Introduction
Any circulatory ailment that interferes with the heart's regular operation is referred to as heart disease. Some of these disorders may cause blood arteries to constrict or become blocked, which can result in angina, a heart attack, or a stroke. Other disorders that are also regarded as cardiac ailments affect the muscles, valves, and rhythm of the heart. As the top cause of death in the US, heart disease and stroke are significant community health issues (Murphy, Kochanek, Xu & Arias E, 2014). Additionally, due to their geographical distribution, heart-related illnesses are most prevalent in the US. Furthermore, these conditions cost a considerable amount in terms of financial resources. In fact, according to Healthy People 2020 website, the two aforementioned conditions cost the nation approximately $320 million per year (Mozaffarian et al., 2016). This lays a heavy burden on the nation's annual budget as compared to other health conditions.
Impact on Quality of Life and Economy
Apart from the direct quantifiable financial costs, heart disease and stroke also lead to a decreased quality of life by the affected, and sometimes even disability. This combination of factors leads to a great dent in the American economy in terms of lost revenues from workers who are forced into retirement by these conditions. All these concerns make the issue of dealing with these sicknesses urgent and of significant importance to the American government and even the American citizen.
Prevalence and Risk Factors
Cardiovascular events are so prevalent among adults in the US to the extent that more than 1 out of every 3 American adults are affected (Yoon, Fryar & Carroll, 2014). Unfortunately, however, among those affected, just approximately 50% of them have the condition under control. Obesity, one of the leading causes of most cardiovascular conditions, affects as many Americans as these heart conditions. Other causes of heart illnesses include the lack of regular exercise, high blood pressure, poor eating habits, increased cholesterol concentrations, and the habit of smoking. The distribution of heart disease and stroke in terms of age, gender, race, geographical location, and socioeconomic status is highly irregular and disproportional. The aim of this paper is to examine the risk factors as well as the health enhancing factors connected with heart disease and stroke, as well as the various interventions that have been put in place to combat this condition.
Risk Factors and Health Behaviours
There are many health risk factors that contribute to the development of most cardiovascular conditions including heart disease and stroke. On the flipside, many factors can either be possessed or developed to enhance the health of individuals and hinder the development of these conditions. These factors have been highlighted below.
Risk Factors
The issue of heart disease and stroke is complicated by the fact that a combination of factors may contribute to its deterioration. For instance, the deposition of cholesterol on the walls of blood vessels leads to atherosclerosis, which in turn leads to high blood pressure due to the reduced cross-sectional area for the blood to flow though (Page, 2001). Additionally, the blocking of the arteries supplying blood to the heart leads to decreased blood flows to these muscles and hence heart failure. Similarly, being overweight or obese has a high correlation with other conditions like high blood cholesterol, high blood pressure, and even diabetes, which all contribute to the increased probability of developing heart disease and stroke. Obesity, on the other hand, comes about due to the lack of physical activity, often in combination with unhealthy eating habits. The American society is particularly notorious in engaging in unhealthy lifestyles, especially concerning eating habits. After eating fast foods high in calories and failing to exercise, all these calories are converted into fat which is stored within the body, often deposited along the linings of blood vessels. Cigarette smoking is a habit that has been determined to increase the potential heart disease conditions and stroke. Smoking has been established to cause an increase in blood pressure, decrease in exercise tolerance as well as fasten the blood clotting process (Dinas, Koutedakis & Flouris, 2013). Atherosclerosis is also hastened by cigarette smoking. Most of the risk factors mentioned above are highly interconnected in an intricate web or chain. However, one may develop or increase the effects of one of them at any given time. For this reason, any factor among cigarette smoking, hypertension, high cholesterol, diabetes, poor eating habits, lack of exercises, and overweight/obesity can spell the danger of the development of heart malady or stroke.
Health Enhancing Factors
Just like engaging in some particular activities or possessing some inherent characteristics may indicate a high probability of having heart disease and stroke, some particular activities and characteristics reduce the probability of heart disease and stroke. As has been mentioned above, however, less than half of the patients suffering from heart conditions have these factors under control.Cigarette smoking is the biggest avertible cause of early demise in the United States. This habit is highly under the deliberate action of the smoker, and thus the cessation of smoking should be highly encouraged. Furthermore, most Americans have total control over what to eat. However, they deliberately choose unhealthy diets which put them at higher risks of cardiovascular incidences. The decision not to engage in physical activity even after the intake of a lot of cholesterol due to the poor dieting habits is squarely under the control of most Americans, most of them choose to be inactive, however. Increased physical activity is a step in the right direction towards the fight against heart conditions and stroke. High blood pressure and diabetes may be hard to control, but nonetheless, manageable. The above discussion indicated that there is a great challenge facing the American population concerning the control of cardiovascular disease through the manipulation of factors that can highly enhance the conquering of these heart conditions. The fact that most of the health enhancing factors are under the total control of the at-risk population is what makes the Healthy People 2020 initiative to highly focus on them. According to Healthy People 2020, the risk that the American citizen faces of developing and maybe dying from heart diseases, stroke, or any other cardiovascular disease can be highly reduced in case more efforts are put into the control of Americans’ diet and physical activity. Furthermore, efforts should be put in controlling high blood pressure, cholesterol, diabetes, and Americans encouraged to quit smoking.
Healthy People 2020 Aims and Commitments
Healthy People 2020 is an initiative by multiple organizations and individuals aimed towards the achievement of longer, more fulfilling healthy lives by all Americans (Healthy People 2020, 2017). This initiative was officially launched in 2010 and thus aimed to work for the next 10 years to meet this objective. The scientific data that Healthy People 2020 operates on, however, is informed by three decades of research and monitoring of progress in the public health sector. These data is helpful in terms of encouraging collaborations in multiple facets of society and different sectors and individuals. Moreover, Healthy People 2020 aims at influencing Americans towards making more informed health decisions. The Healthy People 2020 initiative also constantly assesses the impact of preventive measures in order to gauge their performance. Healthy People 2020 aims at increasing the quantity and quality of life enjoyed by Americans, and for this reason, their vision is a society where all people live long, healthy lives. The main objectives of the programme, as indicated on their website, include: ensuring that the American citizen attains a high quality, extended lifespan free of preventable diseases, injuries, disability, and early death (Healthy People 2020, 2017). As the benefits in the health sector are unequally distributed, the Healthy People 2020 initiative aims at levelling the playing ground and ensuring health equity. The initiative aims at eliminating disparities in the health sector and ensuring the health of all groups indiscriminately. The initiative also aims at the development of social and physical environments that promote and encourage the good health for all American citizens. Most of the preventable conditions that affect most Americans occur mainly due to choices and lifestyles which may have been encountered in earlier life stages. For this reason, Healthy People 2020 aims at encouraging healthy development and healthy choices across all life stages.Narrowing down to the issue on heart disease and stroke, the Healthy People 2020 aims at achieving the following. Top on the list is the increasing of the overall cardiovascular health of the US population (Healthy People 2020, 2017). Next, the initiative aims at reducing deaths emanating from coronary heart disease and strokes. Furthermore, the Healthy People 2020 initiative also has the objective of increasing the population of US citizens who regularly get their blood sugar checked, thus in every 2 years they could be able to monitor their blood pressure levels and indicate whether it is normal or high (Healthy People 2020, 2017). The other main objectives are to ensure that the population of individuals who have their cholesterol levels high, hypertension, diabetes, or are obese is reduced.
Interventions Aimed towards the Deterrence of Heart Disease and Stroke
In line with the Healthy People 2020 objectives, many interventions have been put in place to alleviate the heart disease and stroke problem in the US population. Two of these interventions are the engagement of community health workers and the application of self-measured blood pressure monitoring practices, as discussed below.
Engaging Community Health Workers
The first intervention involves the engagement of community health workers to educate the masses about proper actions and behaviour that promote longevity of live and minimise the possibility of premature death due to heart disease and stroke. The community health specialists have devised different models to engage the American population on the prevention of cardiovascular disease (CVD). Some of these models include screening and health education, enrolment, community outreach, and information (Community Preventive Services Task Force, 2016). Others are team-based attention, patient navigation, and community organization. Community health workers screen potentially high risk populations for cholesterol, blood pressure, and BMI. They support affected individuals in making decisions regarding involvement in physical activities, cessation of smoking, as well as provide information on self-management methods in a bid to lower the risk of CVD (Katigbak, Van, Islam & Trinh, 2015). These community health experts also act as proxies between the community and the health organizations. They do so by helping individuals who are in need of medical services apply for these services and follow up on their treatment, including by conducting home visits and appointment reminders.The community health workers target group is mainly that population that is at an increased risk of CVD. Minority and underserved communities are also another target group that this community health initiative intends to serve. In fact, the intervention by these community health workers has been observed to better health and reduce disparities in the health sector when implemented in these underserved communities. The community health workers are often drawn from the community into which they are to serve. Their understanding of the community in which they serve puts them in a privileged position to provide culturally appropriate information and health education. According to evidence collected by the Healthy People 2020, the community health initiative has been very effective in improving the conditions of vulnerable patients.
Self-Measured Blood Pressure Monitoring Interventions
This is the other intervention worth noting in this article, for better blood pressure control. This tool, used collectively with other supporting technologies, has been noted by the Healthy People 2020 initiative as being extremely effective. It involves CVD patients undergoing training on the use of blood pressure self-measurement devices at familiar locations, usually their homes. The results of their tests can then either be shared with the physician on the next clinic visit or electronically, usually instantly (Community Preventive Services Task Force, 2017). With regular blood pressure measurements, the physician can effectively apply this data in treatment decisions.The target population of this intervention is mainly affected patients and high risk individuals. As mentioned earlier in this text, heart disease and stroke cost the American citizen a significant amount in terms of finances. Uhlig, Patel, Ip, Kitsios & Balk (2013) confirm on the effectiveness of self-monitoring of blood pressure. Furthermore, the use of blood pressure self-measurement techniques supported by other technologies has been identified by the Healthy People 2020 programme as contributing immensely towards the reduction in costs associated with heart disease and stroke.
The Role of Health Educators
Health education is an important aspect in dealing with CVD as most of these diseases are preventable. Thus, health educators play a very crucial role in alleviating the CVD problem. The National Commission for Health Education Credentialing (NCHEC) has outlined 7 areas of tasks and proficiencies that any HE specialist requires to take care of and possess respectively. These are evaluating the prerequisites, assets, and capability for health education, forecasting for health education, executing of health education, steering an appraisal and research-related to health education, overseeing and supervising health education, aiding as a health education reserve persons, and eventually collaborating and backing for health and health education.The interventions mentioned above were conducted in line with the seven responsibilities. For instance, in the engagement of community health workers and the implementations of the self-measured blood pressure monitoring interventions, the assessment of the needs was a necessary step. The Healthy People 2020 experts must have noticed the need for community health workers to interact with the community directly in order to achieve better health education and thus healthy lives for that section of society. The determination of the needs and assets required in order to better the health education delivered to the target population must have been reached through a thorough analysis of already available data about the community. After determining the needs and assets available for delivering health education, the next step was the planning on how these community health workers would engage in the actual education efforts on the ground. This was done through the identification of the target populations. The actual implementation of the healthcare education then follows. The actual implementation is the backbone of this entire process and thus needs to be conducted thoroughly, with checks and monitoring plans to ensure that the actual goals which were determined in the previous step are being met. The evaluation of the impact of the health care education is the basis for determining the effectiveness of a certain strategy. It is the evaluation of these impacts that led the Healthy People 2020 to arrive at the conclusions that both the engagement of community health workers and the use of self-measured blood pressure readings were effective in combating heart ailment and stroke.
Conclusion
In conclusion, heart disease and stroke account for the biggest percentage of deaths in the US today. Ironically, these conditions are amongst the most preventable in public health. The formation of the Healthy People 2020 strategy was aimed at dealing with such highly preventable diseases and premature death of most Americans. In doing so, the American citizen would be guaranteed a longer, more fulfilling and healthy live. This article dealt with the issue of heart disease and stroke, delving into some of the deliberate interventions that have been established to alleviate the issue and save the American citizen not only from premature death but also from the loss of potential revenue. The interventions discussed in this paper were the engagement of community health workers and the implementation of the self-measured blood pressure monitoring practice. The risk factors and the health enhancing factors connected to heart disease and stroke were also highlighted.
References
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