Infectious health/ wellness...Pelvic exam and pap/year 40 years and over mammogram/year rectal...

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