Scientific Foundation for Health

Module 5
 Scientific Foundation for Health
Module 5.2
Content
1) Management of chronic illness for better
quality of life
2) Health and Wellness of Youth- a challenge
for upcoming future
3) Measuring of health and wellness
 Unit -1:Chronic illness
• What is chronic disease/illness?
• Chronic diseases are defined broadly as
conditions that last for one year or more and
require ongoing medical attention, as well as
limit activities of daily living.
• Example: heart disease, cancer, diabetes
• They are also leading drives of the nation’s
large scale health care costs.
• Based on the latest data from C D C (centre for
disease control), 10 most expensive chronic
diseases are:
• Cardio vascular diseases
• Smoking related health issues
• Alcohol related health issues
• Diabetes
• Alzheimer’s disease
• Cancer
• Obesity
• Arthritis
• Asthma
• Stoke
• At any given time 50% of the population has a
chronic condition.
• The medical management of chronic disorders
accounts for three quarters nation’s health
spending excluding nursing home care.
• The chronically sick account for 90% of home
care visits
• 83%of prescription drug use
• 80% of the days spent in hospitals
• 66% of doctors visit
• 55% of visits to hospital emergency rooms
• These conditions are not confined to the
elderly. More than one third young adults of
ages 18 to 44 have at least one chronic
disability.
• At time each one of us will hear a physician
say that our condition is chronic and cannot
be cured. It can be managed.
 Quality of life
• “Quality of life is defined as an individual’s
perception of their position in life in the context
of the culture and value systems, in which they
live and in relation to their goals, expectations,
and standards”.
• (Standard indicators of life: wealth, employment,
the environment, physical and mental health,
education, recreational and leisure time, social
belonging, religious beliefs, safety, security and
freedom)
• Simply quality of life means the degree to
which an individual is healthy, comfortable,
and able to participate in or enjoy life events.
• Quality of life has a wide range of contexts. It
includes the field of international
development, health care, politics and
employment
• Quality of life has several components:
Specifically, physical functioning,
psychological status, disease or treatment,
related symptomatology
• Health related quality of life is an evaluation
of quality of life and its relationship with
health. In this field quality of life is often
regarded in terms of how certain ailment
affects a patient on an individual level.
• Until recently quality of life was not
considered an issue of psychological
importance.
• F or many years it was measured only in terms
of length of survival and signs of presence of
disease
• In addition there was no consideration of the
psychological consequence of illness and
treatment.
 Components of quality of life
Quality of life has several components.
Specifically,
• Physical functioning
• Psychological status
• Social functioning
• Disease or treatment
Assessment of quality of life in chronic
illness
• Till now the assessment of the quality of life of
chronically ill was based on how much the
disease and treatment interferes with the
activities of daily living such as –
• Sleeping,
• Eating,
• Going to work and
• Engaging in recreational activities
• For patients with more advanced diseases,
such assessments include whether the patient
is able to bathe, dress, use toilet, be mobile,
be content, and eat without assistance
• Essentially the quality of life assessment gauge
the extent to which a patient’ normal life
activities have been compromised by disease
and treatment
Why we should study quality of life of
chronically ill?
• Studying chronically ill patients and their quality
of life is important for the following
• Documentation of exactly how illness affects
vocational, social, and personal activities. This
provides an important basis for interventions
designed to improve quality of life.
• Quality of life measures can help pinpoint which
problems are likely to emerge for patients with
diseases. Example: such measure might indicate
that sexual functioning is a problem for a patient.
Such information would be helpful in anticipating
the intervention that are required
• Quality of life measures also assess the impact of
treatments on quality of life of the chronically ill
• Quality of life information can be used to
compare therapies and their outcome
• Quality of life information can inform decision
makers about care that will maximize long term
survival with the highest quality of life possible
• Information enables policy makers to compare
the impact of different chronic diseases on health
care costs and to assess the cost effectiveness of
different interventions
• A chronic health condition is any condition
lasting six months or longer. Example: asthma,
arthritis, cancer, obesity, diabetes, chronic
pain or heart diseases
• Modern day treatments have made provision
for people with chronic condition to live
longer with diseases that previously led to
premature death.
 What causes chronic illness and
associate conditions?

• They are caused by a number of different

health factors resulting at simultaneously

• They take some time to develop

• They last for a long time and often lead to

other health problems
 How to maintain better quality of life
in the chronically ill?

• Chronic conditions are not cured completely.

So looking after our self about good medical
advice, living healthy life style, and having
positive attitude help in maintaining better
quality of life
 The measures adopted are:
• Finding reliable information about diseases, its
treatment and management. This will help the
chronically ill patient to feel that he/she in taking
positive step and give a feeling of control over
their illness
• Understanding the medication. This includes
what it is specifically for. It provides special
instruction to be followed in taking medicine/
treatment and potential side effects
• Setting the patient’s goal- short term goals will
give a sense of how the person is progressing
• Developing skills to manage the chronically ill
patient’s pain and fatigue
• Getting emotional support. Speaking to others
who are going through what the patient is
going through, and leaning on family and
friends when there is need
• Planning for the future
 Pain management
• Taking pain relieving medicine. Medication
includes both non-prescription medication and
prescription medication
• Under going physical therapies. There are many
non-drug treatments. A combination of
treatments and therapies (Physio therapy) is
some time more effective. Non drug therapies
include cognitive behavioral therapy (cognitive
behavioral therapy changes how a person thinks
and in turn how he feels and behave).
• Physical therapies also are found in stretching
exercises, walking and other exercises
• Relaxation and stress management techniques
• Transcutaneous electrical stimulation
therapies
• Applying heat packs and cold packs and
• Acupuncture
 Taking care of mental health
• Symptoms of chronic diseases – tiredness,
aches and pains are not quite often visible. It
is not just physical symptoms that affect a
chronically ill. They can affect the limits on life
styles and living with constant pain, it can
impact mentally too.
• Worrying or thinking negatively adds to the
patient’s anxiety or stress. They can affect the
overall health
What are the ways to reduce worrying?
• Write down the concerns and the possible
consequences even if they are negative
• Find out the information about prognosis
• Talking to a friend, a supporting group or seek
specialist help
• Focusing on a variety of things each day
 Good life style choices for better
quality of life
• Maintain a healthy life style can help the chronically ill
patient to feel well, while living with chronic illness
and its condition. This includes eating well, doing as
much physical activity as the patient’s condition will
allow, and getting good rest
• Trying to do some physical activity each day, even if it
is only a small amount, can help with managing pain
and lift your mood. Speak with the doctor or
physiotherapist about exercise that may help.

Sleep is also very important if there is a health

condition
Dealing with multiple health condition
• To achieve this chronically ill person need to
deal with a number of health care
professionals. The most important thing to
remember about seeing multiple healthcare
professionals is to let each one know who else
the patient are seeing and for what health
condition.
Getting support from others for better
quality of life
• Social support can help chronically ill person to
maintain a good quality of life.
• When a chronically ill person has a long term
adverse health condition the person must plan to
catch up with family and friends and inform
about their condition and let them know how
they can help
• Consider new sources of support such as support
groups, clubs, interest group and volunteer
opportunities.
Unit-2:Health and wellness of youth: a
challenge for upcoming future
• Youth is the time of life when one is young
and often means the time between childhood
and adulthood.
• It is also defined as “the appearance,
freshness, vigor, spirit, etc.,
• Its definitions of a specific age range varies, as
youth is not defined chronologically as a stage
that can be tied to specific age ranges, nor can
its end point be linked to specific activities
• Youth is an experience that may shape an
individual’s level of dependency, which can be
marked in various ways according to different
cultural perspectives.
• The United Nations defines youth as persons
between the ages of 15 and 25
• Youth is the stage of constructing the self-
concept. The self-concept of youth is influenced
by variables such as peers, life style, gender, and
culture.
 Health and wellness
• Health is a state of well-being
• Wellness is the state of living a healthy life
styles
• Health refers to physical, mental and social
well=being
• Wellness aims to enhance well-being. It can
affect physical, mental and social well-being
 Health and wellness in youth
• High levels of health and wellness in youth
help them flourish in life as well as act as a
protective factor against some of the
challenges that may arise during this period.
• Youth with strong mental well-being are able
to manage their emotions, enjoy positive
relationships with friends and family
 Challenges facing youth
• In may 2014 W H O published a major report
called “Health for the world’s adolescent.”
• The report analyses what is known about
adolescents’ health
• It includes topic of what promotes or
undermines it, gaps in policies and services,
and draws together guidance and
recommendations
 FACTS
• An estimated 1.3 million adolescents died in 2012,
mostly from preventable or treatable causes.
• Road traffic injuries were the leading cause of death in
2012, with some 330 adolescents dying every day.
• Other main causes of adolescent deaths include HIV,
suicide, lower respiratory infections and interpersonal
violence.
• Globally, there were 49 births per 1000 girls aged 15 to
19, according to 2010 figures.
• Half of all mental health disorders in adulthood appear
to start by age 14, but most cases are undetected and
untreated
• Around 1 in 6 persons in the world is an
adolescent: that is 1.2 billion people aged 10 to
19
• Most are healthy, but there is still significant
death, illness and diseases among adolescents.
Illnesses can hinder their ability to grow and
develop to their full potential. Alcohol or tobacco
use, lack of physical activity, unprotected sex
and/or exposure to violence can jeopardize not
only their current health, but often their health
for years to come.
• Promoting healthy practices during
adolescence, and taking steps to better
protect young people from health risks are
critical for the prevention of health problems
in adulthood, and for countries’ future health
and social infrastructure
 Main health issue- Early pregnancy
and childbirth
• Complications linked to pregnancy and
childbirth are the second cause of death for
15-19-year-old girls globally.
• One of the Millennium Development Goals, is
to achieve universal access to reproductive
health, for which one of the indicators is the
pregnancy rate among the 15 to 19 age group.
 HIV
• More than 2 million adolescents are living
with HIV. Although the overall number of HIV-
related deaths is down 30% since the peak 8
years ago, estimates suggest that HIV deaths
among adolescents are rising
• A second goal of the Millennium Development
is to halt the spread of HIV/AIDS
 Other infectious diseases

• Improved childhood vaccination has resulted

in reducing death and disability from measles
• However diarrhea, lower respiratory tract
infections and meningitis are among the top
10 causes of death for 10 to 19 year olds.
 Mental health
• Depression is the top cause of illness and
disability among adolescents and suicide is the
third cause of death. Violence, poverty,
humiliation and feeling devalued can increase the
risk of developing mental health problems.
• Building life skills in children and adolescents and
providing them with psychosocial support in
schools and other community settings can help
promote good mental health. Programmes to
help strengthen ties between adolescents and
their families are also important. If problems
arise, they should be detected and managed by
competent and caring health workers.
 Violence
• Violence is a leading cause of death. An
estimated 180 adolescents die every day as a
result of interpersonal violence. Around 1 of
every 3 deaths among adolescent males in the
low- and middle-income countries is due to
violence
• Globally, some 30% of girls aged 15 to 19
experience violence by a partner.
• Promoting nurturing relationships between
parents and children early in life, providing
training in life skills, and reducing access to
alcohol and firearms can help to prevent
violence. Effective and empathetic care for
adolescent survivors of violence and ongoing
support can help deal with the physical and
the psychological consequences
 Alcohol and drugs
• Harmful drinking among adolescents is a
major concern in many countries. It reduces
self-control and increases risky behaviours,
such as unsafe sex. It is a primary cause of
injuries (including those due to road traffic
accidents), violence (especially by a partner)
and premature deaths. It also can lead to
health problems in later life and affect life
expectancy
• Setting a minimum age for buying and
consuming alcohol and regulating how
alcoholic drinks are targeted at the younger
market are among the strategies for reducing
harmful drinking. Drug use among 15 to 19
year olds is also a concern.
 Injuries
• Unintentional injuries are a leading cause of
death and disability among adolescents. In 2012,
some 120 000 adolescents died as a result of
road traffic accidents.
• Young drivers need advice on driving safely
• laws that prohibit driving under the influence of
alcohol and drugs need to be strictly enforced.
Blood alcohol levels need to be set lower for
teenage drivers.
• Graduated licenses for novice drivers with zero-
tolerance for drink-driving are recommended
 Malnutrition and obesity
Many boys and girls in developing countries
enter adolescence undernourished, making
them more vulnerable to disease and early
death.
The number of adolescents who are
overweight or obese is increasing in both low-
and high-income countries.
 Exercise and nutrition
• Available survey data indicate that fewer than 1
in every 4 adolescents meets the recommended
guidelines for physical activity – 60 minutes of
moderate to vigorous physical activity daily.
• Anemia resulting from a lack of iron affects girls
and boys, and is the third cause of years lost to
death and disability. Iron and folic acid
supplements help to promote health before
adolescents become parents.
• Developing healthy eating and exercise habits
at this age are foundations for good health in
adulthood. Reducing the marketing of foods
high in saturated fats, trans-fatty acids, free
sugars, or salt and providing access to healthy
foods and opportunities to engage in physical
activity are important for all but especially
children and adolescents.
 Tobacco use
• The vast majority of people using tobacco today
began when they were adolescents. Prohibiting
the sale of tobacco products to minors and
increasing the price of tobacco products through
higher taxes, banning tobacco advertising and
ensuring smoke-free environments are crucial.
Globally, at least 1 in 10 younger adolescents
(aged 13 to 15) uses tobacco, although there are
areas where this figure is much higher. Cigarette
smoking seems to be decreasing among younger
adolescents in some high-income countries
 Rights of youth
• The rights of children to survive, grow and
develop are enshrined in international legal
documents. The Committee on the Rights of
the Child (CRC), which oversees the child
rights convention, in 2013 published
guidelines on the right of children and
adolescents to the enjoyment of the highest
attainable standard of health
• In 2003, the CRC issued guidelines on states’
obligations to recognize the special health and
development needs and rights of adolescents
and young people. The Convention on the
Elimination of Discrimination Against Women
(CEDAW) also sets out the rights of women
and girls to health and adequate health care.
 Unit 3-Health status
A general term for the state of health of an individual,
group, or population measured against defined standards

The W H O definition (2009):

The state of health of a person or population assessed
with reference to morbidity, impairments, anthropological
measurements, mortality, and indicators of functional
status and quality of life.

The WHO health indicators provide internationally

accepted standards for various aspects of health status
• WHO guides health policy in its Member
States toward priority health problems, the
use of solutions known to them, and relevant
directions for problem-orientated research to
improve the effectiveness and efficiency of
investment for health development.
 Types of health status
–includes
1) functional health
2) disability days
3) activity limitation
4) health expectancy and
5) disability free life expectancy
What is the best predictor of health status?
Earlier rising income and subsequent improved
standards of living were thought to be the
most important factors contributing to a long
and healthy life
New research has shown that the level of
education a person has is a much better
predictor of life expectancy
 Measures of health status
• An individual’s health status is usually
measured by a health professional
• Measurement of population health status is
carried using statistics and data presented as a
set of measurement or indicators. It includes:
- Life expectancy; health adjusted life
expectancy; morbidity; under-five mortality;
burden of disease; disability adjusted life year;
incidence; and prevalence
 Wealth Status
• What Is Wealth?
Wealth measures the value of all the assets of
worth owned by a person, community,
company, or country. Wealth is determined by
taking the total market value of all physical
and intangible assets owned, then subtracting
all debts. Essentially, wealth is the
accumulation of scarce resources.
• Specific people, organizations, and nations are
said to be wealthy when they are able to
accumulate many valuable resources or
goods.
• Wealth can be contrasted to income in that
wealth is a stock and income is a flow, and it
can be seen in either absolute or relative
terms.
Understanding Wealth
• Wealth can be expressed in a variety of ways. In a
purely material sense, wealth consists of all the real
resources under one's control. Financially, net worth is
the most common expression of wealth.
• Definitions and measures of wealth have been
different over time among societies. In modern society,
money is the most common means of measuring
wealth. Measuring wealth in terms of money is an
example of money's function as a unit of account.
 How to Measure Wealth

• Measuring wealth in terms of money overcomes

the problem of evaluating wealth in the form of
different kinds of goods. These values can then
be added or subtracted together. This, in turn,
permits the convenient use of net worth as a
measure of wealth. Net worth is equal to assets
minus liabilities. For businesses, net worth is also
known as shareholders’ equity or book value. In
common sense terms, net worth expresses
wealth as all the real resources under one's
control, excluding those that ultimately belong to
someone else.
• Research has consistently shown that people's
perception of their own wellbeing and
happiness depends much more on their
estimates of wealth relative to other people
than on absolute wealth. This is also part of
why the concept of wealth is usually applied
only to scarce economic goods; goods that are
abundant and free for everyone provide no
basis for relative comparisons across
individuals.
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