Healthy People 2020 Impact Paper
Heart disease is the leading cause of mortalities and other adverse consequences among older adults. The elderly population grapples with various modifiable and non-modifiable factors that increase their susceptibility to heart disease. According to the World Health Organization [WHO] (2021), aging is one of the non-modifiable risk factors for heart disease and other cardiovascular diseases. In this sense, the aging process worsens cardiovascular functionality, increasing the risk of cardiovascular diseases (Rodgers et al., 2019). Besides the inevitable aging process, older adults are vulnerable to obesity, diabetes, raised blood lipids, the effects of an unhealthy diet, and risky habits like tobacco use, physical inactivity, and alcoholism. In the context of enhancing population health and wellness, older adults require attention and tailored interventions for health promotion. As a result, this paper focuses on heart disease among older adults in Manistee County, Michigan, explores epidemiological data regarding the disease, and discusses population-level prevention and health promotion approaches consistent with Healthy People 2020 goals and objectives.
An Overview of the Problem
Heart disease is a multifactorial cardiovascular disease (CVD) that encompasses various conditions, including irregular heartbeat, congenital heart defects, heart valve disease, and coronary artery disease. According to Mayo Clinic (2022), the primary cause of heart disease is the accumulation of cholesterol deposits (plagues) in the heart arteries, reducing blood flow from the heart to other body parts. Often, plagues deposits can trigger other cardiovascular conditions, including stroke, angina, and heart attack. The clinical manifestation of heart disease entails multiple symptoms, including chest pain and tightness, shortness of breath, numbness, and pain in the neck, throat, and upper belly area. Other symptoms of heart disease include tachycardia, bradycardia (slow heartbeat), fainting, tiring during physical exercise, swelling of ankles, hands, and feet, and fatigue (Mayo Clinic, 2020). It is essential to note that the various etiologies of heart disease, including heart valve problems, congenital heart defects, and heart arrhythmias, manifest through different symptoms. Therefore, it is essential to conduct a comprehensive screening to identify the exact cause of heart disease.
Although heart disease can affect children in the form of congenital heart defects, older adults are often the at-risk population for this severe disease. According to the Centers for Disease Control and Prevention [CDC] (2019), heart disease is prevalent among older adults due to various comorbid conditions, including limited involvement in physical activities, frailty, and physical balance and strength issues. In this sense, frailty and physical balance concerns deprive older adults of opportunities to benefit from the potential importance of physical exercise, including maintaining healthy heart muscles, improved mobility, vessel elasticity, improved physical balance, and reduced blood pressure. Besides the physiological deficiencies exacerbated by aging, older adults engage in risky behaviors, including cigarette smoke, alcoholism, unhealthy diet plans, and tobacco product use (Ruan et al., 2018). Finally, older adults endure the massive burden of diabetes and chronic obstructive respiratory disease (COPD), increasing susceptibility to heart disease and other cardiovascular diseases.
Epidemiological Analysis of Heart Disease
The national statistics portray heart disease as the leading cause of mortalities, increased care costs, and compromised quality of life through disability-adjusted life years (DALYs). According to the Centers for Disease Control and Prevention [CDC] (2022), one person dies every 34 seconds in the United States from cardiovascular disease. In 2020, about 697000 people succumbed to heart disease, accounting for one in five deaths. Besides contributing to high mortality rates, the disease cost the country about $229 billion annually from 2017 to 2018. The estimated economic burden of the disease accommodates various aspects of care expenditures, including lost productivity due to deaths associated with heart disease, medications, and the estimated cost of healthcare services.
In Michigan, statistics regarding the prevalence and effects of heart disease are consistent with the national trends. The Centers for Disease Control and Prevention [CDC] (2018) contends that the disease was the leading cause of death in 2017, above cancer, chronic lower respiratory disease, accidents, stroke, diabetes, kidney disease, suicide, and Alzheimer’s disease. The disease contributed to about 25,187 deaths in 2017, representing a rate of 196.1 per 1000 people. The heart disease mortality rate in the state (196.1) was higher than the average national rate (165). This factor poses a significant concern for policymakers and healthcare agencies.
Demographic aspects and social determinants of health (SDOH) are primary causal and contributing factors for high mortality rates of heart disease in Michigan. According to County Health Rankings & Roadmaps (2022), about 20% of adults are tobacco users, while 30% grapple with obesity. Further, approximately 20% of adults engage in alcoholism. Only 77% of people have access to exercise opportunities. Finally, about 25% of people struggle with physical inactivity, increasing the risk of heart disease and other cardiovascular diseases. Other core determinants of health in Michigan include a 9.9% unemployment rate, 13% food insecurity, and 6% people with limited access to healthy foods. These factors explain the high prevalence of heart disease and its adverse effects, including increased mortalities.
Healthy People 2020 Goal and Objectives
Healthy People 2030 identifies heart disease as the leading cause of death and other consequences, including poor quality of life and disability in the United States. In response to the overarching need to reduce the prevalence, incidences, and consequences of heart disease, Healthy People 2030 established various goals and objectives. These objectives include improving cardiovascular health in adults by promoting healthy eating behaviors, engaging them in physical activity, and promoting interventions for smoking cessation (Healthy People 2030, 2020). Another objective of Healthy People 2030 is improving cardiovascular health in adults through interventions to lower blood pressure, cholesterol, and body mass index (BMI). These objectives form the basis of population-level health promotion interventions.
Population Level Prevention and Health Promotion Interventions
A comprehensive health promotion plan for preventing and controlling heart disease among older adults should encompass a self-management education program and interventions to avert risk factors like obesity, high blood pressure, and cholesterol deposits. According to Podvorica et al. (2021), an education program for people with heart disease should focus on increasing patients’ knowledge of healthy lifestyles, including healthy diet plans, smoking cessation, and self-management approaches like regular weight monitoring. Equally, an education program should equip the target population with knowledge regarding effects, risk factors, and effective strategies for controlling blood pressure, including moderate physical exercise. It is possible to implement these health promotion programs by assessing the population’s previous and current knowledge, learning needs and abilities, learning styles, motivation, and misconceptions, as well as consolidating adequate educational materials. Finally, continuous evaluation of people’s needs and goals can form the basis of a population-level health promotion program and further self-management education.
Conclusion
Undeniably, heart disease is the leading cause of mortalities at state, national, and global levels. Older adults are an at-risk population due to aging and susceptibility to risk behaviors and factors like alcoholism, tobacco use, physical inactivity, and obesity. As a result, it is essential to reduce their vulnerability to the disease by educating them, engaging them in moderate physical exercise, and teaching them about self-management interventions, including weight management, a healthy diet, effective stress management approaches, and smoking cessation. Regular monitoring and evaluation of older adults’ learning needs can improve the quality and outcomes of health promotion programs.
References
Centers for Disease Control and Prevention. (2018). Stats of the state of Michigan. https://www.cdc.gov/nchs/pressroom/states/michigan/michigan.htm
Centers for Disease Control and Prevention. (2019, July 31). Coronary heart disease, myocardial infarction, and stroke — A public health issue. https://www.cdc.gov/aging/publications/coronary-heart-disease-brief.html
Centers for Disease Control and Prevention. (2022). Heart disease facts. https://www.cdc.gov/heartdisease/facts.htm#
County Health Rankings & Roadmaps. (2022). Michigan. https://www.countyhealthrankings.org/explore-health-rankings/michigan?year=2022
Healthy People 2030. (2020). Heart disease and stroke. https://health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke
Mayo Clinic. (2022). Heart disease – symptoms and causes. https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118
Podvorica, E., Bekteshi, T., Oruqi, M., & Kalo, I. (2021). Education of the patients living with heart disease. Materia Socio Medica, 33(1), 10. https://doi.org/10.5455/msm.2021.33.10-15
Rodgers, J. L., Jones, J., Bolleddu, S. I., Vanthenapalli, S., Rodgers, L. E., Shah, K., Karia, K., & Panguluri, S. K. (2019). Cardiovascular risks associated with gender and aging. Journal of Cardiovascular Development and Disease, 6(2), 19. https://doi.org/10.3390/jcdd6020019
World Health Organization. (2021, June 11). Cardiovascular diseases (CVDs). https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(CVDs)