Transcript The Department of Health and Human Services (HHS)

Chapter 3
Health Promotion and Disease
Prevention
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)
The Department of Health and
Human Services (HHS)
• Center for Medicare and Medicaid
Services (CMS)
• Administration for Children and Families
(ACF)
• Administration on Aging (AoA)
Economic Dimensions
The costs and benefits of prevention programs
• A smoking cessation program saves qualityadjusted 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
Measures of Mortality
• 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
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
The Diversity of Women
The heterogeneity of women is reflected in
difference of
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Race/ethnicity
Socioeconomic status
Geographic location
Sexual orientation
Country of origin
Employment
Education
© Photodisc
The Changing Face of Women
By 2030
• 1 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
Global Health Issues
• 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.
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
*Source: WHO
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
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
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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?