

These could be prevented if only Americans were to do 3 things:

Stop smoking Start eating healthy Get in shape

All of these things could be prevented if only Americans were to do 3 things:

Stop smoking Eat healthfully Get adequate physical activity

WHO's 4 Strategic directions: Empowered People:

Support people in making healthy choices.

Using Tax & Price Interventions to increase health promotions:

Taxation and price policies can provide disincentives for people to start or continue unhealthy habits that affect risk factors, as well as provide incentives for the uptake of healthy habits. • Subsidies for fruit and vegetables in schools and workplaces have been shown to increase consumption (WHO 2005). • The revenue raised can also be used to fund disease prevention programs.

Improving the build environment:

The environment that people live in can affect their health and influence the uptake of behaviors that could be of health benefit. • The increasing availability and convenience of fast foods and larger portion sizes, or lack of access to fresh fruits and vegetables can contribute to public health problems. • People living in neighborhoods with access to both safe places that facilitate physical activity and walking tracks, and have fresh food markets are likely to eat healthy food and be physically active (Sallis & Glanz 2006).

U.S. Dept. HHS Prevention Strategies:

Tobacco Control Strategic Action Plan • HHS Initiative on Multiple Chronic Conditions • Action Plan for the Prevention, Care and Treatment of Viral Hepatitis • Healthcare-Associated Infection (HAI) • Public Health System, Finance, and Quality Program • HHS Action Plan to Reduce Racial and Ethnic Health Disparities • National Prevention Strategy • National HIV/AIDS Strategy • National Drug Control Strategy • Let's Move Campaign • President's Food Safety Working Group • Global Health Initiative • U.S. National Vaccine Plan • National Action Plan to Improve Health Literacy • HHS Environmental Justice

The 7 Priorities:

Tobacco Free Living • Preventing Drug Abuse and Excessive Alcohol Use • Healthy Eating • Active Living • Injury and Violence Free Living • Reproductive and Sexual Health • Mental and Emotional Well-Being

Least likely to kill cancers for men:

Urinary bladder, non-hodgkin lymphoma, kidney & renal pelvis

Least likely to kill cancers for women:

Uterine Corpus, Liver & intrahepatic bile duct, brain/othersystems

Healthy People 2020 is a program organized by:

WHO

Chronic Disease:

are non-communicable illnesses that are prolonged in duration, do not resolve spontaneously, and are rarely cured completely.

About half of adults (47%) have at least one of the following major risk factors for:

heart disease or stroke: uncontrolled high blood pressure, uncontrolled high LDL cholesterol, or are current smokers.

WHO's 7 priorities provide evidence-based recommendations that are most likely to:

reduce the burden of the leading causes of preventable death and major illness.

According to ACS cancer can be prevented through:

weight management, diet, and physical activity