Chronic Diseases and Health Care: New Trends in Diabetes, Arthritis, Osteoporosis, Fibromyalgia, Low Back Pain, Cardiovascular Disease, and Cancer

380 Pages·2006·3.18 MB·English

by  Stephen J. Morewitz (auth.)

Chronic Diseases and Health Care
Stephen J. Morewitz
Chronic Diseases and
Health Care:
New Trends in Diabetes, Arthritis,
Osteoporosis, Fibromyalgia, Low
Back Pain, Cardiovascular Disease,
and Cancer
Stephen J. Morewitz
[email protected]
Library of Congress Control Number: 2005932043
ISBN-10: 0-387-28778-7 e-ISBN 0-387-28779-5
ISBN-13: 978-0387-28778-2
Printed on acid-free paper.
© 2006 Springer Science+Business Media, Inc.
All rights reserved. This work may not be translated or copied in whole or in part without
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Preface
CHRONIC DISEASES AND HEALTH CARE: New Patterns of
Diabetes, Arthritis, Osteoporosis, Fibromyalgia, Low Back Pain,
Cardiovascular Disease, and Cancer.
Twenty-five million Americans are victims of chronic disease,
and approximately two-thirds of all deaths each year are due to
cardiovascular disease (including stroke), cancer, and diabetes.
This book evaluates new trends in epidemiology, health care costs,
risk factors, treatment and rehabilitation outcomes, stress and
coping strategies, social support, disability, patient education, and
self-management for seven prevalent chronic diseases. Case studies
from a clinical psychologist’s private practice and the research
literature are used to clarify the issues underlying chronic diseases
and health care.
There are many questions still to be addressed in the field of
chronic disease and health care. What is the prevalence of chronic
diseases? What are the health care costs associated with these con-
ditions? What are the major risk factors and health care disparities
that contribute to the development of chronic diseases? How have
these risk factors and health care disparities changed over time?
What impact do chronic diseases have on disability, quality of life,
and health care disparities? How do individuals cope with the
stresses of chronic diseases? What are the most effective forms
of social support? What are the most effective treatments and
v
vi PREFACE
rehabilitation programs for chronic diseases? How can patient
education and self-management activities be improved to help
patients and their families better understand and treat their
conditions?
Chapter One analyzes the latest trends in the epidemiology of
the seven chronic diseases. Disparities in socioeconomic status,
race/ethnicity, gender, and age and their impact on chronic dis-
eases are stressed in this chapter. Health care planners can use these
analyses to improve primary and secondary health care prevention
activities through more effective uses of health care resources.
Chapter Two examines the latest information on health costs
that can point to a more efficient means of reducing the rising
health care costs.
In Chapter Three, Dr. Mark L. Goldstein, a clinical psycholo-
gist, uses composite case studies from his practice to illustrate the
problems that patients may have in coping with chronic diseases.
In the remaining four chapters, each of the seven chronic
diseases is evaluated in terms of five major issues. First, the latest
trends in risk factors and health care disparities associated with
each chronic condition are explored. Second, the impact of each
disease on disability, quality of life, and health care disparities are
analyzed. Third, the processes of stress, coping and social support
are described. Fourth, latest information on treatment and re-
habilitation outcomes are discussed. Finally, new trends in patient
education and self-management are presented.
Stephen J. Morewitz
January 2006
Acknowledgments
I would like to thank Mrs. Myra Kalkin Morewitz and Dr. Harry
A. Morewitz for their advice and support. I also want to thank Bill
Tucker, Public Health Editor at Springer, and Anna Tobias, Psy-
chology Associate Editor at Springer, who have been supportive as
well as thorough and thoughtful.
vii
Contents
1. Chronic Diseases: Epidemiology and Health
Care Disparities . . . . . . . . . . . . . . . . . . . . . . . . 1
Diabetes
Arthritis
Osteoporosis
Fibromyalgia
Low Back Pain
Cardiovascular Disease
Cancer
2. Health Care Costs . . . . . . . . . . . . . . . . . . . . . . 9
Diabetes
Arthritis
Osteoporosis
Fibromyalgia
Low Back Pain
Cardiovascular Diseas
Cancer
3. Living with a Chronic Disease
Mark L.Goldstein, Ph.D . . . . . . . . . . . . . . . . . . . 17
4. Diabetes Mellitus . . . . . . . . . . . . . . . . . . . . . . 25
Risk Factors and Health Care Disparities
Disability, Quality of Life, and Health Care Disparities
Stress, Coping, and Social Support
ix
x CONTENTS
Treatment and Rehabilitation Outcomes
Patient Education and Self-Management
5. Rheumatoid Arthritis, Osteoarthritis, Osteoporosis,
Fibromyalgia, and Low Back Pain . . . . . . . . . . . . . 67
Risk Factors and Health Care Disparities
Disability, Quality of Life, and Health Care Disparities
Stress, Coping, and Social Support
Treatment and Rehabilitation Outcomes
Patient Education and Self-Management
6. Cardiovascular Disease . . . . . . . . . . . . . . . . . . . 139
Risk Factors and Health Care Disparities
Disability, Quality of Life, and Health Care Disparities
Stress, Coping, and Social Support
Treatment and Rehabilitation Outcomes
Patient Education and Self-Management
7. Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Risk Factors and Health Care Disparities
Disability, Quality of Life, and Health Care Disparities
Stress, Coping, and Social Support
Treatment and Rehabilitation Outcomes
Patient Education and Self-Management
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
1
Chronic Diseases:
Epidemiology and Health
Care Disparities
Chronic diseases, with their prolonged span of pain and suf-
fering, are a major cause of disability and death. The 25 million
Americans, who are victims of chronic diseases, are unable to work,
experience a decreased quality of life and find themselves sub-
ject to significantly increased direct and indirect medical costs. In
the United States, cardiovascular disease (including stroke), cancer,
and diabetes make up about 2/3rds of all deaths annually (Eyre, et
al., 2004; CDC, National Center for Chronic Disease Prevention and
Health Promotion, p. 1, http://www.cdc.gov/needphp/overview.
htm).
These conditions are the result ofcomplex interactions among
environmental, social, and genetic factors (Quadrilatero and
Hoffman-Goetz, 2003). Health care problems such as: smoking,
overweight,obesity, poor nutrition, sedentary lifestyles, and genet-
ics are some of the many factors associated with chronic diseases.
Racial, ethnic, gender, age, and socioeconomic disparities in
health care may be risk factors for chronic diseases and also exac-
erbate the impact of these conditions. Chronic health problems,
such as diabetes and cardiovascular disease, pose a particularly
severe burden on disadvantaged minority groups, including
1