Informing the Future Critical Issues in Health, Sixth Edition (2011) / Chapter Skim
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The Persistence of Chronic Diseases
The Persistence of Chronic Diseases
Pages 109-120
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From page 109... ...
Nearly one-third of adults have hypertension, more commonly known as high blood pressure. Chronic hypertension is a key risk factor for stroke, heart attack, and heart failure, among other health problems, and it accounts for about one in six adult deaths annually.
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From page 110... ...
In A PopulationBased Policy and Chronic hypertension is a key Systems Change Approach to Prevent and risk factor for stroke, heart Control Hypertension (2010) , the commitattack, and heart failure, tee reports that in today's era of tightening among other health problems, budgets, the DHDSP should shift the baland it accounts for about one ance of its hypertension efforts from healthin six adult deaths annually.
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From page 111... ...
There also is evidence that exposure to secondhand smoke -- that is, smoke from burning cigarettes, cigars, and pipe tobacco, as well as smoke exhaled by smokers -- can be damaging to nonsmokers. At the CDC's request, the IOM convened a committee to assess the evidence on the relationship between exposure to secondhand smoke and effects on the heart, as well as the evidence on how smoking bans affect rates of heart attacks.
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From page 112... ...
• Outreach and educational activities occurring leading up to • Smoking cessation assistance the ban • Evaluating components of bans • Public debate on whether to adopt the ban • Reduction in active smoking and increased smoking cessation • Smoking-cessation assistance secondary to the ban Secondhand Smoke Exposure • Variable exposures depending upon individual sources of • Exposure varies depending upon individual sources of secondhand smoke exposure (e.g., living with a smoker, secondhand-smoke exposure (e.g., possibility of controlled work in smoking environments, time in vehicles with smoke) smoke exposure at home, in cars, bars, and other areas where or existing smoking regulations in certain venues smoking is allowed after the ban)
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From page 113... ...
Further, assessment of smoking status is needed to distinguish between the effects of secondhand smoke in nonsmokers and the effects of a The bulk of studies supports ban that reduces cigarette consumption or the current consensus that supports smoking cessation in smokers. exposure to secondhand In addition, the committee finds only smoke increases the risk of sparse data on the prevalence and incidence coronary heart disease among of cardiovascular disease and heart attacks both men and women.
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From page 114... ...
In July 2010, the White House Office of National AIDS Policy, which coordinates government efforts to stem the HIV epidemic, released its National HIV/AIDS Strategy. To help guide implementation, the office asked the IOM to appoint a committee to evaluate the extent to which fed eral, state, and private health insurance policies and prac tices pose barriers to expanding HIV testing and treatment; examine the current capacity of the healthcare system to administer more HIV tests and accommodate new HIV diag noses; and identify options for overcoming existing barriers and ensuring adequate system care capacity.
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From page 115... ...
Such fragmentation, coupled with multiple funding sources with different eligibility requirements, causes many individuals to shift in and out of eligibility for HIV care. To overcome such barriers, strategies may include making eligibility criteria for public and private coverage consistent with the guidelines issued by HHS for initiating antiretroviral therapies, providing cost-sharing assistance for lower-income populations, imposing monthly and annual caps on a patient's overall out-of-pocket expenses, ending the practice of denying coverage for failure to pay for services, and eliminating annual or lifetime coverage limits for treatment.
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From page 116... ...
Viral hepatitis: A silent epidemic Affecting even more people than HIV/AIDS, chronic viral hepatitis -- hepatitis B and hepatitis C -- causes significant health problems in the United States and is responsible for about Affecting even more people 15,000 deaths each year. Yet because viral than HIV/AIDS, chronic viral hepatitis typically causes few if any obvious hepatitis -- hepatitis B and symptoms, many people do not know they hepatitis C -- causes significant are infected until they develop liver cancer health problems in the United or liver disease many years later.
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From page 117... ...
New public awareness initiatives are needed along the lines of those that succeeded in increasing recognition, prevention, and treatment of HIV/AIDS. Toward this end, the CDC can work with stakeholders to develop and evaluate innovative hepatitis B and C educational programs for healthcare and social service providers, the general public, and specific populations at higher risk of contracting viral hepatitis.
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From page 118... ...
Evaluating biomarkers for use in foods Statements about the healthfulness of foods are commonplace in the media and the marketplace; statements tout various health benefits, including reduc ing the risk of a variety of chronic diseases. It is well established that diet can raise or lower the risk of developing chronic diseases such as diabetes and heart disease, and food manufacturers want consumers to know when their foods may lower those risks.
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From page 119... ...
As the gatekeeper for entry of foods, drugs, and many other products into the marketplace, the FDA examines data and makes decisions about whether biomarkers or surrogate endpoints can be used for regulatory reviews. In recent years, the FDA's Center for Food Safety and Applied Nutrition found that it was reviewing significant numbers of applications for food health claims based on stated effects on biomarkers, and the FDA asked the IOM to convene a committee to study the evaluation process for biomarkers, focusing on biomarkers and surrogate endpoints in chronic disease.
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From page 120... ...
In the spring of 2010, the IOM held a meeting to review the state of research and clinical practice associated with chronic disease illnesses such as cancer, brain tumors, sickle cell disease, epilepsy, diabetes, and congenital heart disease in children. An IOM report on one of the world's most deadly chronic diseases, cardiovascular disease (CVD)
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