Cause and effect of chronic disease and its impact in the United States ********* **** Techniques 1 – Week 3 ****** ****** – Student ID: ******* Instructor: ******* ***** April 18, 2010 The United States is experiencing an unsustainable disease burden; 130 million people today suffer from chronic diseases, taking a tremendous toll on individuals, families, and communities. In addition to lives lost and quality of life lost, we are also a nation in crisis, an economic crisis.

We spend over $2 trillion a year, about 16 percent of our gross domestic product on health care. 75 cents of every health care dollar we spend is on treatment of chronic disease, most of which is preventable. If we do not reverse this trend, chronic disease will continue to devastate Americans’ health, lead to millions more preventable deaths and will ultimately bankrupt our health care system. Page 3 The number one cause of death, disability, and rising health care costs in the United States: chronic disease.

I propose a business model towards an effective means of managing chronic disease to include; challenging policymakers to make the issue of chronic disease a top priority and articulate how they will address the issue through their health care proposals. Educate the public about chronic disease and potential solutions for individuals, communities, and the nation. Mobilize Americans to call for change in how policymakers, governments, employers, health institutions, and other entities approach chronic disease.

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The reality is that the United States spends more money on health care than any other nation in the world, yet nearly half of Americans suffer from a chronic disease, and the vast majority of our health care dollars are spent treating chronic disease. Chronic disease impacts our nation’s businesses and our economy, reducing productivity and placing an unsustainable burden on all sectors of society. With unprecedented increases in childhood obesity, the youngest generations of Americans will struggle with chronic ealth problems even more than did their parents and grandparents, and they will do so at younger ages. We can prevent this from happening. The good news is that we still have a chance to make a big difference. We can change the direction in which our nation is headed if we act now. What this requires is nothing short of a cultural transformation, a change in practice. We need to move away from our current system that is focused on treating disease to one focused on preventing chronic conditions from occurring in the first place.

Preventing chronic disease is a challenge we all face and one that our nation must address together; as individuals, as families, as communities, as well as through our health care system, workplaces and government. Each of us has a responsibility to increase Page 4 awareness of the chronic disease burden, and to do all that we can to prevent and manage chronic disease in our own lives and our family’s lives. We must also hold our elected leaders, accountable to put policies in place that encourage Americans to make better health decisions, establish appropriate incentives to prevent and manage chronic disease.

Chronic diseases generally cannot be prevented by vaccines or cured by medication, nor do they just simply disappear. 88% of Americans over 65 years of age have at least one chronic health condition. 1 Health damaging behaviors; particularly tobacco use, lack of physical activity, and poor eating habits are major contributors to the leading chronic diseases. As the United States population ages, and as health challenges, such as rates of obesity, continue to rise, so too does the burden of chronic diseases increase and strain our already vulnerable health systems.

Chronic conditions; such as heart disease, stroke, diabetes, cancer, asthma, and arthritis, as well as mental health are complex and expensive to manage and treat. Communities and health care facilities need to interact and become proactive towards addressing a range of topics such as: •Making an economic assessment for businesses and employers to take action on chronic diseases and conditions. •Identifying successful models for engaging businesses and employers in chronic disease prevention and management efforts. Building an economic assessment towards reducing the excess burden of chronic diseases among vulnerable populations and regions of the country. •Assessing the economic impact of chronic disease prevention strategies for children and youth. Page 5 •Identifying effective methods and tools for delivering comprehensive care for chronic conditions in workplaces, homes and communities. •Promoting approaches and tools, including those involving businesses and employers, to support individuals in their own care and self-management.

Dialogue among leaders in communities, health care facilities, businesses, and employers involving critical exchange, commitment towards understanding, and implementation are factors critical towards stimulating action. Chronic health conditions are a substantial challenge to global health. By 2020 they will account for 73% of all deaths and 60% of the global burden of disease. United States experience matches that of much of the developed world, where in the next decade deaths caused by chronic diseases will increase by 15%. The growing burden of chronic diseases threatens the sustainability of health care systems.

In the United States, for example, the annual economic effect on the United States economy of the most common chronic diseases is more than $2 trillion and could reach nearly $6 trillion by the middle of the century. The United States stands to lose $9 billion in the next decade from premature deaths caused by heart disease, stroke, and diabetes. 2 Policy makers have become increasingly interested in the potential of high-quality primary care to help deal with the chronic disease challenge. Primary care is well positioned to have an important impact on outcomes of care for patients with chronic conditions.

There are, however, important variations in the delivery of chronic disease management programs and Page 6 services in primary care. Recent studies suggest that the way chronic disease management is delivered in general practice is highly influenced by organizational factors. Various studies have suggested that high quality chronic disease management can be promoted by financial incentives, capitated payment structures, improved Internet technology infrastructure, and the wider use of nonmedical health care professionals. To assure the best of quality health care for all individuals in the United States an assessment and implementation of prevention in chronic diseases needs to be addressed and acted upon. Exercise, proper eating habits, and routine physicals are the responsibility of both health care providers and individuals alike. Programs in self-management towards eliminating health damaging behaviors such as tobacco use, over eating, and over indulgence in alcohol consumption should be at the forefront.

Educating the public to the double benefits achieved pertaining to over-all health conditions and control in the stabilization of the impact on our economy, are essential in strengthening our nation and our communities at large. References 1. Anderson G. Chronic Conditions: Making the case for ongoing care. Page 72. Johns Hopkins University. November 2007. 2. Annals of family medicine. www. annfammed. org. Volume 7, number 4. July/August 2009. 3. Sperl-Hillen JM, Solberg LI, Hroscikoski MC, Crain AL, Engebretson KI, O’Connor PJ. Do all components of the chronic care model contribute equally to quality improvement? 2004 page 303.

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