Category Archives: Chronic disease management
Recommended Reading: Life Expectancy Gains Threatened When Older Americans Have Multiple Medical Conditions
A new study from the Johns Hopkins Bloomberg School of Public Health finds that nearly four in five older Americans are living with multiple chronic medical conditions. That’s very concerning, say the researchers, because their work shows that the more ailments a person has after retirement age, the shorter their life expectancy. The researchers say the new study is one of the first to look at the burden of multiple chronic conditions on life expectancy among the elderly and may help explain why increases in life expectancy among older Americans are slowing.
“Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States,” said Eva H. DuGoff, PhD, a researcher at the school of public health and the lead author of the new study. “The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy.”
The study found that a 75-year-old American woman with no chronic conditions will live to be an average of 92, but a 75-year-old woman with five chronic conditions will only live to an average age of 87 and a 75-year-old woman with 10 or more chronic conditions will only live to the age of 80. Women continue to live longer than men and white people live longer than black people, based on data from annual U.S. surveys.
On average, life expectancy is reduced by 1.8 years with each additional chronic condition, the researchers found. But while the first disease shaves off just a fraction of a year off life expectancy for older people, the impact grows as the diseases add up. The study is based on an analysis of the records of 1.4 million Medicare enrollees and was published in the journal Medical Care.
Other groups are also beginning to look at this issue. Healthy aging will be this year’s focus of the President’s Initiative of the Association of State and Territorial Health Officers. A year-long focus on healthy aging will begin during the association’s annual conference in September.
Read the full study.
The annual meeting of the Association of State and Territorial Health Officials (ASTHO) begins tomorrow in Orlando, Florida. Attendees at the ASTHO annual meeting head to the same sessions and listen to the same speakers over three days, which helps create a common fluency with critical public health issues. It also creates cohesion among state health officers, who often work with each other during public health crises and learn from each others’ successful approaches to dilemmas such as budget cuts and entrenched chronic disease.
>>Follow our ASTHO Annual Meeting coverage throughout the week.
Ahead of the meeting, NewPublicHealth spoke with ASTHO’s long-time executive director, Paul Jarris, MD, about the key issues participants will engage in during the 2013 ASTHO meeting.
NewPublicHealth: What are key themes at this year’s annual meeting?
Dr. Paul Jarris: There are a number of major health issues on the agenda for the conference, including an update on Healthy Babies are Worth the Wait, last year’s ASTHO presidential challenge. Together with the Health Resource Services Administration (HRSA) there’s an intention to roll out Healthy Babies learning collaboratives across the country, and we’ll be sharing successes of the initiative from the past year.
Another major area we’ll be talking about will be the reintegration of public health and health care. A lot of this work has been outgoing ASTHO president Dr. Jose Montero’s presidential challenge for the last year, and there’s been a lot of work going on, including the development of a national collaborative between public health and primary care that ASTHO is supporting. The collaborative involves more than 50 different health care and public health organizations, brought together for the purposes of improving the population’s health.
Incoming president Terry Cline will launch his Presidential Challenge, a major initiative on prescription drug abuse and misuse and overdose. There are more people who die from prescription drug overdose than from motor vehicle accidents in this country—and there’s much that can be done about it. We’ll also have the leadership from the Office of National Drug Control Policy speaking on this critical issue.
Living Well with Chronic Illness: A Call for Public Health Action is a recent report from the Institute of Medicine, requested by the Centers for Disease Control and Prevention and the Arthritis Foundation to help identify public health actions to reduce disability and improve the function and quality of life for people living with chronic illness.
Among the major findings of the report:
- All chronic illnesses hold the potential to worsen the overall health of our nation by limiting an individual’s capacity to live well.
- Evidence-based interventions aimed at preventing chronic disease (such as stopping smoking, eating better and limiting weight gain) need to be studied in people with one or more chronic illnesses to assess their effectiveness in preventing further illness.
- Enhanced collaboration among the public health, health care, and community sectors could produce better prevention and treatment outcomes for people living with chronic disease.
NewPublicHealth spoke with Robert Wallace, MD, chair of the IOM committee that developed the report. Dr. Wallace is the director of the Center on Aging at the University of Iowa College of Public Health.
NewPublicHealth: What do you think would strengthen public health actions to manage chronic disease?
Dr. Wallace: A complex question. First of all, everyone appreciates that improving the quality of life for people with chronic illness and mitigating progression is a job jointly for the health care system and the public health system. There really needs to be a lot of research. This wasn’t supposed to be a research treatise, and it’s not in the end, but what comes up all the time is–do public health interventions to prevent diseases also reach and have an impact on persons who already have a chronic illness? And that’s not quite so well known.
People with chronic illness need prevention for not only the illnesses they have and follow-on illnesses, but they need primary prevention for everything else because they’re still citizens trying to make their way in the world. And so one of the questions is: irrespective of what disease they have, we should try to get people to stop smoking or to take the fat out of their diet or get some more exercise or whatever it happens to be. So, one of the main points here then is that we need to know more about how public health interventions reach people with chronic illness and does it help them?
NPH: What benefits could be had from enhanced collaboration among public health, health care and community non-health sectors?