Public Health Workforce

how does the CDC define chronic diseases

prolonged illnesses that do not resolve spontaneously and are rarely cured completely

the US national center for health statistics defines chronic disease as

a disease lasting three months or longer (this is the threshold)

what are some chronic diseases

obesity, COPD, asthma, diabetes, arthritis

how many Americans are limited by chronic health conditions

about 40 million are limited in usual activities due to one or more chronic health conditions

chronic diseases are the leading causes of

death and disability

are chronic diseases deadly

not in the short run but have severe impacts on the quality of life

what is true about chronic disease risk factors

they often have less recognizable risk factors because there are multiple 'causes'

what is the period of onset for a chronic disease

long period of onset

what prevention is used for chronic diseases

primary would be ideal but there is a possibility of secondary prevention

why are animal models important in chronic diseases

ethical concerns limit experiments on humans

how many adults have at least 1 chronic disease

about half - 1 in 2

how many adults have at least 2 chronic diseases

25%

what is a one word risk factor for chronic disease

lifestyle

is chronic disease contagious

no

chronic disease can often be controlled but never

cured

what is the leading cause of death in the US

cardiovascular disease

what is the second leading cause of death in the US

cancer

what is the leading cause of disability in the US

arthritis (some say mental illness)

what is true about diabetes and its rise

if not addressed it may become the leading cause of disability soon

how many are afflicted with obesity

one in three

what are common causes of obesity (chronic diseases?)

physical inactivity, tobacco use, poor nutrition, excessive drinking

in 2010 what is true about the top 10 causes of death

7 were chronic diseases

what accounted for nearly 48% of all deaths

cancer and heart disease together

when compared with other high-income "peer" countries, what is true for the US and health

we are less healthy in key areas including obesity, diabetes, heart disease, chronic lung disease, and disability

how much do we spend on healthcare per capita

about 11k where the next most is 7k. we spend the most and get the least

what percent of health care costs are due to chronic conditions

more than 75%

what is true about the most expensive health conditions in the US

four out of the five most expensive are chronic (based on total health care spending in a given year) - heart disease, cancer, mental disorders, and pulmonary conditions

how much does the US spend on obesity alone

250 billion indirect and direct cost

in 2007 how much healthcare expenditure was for chronic diseases

about a third

a 2007 study showed what chronic diseases (7) having what economic impact on the economy

cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental illness had a $1.3 trillion impact annually

according to the 2007 study, by 2023 how much could be spent on those same 7 conditions

projected to be $4.2 trillion in treatment cost and lost economic output

in 2010 what was the total spending for Medicare

(largely greater than or equal to 65) more than $300 billion

what percent of medicare was for people with two or more chronic conditions

93%. (beneficiaries with 0-1 condition make up most but those with 6+ conditions spend the most)

what is the correlation between conditions a person has and the expenditure

the more conditions, the higher the expenditure. positive corrolation

what two leading causes of death are encompassed in the title cardiovascular disease

heart disease and stroke

epidemiologic studies have done what for cardiovascular disease

they have relatively well established the causes

describe causes to cardiovascular disease (CVD)

diet, high blood pressure, diabetes, and smoking interact, causing injury of artery walls

what is a part of development of CVD

atherosclerosis. plaque begins at an early age in the US and the American diet raises risk

what is true about cholesterol levels and CVD

lower is better for total. want low levels of LDL and high levels of HDL

what can exercise do for cholesterol

lower the total and increase HDL

what raises HDL

moderate alcohol consumption

what lowers HDL

smoking

what is a major factor in cholesterol levels

genetics

what is widespread for secondary prevention with cholesterol

the use of statins

what type of diabetes is more tied to genetics than the other

type II

when should you be more careful about type II diabetes

if over 40 years old. it happens in kids too though

HBP or hypertension is an important risk factor for

CVD

what is true about the cause of "essential hypertension"

there is no known cause

what is effective prevention for hypertension

secondary prevention

what may be risk factors for hypertension

obesity, smoking, stress, increased salt

what are "white poisons"

salt and sugar

what (numbers) is considered high blood pressure

over 140/90. normal is below 120/80. in between is prehypertension

what is the best salt

Himalayan salt (you should decrease salt use little by little)

why is cancer harder to understand than CVD

we don't know cause for many cancers. there are many diseases each with different risk factors, treatments, etc.

how does cancer arise

from mutations in DNA caused by chemicals viruses, radiation

what two things also play a role in developing cancer

diet and hormones

what causes one third of cancer deaths

tobacco use

HPV causes cancer, but recently

there is a vaccine you can get for it

testing chemicals for carcinogenicity is

complex

what does Hep B vaccine prevent

liver cancer

what is the most frequent STD in the US (causes cancer)

HPV

what are symptoms for HPV

there are little symptoms but warts may occur

what cancer does HPV cause (mostly?)

it can cause cervical cancer in females

what percent of cancer does HPV cause

3% of cancer in females and 2% of cancer in males

what states suffer from HPV most

southern states

a trend for diabetes in the US is moving towards

1 in 3 people having it. it will be major disability cause very soon

what is diabetes

deficiency in ability to metabolize sugar. it is a major cause of disability and there are two types. both are usually treatable but need long-term monitoring and good access to medical care

type I diabetes

"childhood onset" insulin production failure

type II diabetes

"adult onset" insulin resistance. this is closely correlated with obesity and prevalence is rising in the US along with obesity

what contributes to the seriousness of diabetes as a PH problem

lack of access to routine medical care

diabetes is the leading cause of

kidney failure

lower-limb amputations other than those cause by injury

new cases of blindness among adults

poor wound healing

during 2009 through 2010, more than how many adults were obese

one third, or about 78 million.

how many youths aged 2 to 19 were obese (2009-2010)

one of five (BMI greater than or equal to 95th percentile)

how do we define obesity in BMI

(body mass index)

over 40 = severe obesity

over 30 = obese

over 26 = overweight

what is the most common cause of disability

arthritis

Of 53 million adults with a doctor's diagnosis of arthritis, how many say that it causes them to have trouble with their usual activities

22 million of the 53 million

what is a difference between bronchitis and asthma

bronchitis goes away asthma is chronic

what are other chronic disease of PH importance

Alzheimer's disease and other dementias

mental illness

asthma

multiple sclerosis (MS)

Parkinson disease

two famous people with Parkinson's

Muhammad Ali, Michael J. Fox

what are health risk behaviors

unhealthy behaviors that can be changed. four of them cause much of the illness suffering and early death related to chronic diseases and conditions

what are the four behaviors that are related to causing most of chronic disease and conditions

lack of exercise or physical activity

poor nutrition

tobacco use

drinking too much alcohol

what percent of adults have at least one of the following major risk factors for heart disease or stroke: uncontrolled HBP, uncontrolled high LDL cholesterol, or are current smokers

47%

what are priorities for chronic disease

preventing

detecting

mitigating

preventing (as a priority for chronic disease)

stopping the development of the diseases

detecting (priority for chronic disease)

discovering chronic diseases early and slowing their progression

mitigating (priority for chronic disease)

mitigating complications of chronic disease to optimize quality of life and to reduce demand on the health care system

three things about chronic diseases

no cause

no cure

dangerous

health does what for chronic disease development

reduces probability (doesn't eliminate)

discussion question: how do epidemiology and biomedical science complement each other in improving people's understanding of chronic diseases?

"Biomed science = basis for epidemiology (how risk factors --> epidemics = known biological factor --> epidemiology)

i.e. Franingham's study = high cholesterol is risk factor for heart disease" Biomedical sciences help us to pinpoint the risk factors and causes in chronic diseases and where epidemiology can then use its surveillance to help control the disease through its use of measuring incidence and distribution, and then helping to possibly control of diseases and other factors relating to health. biomedical science can use this information as well as their understanding of natural sciences to help understand chronic diseases.

discussion question: compare the medical approach with the public health approach to saving lives from cancer. what are the advantages and disadvantages of each approach

"ex: telling people smoking while taking birth control is bad. preventive care= public health vs medical approach, treatment" PH measures are going to target actual causes of death for prevention (behavior and lifestyle risk factors) this is more effective granted you know what the causes of the disease are. unfortunately it cannot 100% prevent the disease from happening. in this case the medical approach is beneficial because treatments can help a person manage their disease. this is not as effective and usually costs more than a preventative measure like PH initiatives