Free Health Promotion Essay Sample

Introduction

Several common risk factors are implicated in pathogenesis of cardiovascular diseases like coronary heart disease, stroke, hypertension and diabetes, etc. These risk factors include, obesity, low level of physical activity, sedentary lifestyle, tobacco use and poor dietary practices. (Forman, Stampfer & Curhan, 2009) (Johnson, Locola & Brown, 2014) Many of these operate from the early years of life. More importantly, many of these are amenable to prevention and /or amelioration with population-based health promotion interventions. (Chomistek, Chiuve & Eliassen, 2015) (Eckel, Jakicic & Ard, 2014) (Eilat-Adar, Mete & Fretts, 2012) Further, in individuals already diagnosed with cardiovascular disorders, adoption of healthy lifestyle has the potential for reducing morbidity, preventing premature mortality and effecting significant system-wide cost savings. (Eckel, Jakicic & Ard, 2014) This work aims to review available evidence for better understanding of distribution and determinants of cardiovascular morbidity in United States. Further, it discusses the framework for a comprehensive health promotion intervention at the primary care level.

Background and literature review

Sedentary lifestyle, poor dietary practices, obesity, smoking, alcohol abuse are well known risk factors for cardiovascular morbidity and mortality. (Forman, Stampfer & Curhan, 2009) (Chomistek, Chiuve & Eliassen, 2015). The effect of risk factors increases in direct proportion to the duration of exposure and presence of multiple co-existing risk factors often has a disproportionately high cumulative effect. Studies have also shown that level of physical activity is inversely proportional to cardio vascular risk. Further, the beneficial effect of physical activity on CVD risk appears to be dose-dependent. This relation is mediated through, among other things, reduction in weight, lowering of serum lipid levels, blood pressure and decreased stress levels.
The high prevalence of cardiovascular risk factors among United States adult population is well documented. (Ogden, Carroll, & Kit, 2014) For example, just under two-thirds of American adults are at risk for hypertension, while at least one-third have elevated cholesterol levels. (Cory, Ussery-Hall &Griffin-Blake, 2010) (Johnson, Locola & Brown, et al. 2014) The lifestyle management strategy endorsed by the American Heart Association and American College of Cardiology (AHA/ACC) includes population-based health promotion as a key component of reducing burden of cardiovascular diseases. (United States Centers for Disease Control and Prevention, 2013)

Synthesis

Despite the proven value of population-based health promotion programs, attainment of synergies between health system, communities and other stakeholders at the primary care level, is typically challenging. (Villablanca, Arline & Lewis, et al., 2009) (Carson, Carr & Kohler, et al. 2014) The reasons include shortage of physicians and poor orientation of human resources, poor access, general impetus on curative services and financial constraints, etc. For sustainability purposes, positioning of health promotion as a key primary care intervention is important. Moreover, for it to be successful, health promotion programs should envision buy-in from local communities, local government authorities, education sector, non-profit organizations and other stakeholders. (Carson, Carr & Kohler, et al. 2014) Since issues and risk factors may vary from one state to another, local level of planning may be the most critical aspect impinging on acceptance and uptake of services. (Villablanca, Arline & Lewis, et al., 2009) Multi stakeholder participation in ongoing review and evaluation of intervention is also reported to be critical to the success of population based health promotion. (Carson, Carr & Kohler, 2014)

Framework for health promotion

Community-based health promotion interventions are key to reduce cardiovascular risk in a cost effective and sustainable manner. (United States Centers for Disease Control and Prevention, 2013) A comprehensive public health strategy needs to address all possible facets of the health problem. Further, a fundamental tenet of health promotion is to empower people for making informed life-style choices in order to improve and maintain their health. In addition to curative services, a comprehensive approach is required including facilitation of supportive environments; strengthening of community-level actions; skill development and reorientation of health services that improves access. (Grandes, Sanchez & Cortada, 2008)
The United States Centers for Disease Control’s framework for comprehensive public health strategy is a useful reference for guiding cardiovascular risk reduction strategy. (United States Centers for Disease Control and Prevention, 2013). The framework emphasizes five major components to be included for cardiovascular health promotion.

These will be the basis of the health promotion intervention at the community level. These are briefly underlined below:

Targeting of whole population with prioritization of vulnerable population groups and at-risk communities: e.g., communities with traditionally poor uptake of health services, immigrant population, minority groups, gender and culture-sensitive approach, etc.

Health system capacity-building at local level through APN-led trainings for paramedical and auxillary health workers and community volunteers.

Innovative means for delivering community-based health promotion: A vibrant outreach program reaching people within their communities through trained community health volunteers. Health education messages in an easy and simple language.

Data-guided on-going evaluation (formative evaluation) : Institutionalization of data analysis and use for planning.

Multi-sectoral approach and partnerships with local stakeholders: e.g., School teachers, local public health authorities, employees and students, etc. Well functioning coordination system with a system for regular meetings and discussions for trouble shooting and mid-term corrective actions.

References

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Chomistek, A.K., Chiuve, S.E., Eliassen, A.H., Mukamal, K.J., Willett, W.C. & Rimm, E.B. (2015). Healthy lifestyle in the primordial prevention of cardiovascular disease among young women. Journal of American College of Cardiology;65(1):43-51.
Cory, S., Ussery-Hall, A., Griffin-Blake, S., Easton, A., Vigeant, J. & Balluz, L. et al. (2010). Prevalence of selected risk behaviors and chronic diseases and conditions-Steps communities, United States, 2006-2007. U.S. CDC - Morbidity and Mortality Weekly Report Surveillance Summary;59(8):1-37.
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