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80-589: The mission of the Hippocrates centre is to improve the quality of health of disabled children from marginalized families by improving their access to high-quality medical recovery services in order to facilitate their efficient integration into society. The suffering caused by chronic conditions in children both to the children themselves and to their families has served as an incentive for founding this non-governmental, non-profit organisation for children with chronic diseases coming from socially vulnerable families, at

160-705: A sexual minority also means being disproportionately affected by multimorbidity, especially mental health conditions. Research funders in the UK, including the Medical Research Council (MRC), the Wellcome Trust and the National Institute for Health and Care Research (NIHR) have published the " Cross-funder multimorbidity research framework " which sets out a vision for the research agenda of multiple long-term conditions. The framework aims to drive advances in

240-421: A burden. This burden fluctuates and is often hidden from health and social care practitioners. For example, the burden, on the family carer, may increase if the older person is suffering from confusion or dementia . In general there are five burdens that make managing medicines challenging for older people: when the purpose of reviewing medicines is not clear to the person; when a lack of information prevents

320-405: A higher chance that their long-term conditions include mental health disorders. In England, according to research, people from deprived neighborhoods had complex multimorbidity (3 or more conditions) 7 years earlier than the least deprived. People living in deprived areas also have a higher risk of dying because of multimorbidity. Ethnic inequalities also affect who acquires multimorbidity. In

400-738: A major cause for the disparities observed in the care of chronic disease. Lack of access and delay in receiving care result in worse outcomes for patients from minorities and underserved populations. Those barriers to medical care complicate patients monitoring and continuity in treatment. In the US, minorities and low-income populations are less likely to seek, access and receive preventive services necessary to detect conditions at an early stage. The majority of US health care and economic costs associated with medical conditions are incurred by chronic diseases and conditions and associated health risk behaviors. Eighty-four percent of all health care spending in 2006

480-451: A means of improving the number of people with chronic conditions that miss medical appointments, however there is no strong evidence that these approaches make a difference. Nursing can play an important role in assisting patients with chronic diseases achieve longevity and experience wellness. Scholars point out that the current neoliberal era emphasizes self-care, in both affluent and low-income communities. This self-care focus extends to

560-502: A medication. Multimorbidity often results in taking 5 or more medicines (polypharmacy) which can represent a burden and might come with potential harm. When the medications are not effective enough or the risks outweigh the benefits, stopping medicines ( deprescribing ) might be necessary. In people with multiple long-term conditions and polypharmacy this represents a complex challenge as clinical guidelines are usually developed for single conditions. In these cases tools and guidelines like

640-710: A much larger scale in these areas. In Europe, the European Chronic Disease Alliance was formed in 2011, which represents over 100,000 healthcare workers. In the United States, there are a number of nonprofits focused on chronic conditions, including entities focused on specific diseases such as the American Diabetes Association , Alzheimer's Association , or Crohn's and Colitis Foundation . There are also broader groups focused on advocacy or research into chronic illness in general, such as

720-440: A nursing-heavy approach to the management of chronic disease. Foregrounding the problem of distance from healthcare facility, the study recommends patients increase their request for care. It uses nurses and health officers to fill, in a cost-efficient way, the large unmet need for chronic disease treatment. They led their health centers staffed by nurses and health officers; so, there are specific training required for involvement in

800-478: A person could have diabetes , heart disease and depression at the same time. Multimorbidity can have a significant impact on people's health and wellbeing. It also poses a complex challenge to healthcare systems which are traditionally focused on individual diseases. Multiple long-term conditions can affect people of any age, but they are more common in older age, affecting more than half of people over 65 years old. The concept of multiple long-term conditions

880-431: A psychosocial approach to chronic illness to aid the increasing number of individuals diagnosed with these conditions. Despite this movement, there is still criticism that chronic conditions are not being treated appropriately, and there is not enough emphasis on the behavioral aspects of chronic conditions or psychological types of support for patients. The mental health intersectionality on those with chronic conditions

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960-631: A report that estimated investing $ 10 per person annually in community-based programs of proven effectiveness and promoting healthy lifestyle (increase in physical activity, healthier diet and preventing tobacco use) could save more than $ 16 billion annually within a period of just five years. A 2017 review (updated in 2022) found that it is uncertain whether school-based policies on targeting risk factors on chronic diseases such as healthy eating policies, physical activity policies, and tobacco policies can improve student health behaviours or knowledge of staffs and students. The updated review in 2022 did determine

1040-481: A role in AIDS prevalence, only exposure is truly needed to contract this chronic disease. Communicable chronic diseases are also typically only treatable with medication intervention, rather than lifestyle change as some non-communicable chronic diseases can be treated. As of 2003, there are a few programs which aim to gain more knowledge on the epidemiology of chronic disease using data collection. The hope of these programs

1120-431: A single chronic condition. Some of the difficulties experienced by people with multiple long-term conditions include: poor coordination of medical care , managing multiple medications ( polypharmacy ), high costs associated with treatment, increases in their time spent managing illness, difficulty managing multiple illness management regimes, and aggravation of one condition by symptoms or treatment of another. There

1200-592: A slight improvement in measures of obesity and physical activity as the use of improved strategies lead to increased implementation interventions but continued to call for additional research to address questions related to alcohol use and risk. Encouraging those with chronic conditions to continue with their outpatient ( ambulatory ) medical care and attend scheduled medical appointments may help improve outcomes and reduce medical costs due to missed appointments. Finding patient-centered alternatives to doctors or consultants scheduling medical appointments has been suggested as

1280-436: A straightforward cause and effect relationship with chronic disease diagnosis. While typically higher socioeconomic status is correlated with lower occurrence of chronic disease, it is not known is there is a direct cause and effect relationship between these two variables. The epidemiology of communicable chronic diseases such as AIDS is also different from that of noncommunicable chronic disease. While Social factors do play

1360-520: A time when the Moldova is undergoing significant political and economic changes, while poverty levels have registered worrying levels. The crisis in the Moldovan healthcare system has made many specialists explore the possibility of non-pharmacological treatments, comparatively less expensive and yet relatively successful for the recovery/rehabilitation of patients with chronic conditions. The main objectives of

1440-532: A twofold increase in psychiatric disorders. Higher parental depression and other family stressors predicted more problems among patients. In addition, sibling problems along with the burden of illness on the family as a whole led to more psychological strain on the patients and their families. A growing body of evidence supports that prevention is effective in reducing the effect of chronic conditions; in particular, early detection results in less severe outcomes. Clinical preventive services include screening for

1520-452: A year to non-communicable diseases. In the United States approximately 40% of adults have at least two chronic conditions. Living with two or more chronic conditions is referred to as multimorbidity . Chronic conditions have often been used to describe the various health related states of the human body such as syndromes, physical impairments, disabilities as well as diseases. Epidemiologists have found interest in chronic conditions due to

1600-504: Is 77% higher among non-Hispanic blacks, and American Indians and Alaska Natives are 60% more likely to be obese than non-Hispanic whites. Some of this prevalence has been suggested to be in part from environmental racism . Flint, Michigan, for example, had high levels of lead poisoning in their drinkable water after waste was dumped into low-value housing areas. There are also higher rates of asthma in children who live in lower income areas due to an abundance of pollutants being released on

1680-542: Is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes , functional gastrointestinal disorder , eczema , arthritis , asthma , chronic obstructive pulmonary disease , autoimmune diseases , genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome . An illness which

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1760-437: Is a large aspect often overlooked by doctors. And chronic illness therapists are available for support to help with the mental toll of chronic illness a it is often underestimated in society. Adults with chronic illness that restrict their daily life present with more depression and lower self-esteem than healthy adults and adults with non-restricting chronic illness. The emotional influence of chronic illness also has an effect on

1840-508: Is also associated with factors that are related to socioeconomic disadvantage such as food insecurity , low level of education, living in deprived areas and having unhealthy lifestyles. There are multiple theories on how socioeconomic inequality leads to multimorbidity but so far there is a lack of scientific evidence about the exact mechanism. Some of the potential links between the two are health-related behaviours (smoking, drinking, diet), lack of access to financial resources and housing, and

1920-513: Is also more common among people from lower socioeconomic statuses . Multimorbidity is a significant issue in low‐ and middle‐income countries, although prevalence is not as high as in high income countries. Multimorbidity is "a growing public health problem worldwide", "likely driven by the ageing population but also by factors such as high body-mass index, urbanisation, and the growing burden of NCDs (such as type 2 diabetes) and tuberculosis in low- and middle-income countries (LMICs)". Around

2000-452: Is being born premature . Lifestyle factors that may increase the risk of multiple long-term conditions include obesity , poor diet, poor sleep, smoking , air pollution , alcohol ; and lifestyles factors that may reduce the risk of MLTC includes eating a healthy diet , physical activity, and strong social networks. Lower socioeconomic status , measured by a combination of education, occupation and literacy indicators, seems to increase

2080-622: Is diverse and the epidemiology of some chronic diseases can change in response to new treatments. In the treatment of HIV, the success of anti-retroviral therapies means that many patients will experience this infection as a chronic disease that for many will span several decades of their chronic life. Some epidemiology of chronic disease can apply to multiple diagnosis. Obesity and body fat distribution for example contribute and are risk factors for many chronic diseases such as diabetes, heart, and kidney disease. Other epidemiological factors, such as social, socioeconomic, and environment do not have

2160-515: Is growing recognition that living with multiple long-term conditions leads to complex and challenging burdens for people living with MLTC themselves but also health care professionals working in the health system looking after those with long-term conditions. Living with multiple-long term conditions can be burdensome in terms of managing the illness, particularly if the diagnoses results in polypharmacy (taking multiple medicines). Older people and their family carers frequently find medication management

2240-542: Is lifelong because it ends in death is a terminal illness . It is possible and not unexpected for an illness to change in definition from terminal to chronic. Diabetes and HIV for example were once terminal yet are now considered chronic due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV which allow these individuals to live while managing symptoms. In medicine , chronic conditions are distinguished from those that are acute . An acute condition typically affects one portion of

2320-444: Is not clearly defined and may be referred to by various names. Multimorbidity is often referred to as comorbidity even though the two are considered distinct clinical scenarios. Comorbidity means that one 'index' condition is the focus of attention, and others are viewed in relation to this. In contrast, multimorbidity describes someone having two or more long-term (chronic) conditions without any of them holding priority over

2400-459: Is positively associated with individuals with greater number of chronic conditions and reversely associated with socioeconomic status. People with multiple long-term conditions may have a four-fold increase in the risk of death in comparison with people without MLTC irrespective of their socioeconomic status. In some cases, specific combinations of diseases are associated with higher mortality. For example, people with long-term conditions affecting

2480-434: Is the development of combined antiviral therapies that led to remarkable improvement in survival rates and quality of life of HIV -infected patients. In addition to direct costs in health care, chronic diseases are a significant burden to the economy, through limitations in daily activities, loss in productivity and loss of days of work. A particular concern is the rising rates of overweight and obesity in all segments of

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2560-1006: Is to gather epidemiological data on various chronic diseases across the United States and demonstrate how this knowledge can be valuable in addressing chronic disease. In the United States, as of 2004 nearly one in two Americans (133 million) has at least one chronic medical condition, with most subjects (58%) between the ages of 18 and 64. The number is projected to increase by more than one percent per year by 2030, resulting in an estimated chronically ill population of 171 million. The most common chronic conditions are high blood pressure , arthritis , respiratory diseases like emphysema , and high cholesterol . Based on data from 2014 Medical Expenditure Panel Survey (MEPS), about 60% of adult Americans were estimated to have one chronic illness, with about 40% having more than one; this rate appears to be mostly unchanged from 2008. MEPS data from 1998 showed 45% of adult Americans had at least one chronic illness, and 21% had more than one. According to research by

2640-402: Is viewed and treated in society. Women's chronic health issues are often considered to be most worthy of treatment or most severe when the chronic condition interferes with a woman's fertility. Historically, there is less of a focus on a woman's chronic conditions when it interferes with other aspects of her life or well-being. Many women report feeling less than or even "half of a woman" due to

2720-479: The Beers Criteria and STOPP/START could be used safely by clinicians but not all patients might benefit from stopping their medication. Clarity about how much clinicians can do beyond the guidelines and the responsibility they need to take could help them prescribing and deprescribing for complex cases. Further factors that can help clinicians tailor their decisions to the individual are: access to detailed data on

2800-621: The CDC , chronic disease is also especially a concern in the elderly population in America. Chronic diseases like stroke, heart disease, and cancer were among the leading causes of death among Americans aged 65 or older in 2002, accounting for 61% of all deaths among this subset of the population. It is estimated that at least 80% of older Americans are currently living with some form of a chronic condition, with 50% of this population having two or more chronic conditions. The two most common chronic conditions in

2880-433: The odds of multimorbidity occurring in those with the least wealth compared to those with the most wealth. Therefore, reducing socioeconomic inequalities by improving working and living conditions and education to everyone is important to reduce the burden of multiple long-term conditions on population health . Multimorbidity is associated with reduced quality of life and increased risk of death. The risk of death

2960-736: The Hippocrates Centre are: To provide medical recovery services to children with chronic conditions by means of non-invasive, low-cost treatment methods such as physical therapy , occupational therapy , massage therapy , electrotherapy , orthotics and speech therapy ; Children from birth up to the age of 15 who have chronic neuromuscular, skeletal, cardiovascular or respiratory illnesses are treated. To provide parents and carers with educational services in regard to selection of efficient recovery and treatment methods appropriate for their child. Chronic diseases A chronic condition (also known as chronic disease or chronic illness )

3040-819: The National Association of Chronic Disease Directors, Partnership to Fight Chronic Disease, the Chronic Disease Coalition which arose in Oregon in 2015, and the Chronic Policy Care Alliance. Signs and symptoms Syndrome Disease Medical diagnosis Differential diagnosis Prognosis Acute Chronic Cure Eponymous disease Acronym or abbreviation Remission Multimorbidity Multimorbidity , also known as multiple long-term conditions ( MLTC ), means living with two or more chronic illnesses . For example,

3120-1082: The U.S. population. Obesity itself is a medical condition and not a disease, but it constitutes a major risk factor for developing chronic illnesses, such as diabetes, stroke, cardiovascular disease and cancers. Obesity results in significant health care spending and indirect costs, as illustrated by a recent study from the Texas comptroller reporting that obesity alone cost Texas businesses an extra $ 9.5 billion in 2009, including more than $ 4 billion for health care, $ 5 billion for lost productivity and absenteeism, and $ 321 million for disability. There have been recent links between social factors and prevalence as well as outcome of chronic conditions. The connection between loneliness, overall health, and chronic conditions has recently been highlighted. Some studies have shown that loneliness has detrimental health effects similar to that of smoking and obesity. One study found that feelings of isolation are associated with higher self reporting of health as poor, and feelings of loneliness increased

3200-535: The UK's National Institute for Health and Care Excellence (NICE) includes alcohol and substance misuse in their list of conditions considered to constitute multimorbidity. The most commonly used term to describe the concept is multimorbidity . However, scientific literature shows a diverse range of terms used with the same meaning. These include comorbidity , polymorbidity , polypathology , pluripathology , multipathology , multicondition . The UK's National Institute for Health and Care Research (NIHR) uses

3280-774: The United Kingdom, Indian , Pakistani , Bangladeshi , Black African , Black Caribbean people and those who identify as Black other, other Asian, and mixed ethnicity have a higher risk of developing multiple long-term conditions. In England, people from Pakistani and Bangladeshi backgrounds have the highest multimorbidity rates and they are twice as likely than people from the Chinese minority to have multimorbidity. Pakistani, Black African, Black Caribbean and other black ethnic groups in England are also significantly more likely to die due to having multiple long-term conditions. Belonging to

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3360-471: The body and responds to treatment. A chronic condition, on the other hand, usually affects multiple areas of the body, is not fully responsive to treatment, and persists for an extended period of time. Chronic conditions may have periods of remission or relapse where the disease temporarily goes away, or subsequently reappears. Periods of remission and relapse are commonly discussed when referring to substance abuse disorders which some consider to fall under

3440-516: The category of chronic condition. Chronic conditions are often associated with non-communicable diseases which are distinguished by their non-infectious causes. Some chronic conditions though, are caused by transmissible infections such as HIV/AIDS. 63% of all deaths worldwide are from chronic conditions. Chronic diseases constitute a major cause of mortality , and the World Health Organization (WHO) attributes 38 million deaths

3520-604: The chronic illness being a source of stress for the individual. A study of loneliness in adults over age 65 found that low levels of loneliness as well as high levels of familial support were associated with better outcomes of multiple chronic conditions such as hypertension and diabetes. There are some recent movements in the medical sphere to address these connections when treating patients with chronic illness. The biopsychosocial approach for example, developed in 2006 focuses on patients "patient's personality, family, culture, and health dynamics." Physicians are leaning more towards

3600-416: The co-existing conditions have similar origins or treatments the terms used is concordant multimorbidity , while discordant multimorbidity is used to refer to conditions that appear to be unrelated to each other. Definitions of multimorbidity usually differ in the minimum number of concurrent conditions they require (most often this is two or more) and in the types of conditions they consider. For example

3680-514: The development of both depression and anxiety . There are many factors which might explain why physical multi-morbidity affects mental health including chronic pain , frailty , symptom burden, functional impairment , reduced quality of life , increased levels of inflammation , and polypharmacy. Evidence from large population studies from the United Kingdom and China suggests that specific combinations of physical conditions increase

3760-566: The elderly are high blood pressure and arthritis, with diabetes, coronary heart disease, and cancer also being reported among the elder population. In examining the statistics of chronic disease among the living elderly, it is also important to make note of the statistics pertaining to fatalities as a result of chronic disease. Heart disease is the leading cause of death from chronic disease for adults older than 65, followed by cancer, stroke, diabetes, chronic lower respiratory diseases, influenza and pneumonia, and, finally, Alzheimer's disease. Though

3840-404: The existence of the disease or predisposition to its development, counseling and immunizations against infectious agents. Despite their effectiveness, the utilization of preventive services is typically lower than for regular medical services. In contrast to their apparent cost in time and money, the benefits of preventive services are not directly perceived by patient because their effects are on

3920-449: The fact they contribute to disease, disability, and diminished physical and/or mental capacity. For example, high blood pressure or hypertension is considered to be not only a chronic condition itself but also correlated with diseases such as heart attack or stroke . Additionally, some socioeconomic factors may be considered as a chronic condition as they lead to disability in daily life. An important one that public health officials in

4000-564: The four major types as: Other examples of chronic diseases and health conditions include: While risk factors vary with age and gender, many of the common chronic diseases in the US are caused by dietary, lifestyle and metabolic risk factors. Therefore, these conditions might be prevented by behavioral changes , such as quitting smoking, adopting a healthy diet, and increasing physical activity. Social determinants are important risk factors for chronic diseases. Social factors , e.g., socioeconomic status, education level, and race/ethnicity, are

4080-607: The general public. Within the medical-industrial complex , chronic illnesses can impact the relationship between pharmaceutical companies and people with chronic conditions. Life-saving drugs, or life-extending drugs, can be inflated for a profit . There is little regulation on the cost of chronic illness drugs, which suggests that abusing the lack of a drug cap can create a large market for drug revenue. Likewise, certain chronic conditions can last throughout one's lifetime and create pathways for pharmaceutical companies to take advantage of this. Gender influences how chronic disease

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4160-456: The heart, lung, and urinary systems have strong effects on mortality. There are many additional issues associated with living with multiple long term conditions. One study from the US found that having more than 3 conditions significantly increased the chance of reduced quality of life and physical functioning. The researchers called for the holistic treatment of multimorbidities due to the complexities of multiple long-term conditions. Due to

4240-433: The higher prevalence of multimorbidity (55 - 98%), a new concept of "complex multimorbidity (CMM)" has been proposed CMM differs from the definition of conventional multimorbidity in that CMM is defined by the number of body systems affected by the diseases rather than the number of diseases. CMM is associated is mortality and long-term care needs in older adults. Physical and mental health conditions can adversely impact

4320-598: The highest income. Self-management is vital in coping with multimorbidity but people living in deprivation struggle more with managing their conditions. Self-management becomes more challenging due to financial barriers, health literacy (difficulties with understanding health information) and the combined weight of multimorbidity and deprivation. Research shows that in Scotland residents of deprived areas are affected by multiple long-term conditions 10 to 15 years earlier than people living in affluent neighborhoods. They also have

4400-510: The impact of risk factors on the individual's development and functioning. People with chronic conditions pay more out-of-pocket; a study found that Americans spent $ 2,243 more on average. The financial burden can increase medication non-adherence. In some countries, laws protect patients with chronic conditions from excessive financial responsibility; for example, as of 2008 France limited copayments for those with chronic conditions, and Germany limits cost sharing to 1% of income versus 2% for

4480-535: The intellectual and educational development of the individual. For example, people living with type 1 diabetes endure a lifetime of monotonous and rigorous health care management usually involving daily blood glucose monitoring, insulin injections, and constant self-care. This type of constant attention that is required by type 1 diabetes and other chronic illness can result in psychological maladjustment. There have been several theories, namely one called diabetes resilience theory, that posit that protective processes buffer

4560-399: The likelihood of mental health disorders in individuals. The connection between chronic illness and loneliness is established, yet oftentimes ignored in treatment. One study for example found that a greater number of chronic illnesses per individual were associated with feelings of loneliness. Some of the possible reasons for this listed are an inability to maintain independence as well as

4640-580: The long term or might be greater for society as a whole than at the individual level. Therefore, public health programs are important in educating the public, and promoting healthy lifestyles and awareness about chronic diseases. While those programs can benefit from funding at different levels (state, federal, private) their implementation is mostly in charge of local agencies and community-based organizations. Studies have shown that public health programs are effective in reducing mortality rates associated to cardiovascular disease, diabetes and cancer, but

4720-459: The more useful term to use. The broad definition of multimorbidity, consistent with what is used by most researchers, the WHO and the UK's Academy of Medical Sciences is the " co-existence of two or more chronic conditions ". These can be physical non-communicable diseases , infectious and mental health conditions in any possible combinations and they may or may not interact with each other. When

4800-454: The nursing of patients with chronic diseases, replacing a more holistic role for nursing with an emphasis on patients managing their own health conditions. Critics note that this is challenging if not impossible for patients with chronic disease in low-income communities where health care systems, and economic and social structures do not fully support this practice. A study in Ethiopia showcases

4880-410: The onset of depression or depressive episodes in people with long-term physical conditions include psychological interventions and pharmacological interventions, however the long-term effectiveness and benefits of these approaches is very uncertain. People with multimorbidity face many challenges because of the way health systems are organised. Most health systems are designed to cater for people with

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4960-436: The other through a number of pathways, and have significant impact on health and wellbeing. For people whose long-term conditions include severe mental illness , the lifespan can be 10–20 years less than the general population. For them, addressing the underlying risk factors for physical health problems is critical to good outcomes. There is considerable evidence that having multiple long-term physical conditions can lead to

5040-432: The others. This distinction is important in how the healthcare system treats people and helps making clear the specific settings in which the use of one or the other term can be preferred. Multimorbidity offers a more general and person-centered concept that allows focusing on all of the patient's symptoms and providing a more holistic care. In other settings, for example in pharmaceutical research, comorbidity might often be

5120-410: The people in their care (including their backgrounds and personal medical goals), discussing plans to stop a medicine already when it is first prescribed, and a good relationship that involves mutual trust and regular discussions on progress. Furthermore, longer appointments for prescribing and deprescribing would allow time explain the process of deprescribing, explore related concerns, and support making

5200-476: The person contributing to decisions about their health; when people with MLTC don't see the same health care professional consistently; when people are seen by lots of different professionals working across different services; and when the health service does not recognise the experiences of people living with MLTC. To help older people and their family carers experiencing medication-related burden, medical professionals can consider this burden when changing or amending

5280-580: The pressures that society puts on the importance of fertility and health when it comes to typically feminine ideals. These kinds of social barriers interfere with women's ability to perform various other activities in life and fully work toward their aspirations. Race is also implicated in chronic illness, although there may be many other factors involved. Racial minorities are 1.5-2 times more likely to have most chronic diseases than white individuals. Non-Hispanic blacks are 40% more likely to have high blood pressure that non-Hispanic whites, diagnosed diabetes

5360-477: The programmed must be carried out regularly, to ensure that new staff is educated in administering chronic disease care. The program shows that community-based care and education, primarily driven by nurses and health officers, works. It highlights the importance of nurses following up with individuals in the community, and allowing nurses flexibility in meeting their patients' needs and educating them for self-care in their homes. The epidemiology of chronic disease

5440-402: The psychological response to living in difficult circumstances. Knowing the exact pathway would allow designing effective interventions that prevent or mitigate inequalities in multimorbidity. Living in poverty or deprived areas is associated with higher rates of multimorbidity. Those with the lowest income have a 4 times higher chance of having multiple long-term conditions than those with

5520-419: The rates of chronic disease differ by race for those living with chronic illness, the statistics for leading causes of death among elderly are nearly identical across racial/ethnic groups. Chronic illnesses cause about 70% of deaths in the US and in 2002 chronic conditions (heart disease, cancers, stroke, chronic respiratory diseases, diabetes, Alzheimer's disease, mental illness and kidney diseases) were six of

5600-469: The results are somewhat heterogeneous depending on the type of condition and the type of programs involved. For example, results from different approaches in cancer prevention and screening depended highly on the type of cancer. The rising number of patient with chronic diseases has renewed the interest in prevention and its potential role in helping control costs. In 2008, the Trust for America's Health produced

5680-804: The right decisions. There are well-evidenced prevention strategies for many of the component diseases of multiple condition clusters. For example: An increased understanding of which conditions most commonly cluster , along with their underlying risk factors, would help prioritise strategies for early diagnosis, screening and prevention. Multimorbidity is common in older adults, estimated to affect over half of those aged 65 and over. This increased prevalence has been explained by older adults' "longer exposure and increased vulnerability to risk factors for chronic health problems". The prevalence of multimorbidity has been increasing in recent decades. The high prevalence of multimorbidity has led to some describing it as "The most common chronic condition". Multimorbidity

5760-712: The risk of developing depression and anxiety more than others, such as co-occurring respiratory disorders and co-occurring painful and gastrointestinal disorders . There has been a scarcity of economic evaluations concerning interventions for managing individuals with mental-physical multimorbidity, including depression. A recent systematic review identified four intervention types (collaborative care, self-management, telephone-based, and antidepressant treatment)) that were assessed for cost-effectiveness in high-income countries. However, such evaluations are currently absent in low-income and middle-income countries as no studies have been identified in these regions. Strategies to prevent

5840-471: The risk of developing multimorbidity. For instance, based on the Whitehall II Study , people in lower employment positions seem to have a 66% higher risk of developing multiple long-term conditions than people in higher positions. However, socioeconomic status does not appear to influence the risk of dying after the onset of multiple long-term conditions. Another study showed an increase of almost 50% in

5920-537: The social science setting have begun highlighting is chronic poverty . Researchers, particularly those studying the United States, utilize the Chronic Condition Indicator (CCI) which maps ICD codes as "chronic" or "non-chronic". The list below includes these chronic conditions and diseases: In 2015 the World Health Organization produced a report on non-communicable diseases, citing

6000-428: The term multiple long-term conditions ( MLTC ) as it is more accepted and understood by patients and the public. A range of biological, psychological, behavioural, socioeconomic and environmental factors affect the likelihood of having multimorbidity. How these risk factors interact to trigger multiple long-term conditions is complex and still not fully understood. One risk factor of multimorbidity in young people

6080-564: The top ten causes of mortality in the general US population. Chronic diseases are a major factor in the continuous growth of medical care spending. In 2002, the U.S. Department of Health and Human Services stated that the health care for chronic diseases cost the most among all health problems in the U.S. Healthy People 2010 reported that more than 75% of the $ 2 trillion spent annually in U.S. medical care are due to chronic conditions; spending are even higher in proportion for Medicare beneficiaries (aged 65 years and older). Furthermore, in 2017 it

6160-539: The understanding of multiple long-term conditions and promote a change in research culture to tackle multimorbidity. The NIHR also published its own strategic framework regarding MLTC which aligns with the cross-funder framework. As rehabilitation usually focuses on a single disease people with multiple long-term conditions are often excluded or not all their conditions are treated during rehabilitation. Researchers are looking for new models of rehabilitation that could be applied to people with multimorbidity. For example

6240-478: The world, many people do not die from one isolated condition but from a multitude of factors and conditions. A study suggested there is a paucity of multimorbidity and comorbidity data globally and mapped comorbidity patterns. The likelihood of having multiple long-term conditions is increased by socioeconomic inequalities . Certain groups of disadvantaged or discriminated people are more likely to struggle with earlier and more severe multimorbidity. Multimorbidity

6320-461: Was estimated that 90% of the $ 3.3 billion spent on healthcare in the United States was due to the treatment of chronic diseases and conditions. Spending growth is driven in part by the greater prevalence of chronic illnesses and the longer life expectancy of the population. Also, improvement in treatments has significantly extended the lifespans of patients with chronic diseases but results in additional costs over long period of time. A striking success

6400-425: Was for the 50% of the population who have one or more common chronic medical conditions (CDC, 2014). There are several psychosocial risk and resistance factors among children with chronic illness and their family members. Adults with chronic illness were significantly more likely to report life dissatisfaction than those without chronic illness. Compared to their healthy peers, children with chronic illness have about

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