Public Health - lecture 8 - Public Health and Preventive Medicine

Common Chronic Diseases in the US

• Major chronic diseases:

  • Cardiovascular Disease

  • Cancer

  • Diabetes

• Economic impact: $700 billion in annual costs (direct and indirect)

• Aging population will increase the physical and financial burden of chronic diseases

• Healthcare providers' roles will expand in preventive medicine

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Modifiable Factors for Prevention of Chronic Diseases

• Key factors:

  • Physical Activity

  • Reduction in Obesity

  • Dietary Modification

Physical Activity and Chronic Disease Prevention

• Benefits of physical activity:

  • Prevents/treats conditions such as:

    • Hypertension

    • Diabetes

    • Hyperlipidemia

    • Obesity

    • Colon Cancer

    • Breast Cancer

    • Osteoporosis

    • Depression/Anxiety

• Recommended guideline:

  • 30 minutes of moderate-intensity physical activity on most days, according to CDC and ACSM.

Obesity and Health Implications

• Current obesity trends suggest all Americans may be overweight/obese by 2048

• Fat location affects clinical complications:

  • Central adiposity leads to metabolic syndrome (includes cardiovascular disease and diabetes)

• Obesity associated with pathologies:

  • Coronary Heart Disease

  • Hypertension

  • Arthritis

  • Cancer

Dietary Modification

• Impact of diet on chronic diseases:

  • High in salt, saturated fats, low in fiber contributes to heart disease, cancer, diabetes

  • Diets with high glycemic index negatively affect metabolism and appetite regulation

Heart Disease

• Types include:

  • Coronary Artery Disease

  • Hypertension

  • Myocardial Infarction

  • Stroke

• Approximately 1 in 3 adults in the US has heart disease, leading cause of death

• Modifiable risk factors include:

  • Lifestyle changes, low-fat vegetarian diet, quitting smoking, stress management, moderate exercise

  • Effective in reducing coronary atherosclerosis by up to 82% without medication

Prevention Strategies for Heart Disease

• Discuss with patients:

  • Reduce blood pressure

  • Lower cholesterol levels

  • Manage diabetes

  • Quit smoking (if applicable)

  • Increase physical activity

  • Maintain a healthy weight

  • Follow a healthy diet low in carbs, processed sugars, saturated/trans fats

Diabetes

• Incidence doubled over the past 30 years

• Lifetime risk: 33% for males, 38% for females

• Prevention discussion:

  • Healthy lifestyle

  • Maintain a healthy weight

  • Low-fat, non-processed diet

  • Avoid cigarette smoke

Cancer Prevention

• Significant progress in reducing cancer burden through risk factor prevention

• Notable declines in mortality from major cancers: lung, colon, prostate (men); breast, colorectal (women)

Lung Cancer Prevention

• Strategies:

  • Avoid smoking and second-hand smoke

  • Limit exposure to radon, asbestos, toxins

  • Limit alcohol intake

  • Balanced diet

• Screening: Recommended low-dose CT scan for high-risk individuals per US Preventive Services Task Force

Lung Cancer Screening Recommendations

• Yearly screening for those:

  • 20 pack-year smoking history

  • Aged 50-80, smokers, or have quit within the past 15 years

Breast Cancer Prevention

• Strategies:

  • Minimize oral contraceptives and hormone replacement therapy

  • Healthy weight, regular exercise, minimize alcohol intake

  • Benefits of early childbirth and breastfeeding

• Screening recommendations:

  • Mammograms every 2 years for women aged 40-74 at average risk

  • Guidelines for cervical cancer: Pap tests and HPV testing recommendations for various age groups

Colorectal Cancer Prevention

• Recommendations include:

  • Screening colonoscopies

  • Lifestyle upkeep (healthy weight and diet)

• Updated screening age to 45 years due to increased incidence in younger populations

Colorectal Cancer Screening Guidelines

• Screening recommendations:

  • Adults aged 45-75 should all be screened

  • Various recommended tests with differing procedures and frequencies

  • Discussion with patients about testing options based on personal health status and preferences

Prostate Cancer Prevention

• Strategies:

  • Low-fat diet, fruits and vegetables, maintain healthy weight

  • Exercise, consume green tea, and manage prostate infection/inflammation

Prostate Cancer Screening Recommended Practices

• PSA test to measure prostate substance levels

• DRE not recommended for routine screening due to insufficient evidence of benefits