Health Promotion and Disease Prevention Chapter 3

Health Promotion and Disease Prevention Efforts to actively bring people to good health (or keep them there) and prevent disease. “ An apple a day keeps the doctor away.”

Leading Behavior-Related Causes of Death in the United States

Most Health Care in the U.S. focuses on fixing problems, not preventing them If you have advanced heart disease, lung cancer, or another serious condition, you can get the best treatment in the world. But…it’s more effective, cheaper, and less painful for everyone to get someone to quit smoking than it is to try and cure lung cancer. The United States is not as good when it comes to prevention.

The Department of Health and Human Services

The Department of Health and Human Services (HHS) National Institutes of Health (NIH) Food and Drug Administration (FDA) Centers for Disease Control and Prevention (CDC) Agency for Toxic Substances and Disease Registry (ATSDR)

The Department of Health and Human Services (HHS) Indian Health Service (IHS) Health Resources and Service Administration (HRSA) Substance Abuse and Mental Health Services Administration (SAMHSA) Agency for Healthcare Research and Quality (AHRQ)

Center for Medicare and Medicaid Services (CMS) Administration for Children and Families (ACF) Administration on Aging (AoA) The Department of Health and Human Services (HHS)

Economic Dimensions The costs and benefits of prevention programs A smoking cessation program saves quality- adjusted years of life ($1,109–$4,542) Each $1 spent on school STI/HIV programs saves $2.65 on medical and social costs Cost of 100 Pap tests saves $5,907 and 3.7 years of life (and Pap tests, though useful, are quite inefficient!) Every $1 spent on preconception care programs for women with diabetes saves $1.86 by preventing birth defects Mammograms can also save money and lives (best schedule is under debate)

Important Terms Epidemiology — Study of pattern of disease in a population Incidence — New cases of a condition that occur during a specified period of time Prevalence — The total number of people affected by a given condition at a point in time or during a period of time

Mortality rate—The incidence of death in a given population during a particular time period. It is calculated by dividing the number of deaths in a population by the total population Morbidity rate—The incidence of illness in a given population during a particular time period. It is calculated in a similar manner to mortality rate Measures of Mortality

Levels of Prevention Primary prevention Reducing exposure to a risk factor that may lead to the disease Examples –Healthy nutrition (preventing heart disease and cancer) –Regular physical activity (preventing heart disease and other diseases) –Cessation of smoking (preventing lung cancer and other diseases) –Safe sexual practices (preventing sexually transmitted infections)

Levels of Prevention Secondary prevention Early detection and prompt treatment of disease Examples –Screening tools such as mammography, Pap smears, and HPV testing (find cancer early) –Prompt use of medications after a disease is diagnosed –Lifestyle behaviors to control chronic diseases that cannot be prevented (e.g., keep diabetes, asthma under control)

Levels of Prevention Tertiary prevention Takes place once a disease has advanced Examples –Alleviating pain, providing comfort to a cancer patient –Halting progression of an illness –Limiting disability after a serious injury –Restoring function through rehabilitation after a person has had a stroke

© Photodisc The Diversity of Women The heterogeneity of women is reflected in difference of Race/ethnicity Socioeconomic status Geographic location Sexual orientation Country of origin Employment Education

The Changing Face of Women By in 5 American women will be Hispanic 1 in 14 American women will be Asian 1 in 4 American women will be over 65 years of age

The Diversity of the Population

Diversity of Motherhood Delay of marriage and family to focus on careers –New issues: fertility, parenting at older ages Teenage mothers –Issues: childbearing responsibilities, grandparents raising children Choice to not have children –Issues: pursue career and other opportunities

Diversity of Sexual Orientation Misconceptions about health needs of lesbians by health-care providers and individuals themselves Barriers to health care –Belief that routine gynecological care or contraception to protect from STIs is not needed –Homophobia from health-care providers –Lack of health insurance because lack of eligibility for lesbian partner vs. heterosexual spouse

Other Types of Diversity Incarcerated women –Drug addictions, mental health issues –Lack of regular health care Women with disabilities –Focus of less research and clinical attention –Possible physical barriers, such as inaccessible facilities or examination equipment –Possible communication barriers

10 leading risk factors account for more than 40% of the disease burden worldwide (WHO) Almost 300,000 global deaths related to childbirth— 99% in developing countries. Infectious diseases, many of them curable, are a much bigger problem in the developing world. But, chronic, “first world” diseases (heart attacks, diabetes, cancer, strokes) are also important health concerns throughout the world. Global Health Issues

The 10 Leading Causes of Death Global 1.Lower respiratory diseases 2.Diarrheal diseases 3.HIV/AIDS 4.Heart disease 5.Malaria 6.Stroke 7.Tuberculosis 8.Premature birth and low birth weight 9.Birth trauma and asphyxia 10.Infant infections United States 1.Heart disease 2.Cancer 3.Lower respiratory diseases 4.Stroke 5.Accidents 6.Alzheimer’s disease 7.Diabetes 8.Kidney diseases 9.Flu and Pneumonia 10.Suicide *Source: WHO

Another Way to Look at Health Promotion: Stages of Life 1.Adolescence 2.Young adulthood 3.Midlife 4.The senior years

Adolescence Begins with onset of puberty and continues until approximately age 17 Secondary sex characteristics/menstruation Sense of identity Peer pressure Risky behaviors—sexual relations, substance use, tattooing and piercing

Adolescence Top five causes of death for female adolescents Accidents (unintentional injuries) Cancer Assault (homicide) Suicide Heart disease

Young Adulthood (Ages 18–44) Sense of self with increased independence Risky behaviors—sexual activity, substance abuse, violence (date rape), poor nutrition, lack of exercise Top five causes of death for young adult women Unintentional injuries Homicide Cancer Suicide Heart disease

Midlife (Ages 45–64) Job advancement and establishment of productive careers Raising children, caring for elderly parents, working to keep healthy relationships Menopause Top five causes of death for women of midlife Cancer Heart disease Stroke Chronic obstructive pulmonary disease Diabetes

Senior Years (Ages 65+) Increased life expectancy for women Issues of retirement, possible loss of spouse and friends, depression, chronic conditions Top five causes of death for women of senior years Cancer Heart disease Chronic lower respiratory diseases Stroke Diabetes

Discussion/Summary What are some ways that you as an individual/class can work to promote your own health and prevent diseases? How do the needs you have as an individual/class compare to your parents? To younger siblings? To a class of similar women in the developing world?