Social, Behavioral, and Psychosocial Causes of Diseases

Analyze the development of T2D in the U. S. , and compare its development to developing countries in general. T2D is a progressive endocrine disorder characterized by abnormal secretion or action of insulin, which leads to elevated blood glucose. Over time elevated blood glucose results in damage to multiple organ systems. Data from the 2011 National Diabetes fact sheet states that 25. 8 million children and adults in the United States, or 8. 3% of the population, have diabetes. 18. 8 million People have been diagnosed while there are 7 million people who have diabetes but it is undiagnosed.

1. 9 million New cases of diabetes were diagnosed in people over age 20 in 2010 (Diabetes Statistics). In 2007, diabetes was listed as the underlying cause on 71,382 death certificates and was listed as a contributing factor on an additional 160,022 death certificates. This means that diabetes contributed to a total of 231,404 deaths. After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2. 3 times higher than what expenditures would be in the absence of diabetes.

$245 billion was the total costs of diagnosed diabetes in the United States in 2012 with $176 billion for direct medical costs and $69 billion in reduced productivity (Diabetes Statistics). While considered a disease of affluence, diabetes is now becoming increasingly prevalent in developing countries. Diabetes affects almost 6% of the world’s adult population, and accounts for approximately 5% of all global deaths, showing that it truly is a disease of global proportions. The number of deaths is expected to increase by more than 50% in the next 10 years (Friis, 2004).

Several interesting trends arise as public health professionals and epidemiologists attempt to analyze morbidity data. For example, 80% of people with diabetes worldwide live in low and middle-income countries. While the rate of obesity among these countries is lower than high income countries, it is expected that low and middle-income countries will experience the greatest increase in prevalence. This indicates that there could possibly be a causal relationship between a country’s socioeconomic status and the prevalence of diabetes.

Furthermore, the age distribution of sufferers differs greatly: most people with diabetes in low and middle-income countries are middle-aged (45-64), unlike high income countries, where most diabetic patients are elderly. Using T2D statistics, compare the rates in the U. S. to the rates in your home state. Diabetes is a serious health condition that has continued to increase in Ohio. According to 2009 state data, it is estimated that 10. 1 percent of Ohio adults have been diagnosed with diabetes. The estimated adult prevalence of diagnosed diabetes in Ohio has grown considerably since the year 2000.

If current trends continue in our state as they have nationally, 1 in 3 Ohioans will develop diabetes sometime in their lifetime, and those with diabetes will lose an average of 10 -15 years of potential life. Diabetes was the seventh leading cause of death in Ohio in 2008. In 2008, 3561 deaths were directly attributed to diabetes. However, diabetes is likely to be underreported as the underlying cause of death. Studies have found that about 35 to 40 percent of decedents with diabetes had it listed anywhere on the death certificate and about 10 to 15 percent had it listed as the underlying cause of death.

Diabetes is economically costly in Ohio. According to a 2007 report by the American Diabetes Association, diabetes cost Ohio $5. 9 billion annually, including $3. 9 billion in medical expenditures and $2 billion in reduced state productivity and premature mortality. Also in 2007 Ohio discharges with a primary diagnosis of diabetes was approximately $442 million (Ohio, 2010). In addressing community concerns, analyze the cost of treating T2D in your community. Suggest five (5) prudent steps to address the psychosocial proliferation of the disease. Provide support for your suggestion.

Northeast Ohioans are increasingly feeling the effects of diabetes as nearly 330,000 people suffer from the disease, and many others may have diabetes and not know it! It is estimated that one out of every three children born after 2000 in the United States will be directly affected by diabetes. In northeast Ohio, 330,000 children and adults have diabetes. Recent estimates project that one in three U. S. adults will have diabetes in 2050; an additional 79 million Americans are at high risk for type 2 diabetes if we don’t do something about it. The American Diabetes Association estimates the total national cost of diagnosed diabetes in the U.

S. is $245 billion (Ohio, 2010). Type 2 diabetes typically emerges in middle adulthood, a period of life where lifestyle patterns and behaviors have become firmly established and may require greater effort to change. Also, during the pre-complications phase of type 2 diabetes, and even in the early phase of complications, the patient is often asymptomatic. Driving forces that might motivate a patient to seek medical care – unpleasant symptoms and awareness and fear of a serious illness – are therefore not present to provide a sufficient level of threat and motivation to make changes.

Type 2 diabetes poses a wide range of problems for patients and their family members. These problems include pain, hospitalization, changes in lifestyle and vocation, physical disabilities, and threatened survival. Direct psychological consequences can arise from any one of these factors, making it harder for patients to treat their diabetes and live productive, enjoyable lives. Diabetes self-management can be difficult and frustrating for both patients and practitioners.

Information is needed about which barriers present the greatest obstacles for which types of patients, and from this, practical, cost-effective interventions need to be developed. Little published research exists on psychosocial issues in adolescents with type 2 diabetes because until two decades ago, diabetes diagnosed in children and adolescents was almost exclusively type 1 diabetes mellitus or insulin-dependent diabetes. In the past two decades, rates of T2D have increased, especially in adolescents from families of minority racial and ethnic groups.

Youth with T2D are most often obese, have a parent or other first-degree relative with T2D, and are of low socioeconomic status. There are a wide range of psychosocial issues important to address in the clinical management of type 2 diabetes. For some patients, these issues are serious enough to warrant active treatment by the clinician, or referral to other healthcare professionals. Some psychosocial issues have practical, patient- centered strategies to aid the busy clinician. We should not lose sight of the fact that both obesity and type 2 diabetes are preventable diseases that have major public health implications.

As a society, we need to focus on the profound social and cultural changes that have occurred in our daily lives. These involve reduced habitual activity and increased food intake. Practical preventive strategies at the societal and cultural level must be generated to reverse these trends. This may be the greatest challenge we face in tackling the current epidemic of type 2 diabetes. Propose at least six (6) steps to address T2D in your current or previous workplace environment, and recommend the one (1) you believe to be the most important.

Provide support for your recommendation. Diabetes in all its forms is costly in the working population. In 2007, the total estimated costs of diabetes were $174 billion, including $116 billion in medical expenditures and $58 billion in lost productivity. Employee health surveys in the workplace provide assessment and implementation opportunities Information from employee health surveys can be used to identify the percent of employees that have received appropriately timed type 2 diabetes screening (e. g. , blood glucose testing).

Survey information can be used not only in obtaining baseline group data on employee health but also to educate individual employees to their needs for counseling and follow-up for specific health concerns. Assessment should also include employees’ responses regarding lifestyle issues such as obesity, nutrition, and physical activity. Blood glucose testing should be carried out within the health care setting because of the need for follow-up and discussion of abnormal results. Use multifaceted employee lifestyle change participation programs.

Obesity, nutrition, and physical activity programs in the workplace are critical elements in addressing type 2 diabetes. Research suggests that the progression from pre-diabetes to type 2 diabetes can be prevented or delayed. In 2001, results from landmark clinical trials, including the Diabetes Prevention Program, showed that sustained lifestyle changes that included modest weight loss and physical activity substantially reduced progression to type 2 diabetes among adults who were at very high risk. The lifestyle intervention worked equally well for men and women and all racial/ethnic groups, and it was most effective among people aged 60 or

older. A healthy diet can help people cut their risk for type 2 diabetes The American Diabetes Association recommends that people with pre-diabetes should be counseled on lifestyle changes with goals similar to those of the DPP (Type 2 Diabetes). Offer employees on-site services such as pneumococcal vaccination and yearly flu shots. People with diabetes are almost 3 times more likely to die with influenza or pneumonia. Flu vaccines are available at little or no cost and can be easily given at the worksite.

Policies that enhance worksite lifestyle programs such as physical activity or nutrition are important in preventing and controlling diabetes. The health-related policy strategies and interventions listed for Obesity, physical activity, and nutrition include major lifestyle activities recommended to address diabetes Employee health benefits are part of an overall compensation package and affect an employee’s willingness to seek preventive services and clinical care. Including coverage of blood glucose screening at regular intervals in preventive health examinations allows early detection of pre-diabetes and type 2 diabetes.

Special clinical programs for managing diabetes care improve health outcomes (Type 2 Diabetes). Increasing evidence supports the need for workplace wellness programs and more companies than ever are implementing health and wellness strategies to reduce injuries, health care costs and long-term disability. With additional benefits such as reduced absenteeism, higher productivity, reduced use of health care benefits and increased morale and loyalty, it’s not surprising more and more employers are choosing to implement workplace wellness programs within their companies.

Employee wellness is considered a potential high return on investment for employers due to rising health care costs. In fact, research now suggests employers get an average of $3. 48 back in reduced health care costs and $5. 82 in lower absenteeism cost for every dollar spent on employee wellness (Workplace). Employers who live more healthy lifestyles have reduced sick leave, improved work performance, decrease health insurance costs, increased productivity and reduced overall costs.

Employees with more risk factors, including being overweight, smoking and having diabetes not only cost more to insure, they also pay more for health care than individuals with less risk factors. To take a stand against this startling fact, many employers are now offering some type of workplace wellness program to offset the rising costs of health care. Employee Wellness programs are the best programs in the workplace for helping to reduce type 2 diabetes. My employer takes this serious and offers up to a $1000 incentive if you meet or beat your blood pressure and glucose levels from the previous year.

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