Transcript Historical Context of Wellness Paradigm

WELLCOME
926.03 Advanced Interventions
Wellness & Prevention
Dr. Paul F. Granello, PhD LPCC
Status of Healthcare in U.S.
• Spending 2.16 trillion a year
– Less then 1% on prevention of disease
• 2002 our healthcare spending was 15.2% of our total GDP
• Medical premiums rose an average of 14% in 2002 (Hays
2002)
• Prescription drug expenditures increased 17% in from 1990 to
2000 and continue to rise
3 Leading Causes of Death
United States 1900
1. Pneumonia
2. Tuberculosis
3. Enteritis, Colitis
Americans Died of Infectious Diseases
Leading Causes of Death
United States 2004
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Heart disease: 654,092
Cancer: 550,270
Stroke (cerebrovascular diseases): 150,147
Chronic lower respiratory diseases: 123,884
Accidents (unintentional injuries): 108,694
Diabetes: 72,815
Alzheimer's disease: 65,829
Influenza/Pneumonia: 61,472
Nephritis: 42,762
Septicemia: 33,464
Prevalence of Obesity* among U.S. Adults
BRFSS, 1991
(*Approximately 30 pounds overweight)
<10%
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
10% to 15%
>15%
Prevalence of Obesity* among U.S. Adults
BRFSS, 1992
<10%
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
10% to 15%
>15%
Prevalence of Obesity* among U.S. Adults
BRFSS, 1993
<10%
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
10% to 15%
>15%
Prevalence of Obesity* among U.S. Adults
BRFSS, 1994
<10%
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
10% to 15%
>15%
Prevalence of Obesity* among U.S. Adults
BRFSS, 1995
<10%
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
10% to 15%
>15%
Prevalence of Obesity* among U.S. Adults
BRFSS, 1996
<10%
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
10% to 15%
>15%
Prevalence of Obesity* among U.S. Adults
BRFSS, 1997
<10%
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
10% to 15%
>15%
Prevalence of Obesity* among U.S. Adults
BRFSS, 1998
<10%
Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.
10% to 15%
>15%
Physical Activity
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 1991-92
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 1993-94
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 1995-96
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 1997-98
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 1995
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 1999
Source: Mokdad et al., Diabetes Care 2001;24:412.
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 2000
Source: Mokdad et al., J Am Med Assoc 2001;286:10.
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 2001
Source: Mokdad et al., J Am Med Assoc 2001;286:10.
COSTS?
Dollars and Human Suffering
• 129 million U.S. adults are overweight or obese which costs this
Nation anywhere from $69 billion to $117 billion per year.
• 2000, an estimated 17 million people (6.2 percent of the population)
had diabetes, costing the U.S. approximately $132 billion.
• Heart disease and stroke - 2003 alone, 1.1 million Americans had a
heart attack. Cardiovascular diseases cost the Nation more than $300
billion each year.
• 23 million adults and 9 million children have been diagnosed with
asthma at some point within their lifetime, with costs near $14
billion per year.
What are some strategies to cope with
increased medical costs?
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Consolidate health plans
Pass costs to employees
Health Reimbursement Arrangements (HRA’s)
Wellness and Disease Management
What is health and wellness?
Health is a state of complete physical, mental, and
social well-being, and not merely the absence of
disease or infirmity. (World Health Organization)
Illness
Pathogen
Health
Wellness
Salutogen
Wellness Counseling Definition
Holism, Holistic Health, Health Promotion, Wholism, Prognostic Health,
Preventative Medicine
Wellness counseling is the science and art
of helping people change their lifestyle to
move toward a state of optimal health.
Optimal health is defined as a balance of
physical, emotional, social, spiritual, and
intellectual health.
Historical Context of
Wellness Paradigm
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Ancient Greeks - Asclepius
Cartesian Dualism yields reductionism
German Gestalt Psychology
Alfred Adler – “striving” for superiority
Abraham Maslow – Self-Actualization
H. Dunn - “High Level Wellness”
Stress and Immunity Research
Market for Alternative Medicine
Private Industry, Insurance, Government
Characteristics of A Wellness
Model
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Holistic and Integrative
Persons oriented
Developmentally all inclusive
Quality and Longevity of Life
Positive Wellness
Proactive
Cross Cultural - Universal
Eclectic Approaches and Methods
Lifespan Model of Wellness
Witmer & Sweeney, 1991
LifeSpan Model of Wellness
Life Tasks
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Spirituality
Self-Regulation
Work - Leisure
Friendship
Love