infectious health/ wellness...pelvic exam and pap/year 40 years and over mammogram/year rectal...
TRANSCRIPT
Infectious Diseases
treating chronic
diseases
maintaing health/
wellness
What is ‘Wellness’
• Bezner (1995): “A person is described as being in a state of positive wellness if he or she:
is free from the symptoms of disease for a great part of the time;
is active and able to do what he or she wishes;
remains in a pleasant state of mind and good spirits for the most part.”
Wellness: an expanded idea of health, that includes physical, emotional, intellectual, spiritual, interpersonal/ social, and environmental wellbeing
Wellness is not just the absence of disease. It is a sense of vitality that is independent of whether or not a person has a disease.
Physical Wellness
get adequate sleep
be physically active
manage stress
wash your hands frequently
obtain all recommended immunization
eat foods that are high in fiber and low in saturated fats
read food labels
obtain all recommendedscreening tests
eat reasonable servings
protect yourselfagainst accidentsand violence
• SELF-ACCEPTANCE
• TRUST
• AUTONOMOUS/BOLD
• CAPABLE OF INTIMACY
• CREATIVE
• OPTIMISM
• SELF ESTEEM
Emotional Wellness
Self-Esteem
Develop skills in what is important to you: social skills, study skills,…
Be true to yourself
Be around people who appreciate you
Stay true to your goals and your values
Develop good communication skills and stay away from abusive relationship
Quick Write: What do you do to protect your own self-esteem?
Tell your neighbor what physical wellness and emotional wellness entail.
Develop:
an openness to new ideas,
a capacity to question and think critically,
the motivation to master new skills
a sense of humor
creativity
curiosity
Intellectual Wellness
Spiritually Wellness means …having guiding beliefs, principles, or values that give meaning and purpose in life. It involves the capacity for compassion, love, joy, and forgiveness.”
Involves developing:
good communication skills,
the capacity for intimacy,
a good support network of caring family members/ friends…”
Interpersonal Wellness
Environmental Wellness
“Increasing personal health depends on the health of the planet, starting from the food
supply to the degree of violence in the society”
Quick Write: What is ‘Wellness’?
Before the music ends, fill in the ‘Wellness Mind Map’ with as much detail as possible for each of the components of ‘Wellness.
Which of the components of „Wellness‟
is/are the strongest in you?
Share what you wrote with a neighbor
How are we doing as a nation?
The USA spends more than
$2 trillion annually on health care,
more than any other nation in the world!
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Health care is so
expensive
in the US that it is
one of the
main causes of
bankruptcy.
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Dr. David Himmelstein, Associate Professor of Medicine at
Harvard, commented: "Unless you're Bill Gates you're just one
serious illness away from bankruptcy.
Most of the medically bankrupt were average Americans who
happened to get sick.“
“Illness and medical bills caused half of the
1,458,000 personal bankruptcies in 2001, according to a study published by the journal Health Affairs.
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"The paradox is that the costliest
health system in the world performs
so poorly.
We waste one-third of every health
care dollar on insurance bureaucracy
and profits
*while two million people go bankrupt
annually
and
*we leave 45 million uninsured“
Dr. Quentin Young, 25
QW: So…How are we doing as a nation?
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Cardiovascular Diseases
• Atherosclerosis– Plaque builds up in vessels causing blockage
• Coronary Artery Disease (CAD)- Disease of the coronary arteries (the arteries that
nourish the heart)
• Hypertension– Chronically elevated blood pressure (>120/80)
• Heart attack/Stroke
– Restricted blood flow to the heart/brain
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HEART ATTACK
CHEST PAIN (SPREADS TO
NECK, SHOULDER, ARM)
ASSOCIATED WITH:
– SWEATING
– NAUSEA
– SHORTNESS OF BREATH
– DIZZINESS
SHORTNESS OF BREATH
ASSOCIATED WITH:
– TIGHTNESS IN CHEST
– FATIGUE
– DIZZINESS
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30
mi
Cardiovascular Diseases
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• Atherosclerosis– Plaque builds up in vessels causing blockage
• Coronary Artery Disease (CAD)- Disease of the coronary arteries (the arteries that
nourish the heart)
• Hypertension– Chronically elevated blood pressure (>120/80)
• Heart attack/Stroke
– Restricted blood flow to the heart/brain
NUMBNESS OR WEAKNESS
LOSS OF FUNCTIONLOSS OF SPEECH OR DIFFICULTY SPEAKING
LOSS OF VISION
DIZZINESS
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STROKE
33Stroke heroes
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Update on Biological risk factors for
cardiovascular disease:
•Diabetes
•Obesity (75% of the hypertension cases
can be attributed to obesity)
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(subtract level of HDL cholesterol from total cholesterol) Should be
no more than 30mg above the target levels for LDL cholesterol!
•Low HDL2
•Increase in Apolipoprotein B•Increase in Lipoprotein (a) (a subtype of LDL, increase is
usually determined genetically)
•Increase in Non-HDL cholesterol
•Abnormal lipids:
Impact of changes in lifestyles
• Running 31 miles/week increases the HDL by 10 points
• Stopping smoking and losing weight also increases HDL
Lifestyle Risk Factors for cardiovascular disease
Smoking, No physical activity (sedentary life style) Diet high in saturated fat, low in fiber, and high in calories
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Cancer
The strongest risk for cancer is advancing age. The older people become, the greater their chances of developing and dying of cancer.
Smoking and diet account for 2/3 of all cancer deaths in US
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CANCER
A GROUP OF DISEASES CHARACTERIZED BY
ABNORMAL AND UNCONTROLLED GROWTH OF
CELLS
IN SITUSURROUNDING
STRUCTURESMETASTASIS
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LEADING CANCER SITES:
SKINLUNG
BREASTPROSTATE
COLONCERVIX
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42How cancer develops
TO PREVENT CANCER:
STOP SMOKING CIGARETTESDON’T BREATH IN SMOKE FROM OTHERS
PROTECT YOUR SKIN FROM THE SUNEXERCISE
EAT A HIGH FIBER (especially cruciferous vegetables), LOW SATURATED FAT DIET, with NO SALT-CURED, NO SMOKED and NO NITRITE-CURED
FOODS
USE A LATEX CONDOM/HPV & Hep B IMMUNIZATIONS
SELF-EXAMS, SCREENING EXAMS43
SELF-EXAMS/SCREENING EXAMS THAT HELP IDENTIFY CANCERS EARLY
18 years and over Breast self exam/month
Testicular self-exam/month
Clinician breast exam/year
Clinician testicular exam/year
Pelvic exam and pap/year
40 years and over mammogram/year
rectal exam/year
50 years and over prostate exam/year
Colonoscopy exam/5 - 10years
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QW: What can we do to improve our healthy life expectancy?
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Share your thoughts with your neighbor.
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In our society, we deal with the
management of disease on a
personal level because we focus
on the individual’s
biology/genetics and behavior as
the cause of the disease.
We hold individuals personally responsible for
their own health…
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…when this is an issue that involves all of
society and which can only be solved
effectively by changes in the overall society.
“No epidemic has ever been resolved
by attention to the affected
individual.”Dr. George Albee
We are the only developed nation, except
South Africa, that does not provide health
care to all its people.
In 1999, 47 million people were
uninsured …
In the US, no
health insurance
means no health
care!
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In addition to not providing
health care for all our citizens,
the focus of our health care
system is on crisis intervention,
instead of prevention.
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The New York Academy of Medicine
demonstrated that if we invested in
Preventive Care in the nation, for five
years, we would save $16 billion per
year.
The study ‘Healthier California’
demonstrated that a $10 investment per
person per year in healthy behavior (increase in
physical activity, improved nutrition, prevention of tobacco use) could save the state
more than $1.7 billion in annual health
care costs.53
Finally,… for individuals to be healthy, the community needs to be healthy.
Individual and Community Health
• “Over the years, it has become clear that individual health is closely linked to community health…
• Likewise, community health is profoundly affected by the collective beliefs, attitudes, and behaviors of everyone who lives in the community.”
Healthy People 2020
A document drawn up by numerous health experts to guide us, as a nation, to make the most effective changes in our behaviors and policies by the year 2020.
2/8/10
The vision of Healthy People 2020 is to help create ‘a society in which all people live long, healthy lives’.
HEALTHY PEOPLE 2020
• Goals:
– Attain high quality, longer lives free of preventable disease, disability, injury, and premature death.
– Achieve health equity, eliminate disparities, and improve the health of all groups
– Create social and physical environments that promote good health for all
– Promote quality of life, healthy development and healthy behaviors across all life stages
Does heredity alone determine our wellness?
No!
We know that the only way to effectively improve the nation’s health,
and therefore improve the quality of health of each individual,
is to manage health issues by addressing the Determinants of Health.
Determinants of Health
The Determinants of Health are:
BiologyBehavior
Social environmentPhysical environment
Policies and interventionsAccess to quality health care
When trying to change an
individual‟s behavior we need to
focus on ‘creating environments
where the healthy choice is the
easy choice’.
Quick Write: How does addressing the Determinants
of Health help individuals stay healthier?
While ‘Healthy People’ researched which behaviors and policies promoted wellness, the Institute of Medicine (IOM) researched why we have so much disparity* in our health care system.
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*Disparity ~ inequality**.
**The World Health Organization (WHO) defines health inequities as “differences in health which are not only unnecessary and avoidable, but, in addition, are considered unfair and unjust”.
• When looking at disparity, Part of the problem is no access to health care….No insurance, No clinics in certain rural areas or parts of cities, social pathologies {i.e. racism, sexism} which prevent access to good quality of health care. If there is no access to clinicians who provide equally good education and care, some patients will develop more complications than others.
In 2002, the IOM published their findings
in the document Unequal Treatment.
Health care disparities are costly.
As discussed in the study „Unequal Treatment‟….
“The personal cost of disparities [is that it can] lead to
significant morbidity, disability, and lost productivity at the
individual level.”
“At the societal level, „distal‟ costs follow from „proximal
opportunities that were missed‟ to intervene and reduce
burden of illness.”
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Institute of Medicine findings
Disparities are found even when insurance status, stage of disease presentation, co-morbidities, age, and severity of disease are taken into account.
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This strips away the pretense
that the differences can be
explained by minorities' lack of
access to timely care.
Media response to the study by the Institute of Medicine
USA Today
“In unassailable terms, the
report found that even when
their insurance and income are
the same as those of whites,
minorities often receive fewer
tests and less sophisticated
treatment for ailments, including
heart disease, cancer, diabetes
and HIV/AIDS.”
Many sources –including health systems, health care providers, and utilization managers –contribute to racial and ethnic disparities in health care.
Institute of Medicine findings
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Recommendations made by the Institute of Medicine included:
1. Increase the proportion of underrepresented
racial and ethnic minorities among health care
providers.
2. Provide greater resources to the U.S.
Department of Health and Human Services (U.S.
DHHS) Office for Civil Rights to enforce civil rights
laws.
3. Integrate cross-cultural education into the
training of all current and future health
professionals.
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Dialogue Cards on Diversity
What determines how healthy we are?
QW: What are some of the factors
which prevent us from having one
of the best healthy life
expectancies in the world?
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QW: Share what you learned about our health
care system with your neighbor. 78