The Aging Population in the Twenty-First Century Statistics for Health Policy (1988) / Chapter Skim
Currently Skimming:
5 Health Promotion and Disease Prevention
5 Health Promotion and Disease Prevention
Pages 108-125
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 108... ...
. The health promotion and disease prevention approach is one of a number of possible strategies to deal with what has increasingly become a hallmark of current times: the prevalence of chronic illness and multiple chronic illnesses or functional impairments among the elderly.
|
From page 109... ...
Should public and private health insurance programs pay for health promotion and disease prevention interventions? DEFINITIONS, FEDERAL INITIATIVES, AND GOATS What is health promotion and disease prevention?
|
From page 110... ...
. Federal Initiatives Interest in health promotion and disease prevention activities nationwide, and in particular for older Americans, has been stimulated by federal initiatives.
|
From page 111... ...
A more recent federal initiative in the area of health promotion and disease prevention is the establishment in 1984 of the U.S. Preventive Services Task Force within the Public Health Service to develop recommendations for the appropriate use of preventive services in clinical settings (see U.S.
|
From page 112... ...
For the elderly population as a whole, shifting or delaying the average age of onset of particular diseases and disabilities, such as hip fracture, may make survival to old age more pleasant, as active life expectancy is increased and morbidity is shifted to the end of the life span. Preservation of personal independence and avoidance of institutionalization may also be viewed as legitimate goals of a health promotion and disease prevention strategy for the elderly, as they are so intimately related to quality of life.
|
From page 113... ...
This controversial finding is difficult to explain in view of the known adverse ejects of obesity on diabetes, hypertension, and hyperlipidemia and indicates a need for detailed evaluation of the potential protective effect of moderate overweight in old age (the two preceding paragraphs closely parallel Rowe, 1985:8283. There are several reasons for adopting a health promotion and disease prevention approach for the elderly, despite legitimate cautions.
|
From page 114... ...
The High Incidence of Chronic Disease and BInese Among the Elderly While persons of any age may have chronic disease or disability (e.g., both children and adults become deaf or blind, acquire permanent orthopedic disabilities and develop degenerative diseases requiring continuing treatment and care) , the elderly are particularly vulnerable to chronic disease and disability.
|
From page 115... ...
the effect that prospective payment systems, as exemplified by diagnosis-related groups for the elderly under Medicare, will have on the services received. The scientific basis for many of the health promotion and disease prevention activities currently in vogue is inadequate.
|
From page 116... ...
Medicare has not generally covered individuals or compensated providers of care for prevention and promotion activities. Two developments that may affect the rate at which the health promotion and disease prevention approach gains widespread acceptance are the recent dramatic growth in the number and utilization of prepaid health plans by the general public and by the elderly and the provision of coverage and rennbursement for Medicare enrollees and providers of care involved in health plans that are paid prospectively according to a fixed rate capitation formula.
|
From page 117... ...
In 1985 the Health Care Financing Administration issued regulations that encourage HMOs to enroll Medicare beneficiaries on a capitation basis (Ginsburg and Hackbarth, 1986~. DATA NEEDS This portion of the chapter discusses existing federal surveys that provide data relevant to health promotion and disease prevention for the general population and for the elderly.
|
From page 118... ...
As noted earlier, the health needs and concerns of the elderly are somewhat different from those of younger persons, because of their stage in the life cycle, their social circumstances, and the fact that the risk of particular diseases and disabilities changes with age and with the existing health and functional status of the individual. Separate health promotion and disease prevention modules (clusters of items on specific topics)
|
From page 119... ...
; primary prevention activities such as influenza and tetanus shots for the institutionalized and other immunizations and their purposes; incontinence; adverse effects of drugs; social isolation, depression, and other potentially preventable and/or remediable social and emotional conditions; the role of diet, nutrition, and exercise in the prevention or retardation of particular illnesses; and the use of preventive safety measures in the home. Both the National Health Interview Survey and the National Health and Nutrition Examination Surveys would be good vehicles for health promotion and disease prevention items and modules for the general population and for the elderly.
|
From page 120... ...
that successful modules be incorporated in population-based surveys such as the National Health Interview Survey and the National Health and Nutrition Examination Survey, or as supplements to them. Development of these modules will require cooperation and coordination of effort by several agencies, including the Office of Health Promotion and Disease Prevention, the National Center for Health Services Research and Health Care Technology, the National Center for Health Statistics, and institutes within the National Institutes of Health.
|
From page 121... ...
A major drawback to fully exploiting the potential influence of physicians in health promotion and disease prevention among their patients has been the paucity of data on the extent to which physicians currently do engage in prevention activities. Such activities might include screening examinations and inoculations, discussion and counseling, and therapeutic measures and follow-up where effi cacy measures have been scientifically and clinically established.
|
From page 122... ...
develop questions pertaining to the health promotion and disease prevention practices of health care providers that include categories with special relevance for the elderly to be used in providerbased surveys and that (b) these questions be included in the National Ambulatory Medical Care Survey to obtain information on physician-patient encounters.
|
From page 123... ...
Furthermore, health promotion and disease prevention services are also provided in a variety of nonmedical settings, including physical fitness centers and senior centers by professional, paraprofessional, and nonprofessional support personnel. Comprehensive information on the numbers of professionals and allied health personnel who provide health promotion and disease prevention services to the elderly in a variety of settings does not exist.
|
From page 124... ...
The Office of Disease Prevention and Health Promotion within the Department's Public Health Service also does not routinely collect data on the numbers of health personnel involved in health promotion and disease prevention services to the elderly or on their training in this area. The panel believes such information is important to determine whether there is need for additional trained personnel and training programs for health promotion and disease prevention among the elderly.
|
From page 125... ...
HEALTH PROMOTION AND DISEASE PREVENTION of medical and nonmedical, and institutional and noninstitutional, settings. Estimates of the numbers of such personnel and their health promotion and disease prevention activities should be ascertained.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.