NASE News

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