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Managing Chronic Illnesses
In recent years, dire reports about the human and financial costs of chronic
illness have spilled over from medical journals to the pages of newspapers and
consumer magazines. The headlines are grim, the stories full of astonishing
numbers about the prevalence and expense of these diseases.
But what are
chronic illnesses?
Think of the leading causes of death and disability:
- Coronary heart disease
- High blood pressure (hypertension)
- Kidney disease
- Cancer
- Diabetes
- Arthritis
All are considered chronic illnesses – health problems
that last indefinitely and may not be completely curable, although they can be
managed.
Multiple sclerosis, lupus, sickle-cell anemia, asthma and some
mental disorders are considered chronic diseases. Incurable infections such as
HIV/AIDS and hepatitis C also qualify.
And some experts call obesity a
chronic illness because of its well-established links with diabetes, kidney
disease, certain cancers and other maladies.
Finding out that you have a
chronic disease is stressful – but millions of Americans are learning how to
take charge of their condition and maintain a high quality of life nonetheless.
This article will show you ways to prevent chronic illnesses and manage
your health if you do receive a diagnosis.
Chronic Diseases Are On
The Rise
The incidence of many preventable chronic illnesses has
increased in recent decades.
- Kidney disease. It’s on the upswing, say researchers, now affecting
about 13 percent of Americans. Much of the increase is thought to be due to
increases in diabetes, high blood pressure and obesity, as well as the aging of
the population.
- Obesity. More than 64 percent of U.S. residents are now overweight or
obese, say the latest figures from the National Health and Nutrition Examination
Survey (NHANES).
- Diabetes. A 2003 document from the U.S. Centers for Disease Control
and Prevention (CDC), “The Burden of Chronic Disease and the Future of Public
Health,” calls the incidence of diabetes “an epidemic that parallels . . . the
epidemic in obesity.” Cases of diabetes have gone up 50 percent to 60 percent
overall since 1990 and 70 percent to 80 percent in people in their 20s and 30s.
- High-blood pressure. Also known as hypertension, it has increased
substantially, NHANES finds. Older people, non-Hispanic blacks and women are
especially susceptible. It’s likely that much of the increase in hypertension is
due to the obesity rate.
One exception is coronary heart disease,
which – although still the leading cause of death in the U.S. – has gone down
significantly since the mid-1960s. However, the CDC reports that many more cases
could be prevented.
Chronic Illnesses Are Costly
The costs of
chronic diseases aren’t merely personal. They affect not only individuals, but
also employers, insurers, health care providers, communities and governments.
In a 2007 Boston Globe article, a prominent diabetes expert called
chronic illness “the driver behind the rising cost of health care.”
The
numbers paint a dramatic picture: Chronic diseases account for three-quarters of
the $1.7 trillion spent annually on health care in the U. S., reports the World
Health Organization (WHO).
And in 2003, lost-productivity costs due to
chronic illness exceeded $1 trillion, as documented in the Milken Institute’s
2007 publication “An Unhealthy America.”
The American Institute of
Preventative Medicine indicates that the average health care cost per employee
was $3,900 in 1997 – and was projected to double by 2007.
Among those
who have been diagnosed with a chronic illness, 45 percent said their medical
expenses are a financial burden, and 89 percent said they’ve had trouble getting
adequate health insurance, a 2003 Harris survey found.
Among those who
do have health insurance, more than one in five said not all the care they need
is covered.
But economic hardship isn’t the only impact of chronic
illnesses.
Such health problems often cause pain, fatigue, stress,
reduced capabilities, social withdrawal and depression, experts say. The
emotional impact – and the burden of care – affects not only individuals, but
also their families, friends and employers.
Stopping The Spread Of
Chronic Disease
What can you do to halt the increase of chronic
illnesses? Plenty.
In fact, many chronic illnesses are preventable.
A 2007 speech by an official of WHO notes that “at least 80 percent of
premature heart disease, stroke, respiratory diseases and diabetes, and 40
percent of cancer could be prevented through healthy diet, regular physical
activity, and avoidance of tobacco products and harmful use of alcohol.”
Here’s an eye-opening example from a CDC presentation: a 50-year-old
nonsmoking man who exercises regularly and is not overweight has an 11 percent
chance of having heart disease, a stroke or diabetes by age 65. His counterpart
of the same age who smokes and is obese and sedentary has a 58 percent chance of
developing those diseases in the same time frame.
Prevention efforts and
lifestyle changes clearly work to head off chronic diseases.
Learn To
Manage Chronic Disease
The most significant step to managing a chronic
illness is taking responsibility for your health – by learning as much as
possible about the condition, working closely with your physician, and doing
what you can for yourself. That may include taking prescribed medication, eating
better, stopping smoking, exercising and taking steps to relieve stress.
Think of your doctor as a health care partner, not an all-knowing figure
who hands down advice. Work closely with her, asking questions and keeping her
apprised of changes in your symptoms.
Take notes during visits and
discuss the pros and cons of treatment options. Don’t be shy about expressing
opinions on how your care should proceed.
Honestly assess your lifestyle
and set goals for changes you’d like to make. Specific, achievable goals might
include:
- Losing 10 pounds over the next three months
- Eating an additional serving of vegetables every day
- Walking 20 minutes during your lunch hour
Talk over your
goals with your physician so she can support your efforts.
Seek help
from family and friends, online forums, disease-specific support groups or a
therapist, counselor or religious adviser.
Remember that you’re not
helpless, and no matter what your health problems, you can make changes for the
better.
Help Employees Manage Chronic Illnesses
Be
supportive; don’t blame employees for their health problems even if they might
have been prevented.
Understand that receiving a diagnosis of chronic
illness can cause a range of emotional reactions, including shock, anger, fear
and depression. Try to see employees as people who happen to have medical
problems; don’t define them by their illness or by what they can’t do.
Do as much as possible to help employees prevent disease. Talk with
community organizations such as the YMCA, local hospitals and public-health
agencies to see what services are available. Take part in health fairs,
stop-smoking events, and free and inexpensive health screenings.
Turn
your office into a healthier place by making it smoke-free, giving employees
time for exercise breaks, and encouraging healthy nutritional choices during
meetings accompanied by food.
If you have the space, set up a treadmill
for employee use and give small incentives for those who log, say, three
20-minute sessions each week.
Lead by example: Your efforts to take
charge of your own health can have a positive influence on employees.
Prevention Efforts Can Improve Your Small Business
The
immediate payoff of improving your own health and that of employees is greater
productivity and less lost time.
Employee-wellness programs can deliver
big long-term benefits by helping workers take charge of their health and
perhaps avoid illness and lost time on the job. A side effect is improved
employee morale and loyalty.
Fortunately, some disease-prevention
efforts can be provided at low or no cost.
For example, the American
Cancer Society works with employers to help them offer programs to encourage
physical activity, early screening tests and stopping smoking. The society’s Web
site,
www.acsworkplacesolutions.com, provides reliable health
information for employees.
Smoking-cessation programs in particular can
offer big benefits. Smoking, says the CDC, is the No. 1 preventable cause of
death in America. The agency adds that every smoking employee costs employers an
average of $1,300 per year in expenses related to illness, lost time, workers’
compensation payments, accidents, fires and property damage.
The
American Cancer Society reports that the average smoker loses five times as many
work days as a nonsmoker as a result of breaks and sick days.
Another
successful intervention is helping employees lose weight. The American
Association of Occupational Health Nurses Inc. indicates that almost half of
those who participated in workplace weight-loss programs succeeded in attaining
and maintaining their goals. Even losses as little as 10 pounds can have
significant health benefits.
Helping employees get a handle on healthy
lifestyles – with even small changes – can benefit not only them, but your
business, too.
For More Information
Learn more about
managing and preventing chronic illnesses at these government-sponsored Web
sites.
CDC’s Chronic Disease Prevention homepage
Research and
detailed information on prevention
www.cdc.gov/nccdphp/index.htm
MedlinePlus
An
extensive guide to health conditions, medicines, providers and more, from the
U.S. National Library of Medicine and the National Institutes of Health
www.nlm.nih.gov/medlineplus
Next Steps After Your
Diagnosis
Information and support, available in English and Spanish, from
the U.S. Department of Health & Human Services’ Agency for Healthcare
Research and Quality
www.ahrq.gov/consumer/diaginfo.htm
Healthcare.gov
Accurate information on disease prevention, nutrition, physical activity,
stop-smoking programs and more
www.healthcare.gov