CHRONIC DISEASES IN INDIA

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CHRONIC DISEASES IN INDIA CROSS CUTTING ISSUES
POVERTY,ENVIRONMENT GENDER
BY DR. K.L.SHARMA INDIAN GERONTOLOGICAL
ASSOCIATION, JAIPUR
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MODIFABLE RISK FACTORS FOR NON-COMMUNICABLE
DISEASES

• GENERAL ENVIRONMENTAL EXPOSURES
• Physical Environment
• Ambient air quality , Water quality
• Occupational and work site
• Food safety and availability

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MODIFABLE RISK FACTORS FOR NON-COMMUNICABLE
DISEASES

• Social Environment
• Income
• Cognitive Education
• Cultural Education
• Access to Health Services
• Availability of Public Health and Community
  Services

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MODIFABLE RISK FACTORS FOR NON-COMMUNICABLE
DISEASES

• Personal Environmental Exposures
• Smoking ( and tobacco use)
• Nutrition and Obesity
• Dietary Intake, Micronutrient adequacy and
  Caloric balance
• Physical Activity, Alcohol/ Drug Abuse
• Genetic endowment, monogenetic,
  gene-environment interaction

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What Are Chronic Diseases?

• Chronic diseases are non communicable illnesses
  that are prolonged in duration, do not resolve
  spontaneously, and are rarely cured completely.
• Examples of chronic diseases include heart
  disease, cancer, stroke, diabetes, and arthritis.

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Key Chronic Diseases The Facts

• Heart disease and stroke are the first and third
  leading causes of death, accounting for more than
  30 of all U.S. deaths each year. 
• Cancer, the second leading cause of death, claims
  more than half a million lives each year. 
• Diabetes is the leading cause of kidney failure,
  non traumatic lower extremity amputations, and
  new cases of blindness each year among U.S.
  adults aged 2074 years. 
• Arthritis, the most common cause of disability,
  limits activity for 19 million U.S. adults. 
• Obesity has become a major health concern for
  people of all ages. 1 in every 3 adults and
  nearly 1 in every 5 young people aged 619 are
  obese.

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CHRONIC DISEASES SOME FACTS

• Chronic diseases cause 7 in 10 deaths each year
  in the United States. 
• About 133 million Americansnearly 1 in 2
  adultslive with at least one chronic illness. 
• More than 75 of health care costs are due to
  chronic conditions. 
• Approximately one-fourth of persons living with a
  chronic illness experience significant
  limitations in daily activities. 
• The percentage of U.S. children and adolescents
  with a chronic health condition has increased
  from 1.8 in the 1960s to more than 7 in 2004.

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CHRONIC DISEASES SOME FACTS

• Chronic diseasessuch as heart disease, cancer,
  and diabetesare the leading causes of death and
  disability.
• These diseases also cause major limitations in
  daily living.

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Chronic Diseases Leading to deaths
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CHRONIC DISEASES
Distribution in Indian elderly(n1000)
India   Rural   Rural   Urban   Urban  
Chronic Disease Chronic Disease M F M F
Cough   250 195 179 142
Piles   33 16 32 18
Joint Problems Joint Problems 363 404 285 393
High/low BP High/low BP 108 105 200 251
Heart Disease Heart Disease 34 27 68 53
Urinary Problem Urinary Problem 38 23 49 24
Diabetes   36 28 85 66
Cancer   2 3 2 4
Any of the above Any of the above 527 514 528 560
National Sample Survey 52nd Round Survey, 1995-96
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Distribution of Physical Disability in
Aged (n1000)
India   Rural   Rural   Urban   Urban  
           
Disability   M F M F
Visual   249 291 225 260
Hearing   139 156 111 132
Speech   32 38 29 3
Locomotor Locomotor 107 115 80 94
Amnesia/Senility Amnesia/Senility 96 113 61 80
Any Disability Any Disability 380 425 333 367
National Sample Survey 52nd Round Survey, 1995-96
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Estimated Cost of major CD S
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HEALTH PROMOTION DISEASE PREVENTION

• DEFINITION
• Health promotion activities are those
  activities in which an individual is able to
  practically engage, in order to advance or
  improve his or her health.

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Health Promotion

• Three levels of health promotion activities
• Primary Prevention
• Activities are designed to completely prevent
  a disease.
• Example Immunization against Pneumonia or
  Influenza
• Secondary Prevention
• Early detection and management of diseases.
• Example Colonoscopy to detect small
  cancerous polyps
• Tertiary Prevention
• To manage clinical diseases in order to
  prevent them from progressing or to avoid
  complications of the disease.
• Example Use of beta blockers to help
  remodel the heart in
• congestive heart failure.

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AREAS OF HEALTH PROMOTION

• The need to focus on the following areas in
  order to promote health and prevent disabilities
  in the elderly client
• 1. Physical activities
• 2. Nutrition
• 3. Tobacco use
• 4. Safety
• 5. Immunization

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Activities of Daily living and Health
Promotion

• Independence in activities of daily living is
  an important goal for health promoting
  activities.
• Preventing Strategies in lessening disabilities
  
• 1.)Smoke Cession 2.)
  Immunization
• 3.)Physical activity
  4.)Weight control
• 5.)Blood pressure control 6.)Arthritis
• 7.)Diabetes self management program

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SELF MANAGEMENT OF CHRONIC DISEASES (CDSMP)

• CDSMP Of Kate Loring (M.D.) was supported by
  Agency for Health Care Research and Quality
  (AHRQ).
• It is a 17 hours. course for patients with
  chronic diseases that is taught by lay peoples.

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CHRONIC DISEASE SELF MANAGEMENT PROGRAMME

• The course aims at
• To teach patients to improve symptom management.
• To maintain functional ability.
• To adhere to medical regiment.
• HOW TO JUDGE THE EFFECTIVENESS OF THE
  PROGRAMME ?
• BY THE IMPROVED SELF EFFICACY OF CLIENTS WHO
  PARTICIPATE IN THE PROGRAMME.

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CHRONIC DISEASE SELF MANAGEMENT PROGRAMME

• WHAT IS THE DIFFERENCE BETWEEN SELF MANAGEMENT
  PROGRAMME AND HEALTH PROFESSIONALS GOAL ?
• THE GOAL AND CONCERNS ARE DIFFERENT
• FIVE ELEMENTS OF SELF MANAGEMENT PROGRAMME
• PROBLEM SOLVING
• DECISION MAKING
• RESOURCE UTILIZATION
• FORMING A HEALTH CARE PROFESSIONAL / CLIENT
  PARTNERSHIP
• TAKING ACTION

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