Disease Trends and the Delivery of Health Care Services
As at the year 2010, the estimated population of the United States of America was put at three hundred an eight million, nine hundred and thirty six thousand with 6.9% of the population being between the ages of 0 and 4 years with a figure of twenty one million, four hundred and twenty-six thousand children. the age bracket between 5 and 19 years make up 19.6% of the population with a figure of sixty one million, eight hundred and ten thousand individuals and the age bracket between 20 and 24 years taking up about 32.8% of the population having a figure of one hundred and four million, four hundred and forty four thousand. Moreover, the age bracket between 45 and 64 years make up 26.2 % of the population with a figure of eighty one million and twelve thousand individuals. The age bracket between 65 and 84 years make up 11% of the total population, with a figure of thirty-four million, one hundred and twenty thousand individuals and those aged above 85 years making up about 2% of the population with a figure of six million, one hundred and twenty three thousand individuals. A summary of this data shows that the age bracket between 0 and 19 years make 26.9% of the total population, while the age group between 20 and 64 years make up 60% of the population and those aged above 65 years make up 13% of the population.
A comparison of the percentage composition of the various age groups shows that the age bracket between 0 and 19 years would show a 0.6% decline over the next two decades, while the age bracket between 20 and 64 years of age would also show a 5.8% contraction. However, those aged above 65 years of age would increase with a projected percentage increase of 5.3% over the next twenty years (Vincent & Velkoff, 2010).
The change in the trend is said to be influenced by the aging of the baby boomer generation. By the year 2030, it is said that the baby boomers would have become elderly. This is said to lead to a shift in the structure of the population from 13% in 2010 to 19% in 2030 (Vincent & Velkoff, 2010). However, another factor that must be put in consideration is the impact of immigration. It is said that immigration of young people into the working population, over the next two decades would mitigate the impact of the increase in the proportion of the aged population, so in essence, there would be an expanding working class population while at the same time, and the aged population would be increasing. The old dependency ratio is also expected to rise from 22 in 2010 to 35 in 2030 (Vincent & Velkoff, 2010). This is also as a result of increase in percentage of the aged, relative to the working population. This is also due to the baby boomers moving into the elderly population category. (Vincent & Velkoff, 2010).
The effect of ageing on health is such that an increasingly ageing population is going to increase the prevalence of chronic diseases. For example, in a disease like hypertension. Essential hypertension occurs with increasing age. Therefore, in an increasingly ageing population, the prevalence of hypertension would increase due to the persistence of individuals that have hypertension in the population. Also, because of better forms of management of the condition, more people with hypertension continue to survive as the years go by and in that way, contribute to the figures for its prevalence. Also, in a disease like diabetes mellitus, the same reason can be adduced. As a chronic disease, its prevalence would also continue to rise due to the increased number of people ageing in the population, also as a result of better management of cases and increased life expectancy even with individuals who have the disease.
In reducing the health complications due to ageing, one of the most important things to do is to increase the level of awareness of the health issues in the effected population. This is with the view of preventing the occurrence of the disease in the first place. By increasing public awareness about the condition, more people would take precautions against coming down with the condition. As a result, less people would be burdened with the complications in the future. Also, in reducing the health complications of ageing, prompt identification of affected cases and early institution of treatment are essential components of preventing complication. When these cases are identified and treatment instituted early, there would be less people that would progress to the level of complications from the illness. For example, in a condition like obesity, at the level of primary prevention, public awareness about the prevalence of the condition should be instituted so that people at risk of becoming obese would be aware of the dangers of becoming obese and by so doing, can initiate lifestyle modification to reverse the trend. Moreover, in people who are already obese, they should be encouraged to seek medical help as soon as possible so that the morbidity associated with obesity is reduced in them. By so doing, the complications associated with obesity in the aged would be prevented.
According to the National Center for Health Statistics data brief of 2012, more than 35% of people in the United States are obese currently. It is also said that the elderly, 60 years and above, are more likely to be obese than younger adults (Ogden et al 2012). There is said not to be any significant difference in the prevalence of obesity by age in men, however, in women, 42.3% of those aged 60 an above are obese when compared with 31.9% of women who are aged between 20 and 39 years of age. It is also said that 16.9% of children and adolescents are obese (Ogden et al 2012).
Over the last ten years, moreover, it was said that the prevalence of obesity in men increased from 27.5% in 2000 to 35.5% in 2010. In women, however, the prevalence remained steady at 35.8% in 2010 compared to 33.4% in 2000. This has reduced the difference in the prevalence of obesity between men and women to almost equal level (Ogden et al 2012). The same trend was noticed in boys and girls, with the prevalence of obesity increasing from 14.0% in 2000 to 18.6% in 2010. In girls, there was also no significant difference in prevalence from 13.8% in 2000 to 15% in 2010. With this trend, it is estimated that the prevalence of obesity may continue to rise in men if the trend continues unabated and it is projected that the prevalence in women would not increase significantly (Ogden et al 2012).
Some environmental factors that may support this figure is the fact that a lot of individuals still adopt the sedentary lifestyle, spending a lot of time watching television, riding buses instead of walking and generally not talking part in activities that would require burning of calories. Also is the problem of increased consumption of junk and fast food that contain a lot of calories by individuals. A lot of individuals also do not take part in physical activities. In terms of demography, composition of the United States population is also changing. It is said that black and Hispanic women are more likely to be obese than whites. As these minority groups are taking up more percentage in the total population, the rate might continue to increase.
Obesity increases the mortality and morbidity associated with a number of chronic diseases. For example, obesity has been associated with increased risk for cardiovascular diseases. The obese are more likely to be diagnosed with heart diseases because of the increased demand on the heart to cater for the metabolic needs of the body increasing in size. The obese are more at risk of hypertensive heart disease and heart failure. In addition, obesity has also been associated with diabetes mellitus. Obesity leads to increased risk of developing glucose intolerance, which is a precursor to diabetes mellitus. Glucose intolerance develops because of the body increasingly utilizing fat for its metabolic needs instead of glucose leading to the body cells being increasingly insensitive to the action of insulin, which drives glucose into the cells. This later leads to the development of frank diabetes mellitus.
In reducing the health complications related to obesity, it is important for the individual to undergo an aggressive weight reduction exercise with the aim of reducing their weight. In preventing cardiovascular disease, moreover, individuals should be encouraged to undergo aerobic exercises in order to strengthen the heart. Aerobic exercises would improve the blood flow to the heart and therefore make it stronger to be able to cope with stress when it arises. In addition, reduction in the consumption of food that contains polyunsaturated fat would also go a long way not only to reduce the level of obesity but also to reduce the level of dyslipidemia, which causes atherosclerosis and predisposes to stroke. Also in reducing the morbidity due to diabetes mellitus, the individual is encouraged to avoid sweet foods, take a lot of fruits and fibers and to reduce the consumption of confectionaries. Also, it is important to institute the medical treatment of these diseases as soon as they are noticed. This will go a long way in reducing the complications that are likely to arise if they are not well managed. Hypertension should be treated with antihypertensive agents as needed by the individual, diabetes mellitus should be treated with hypoglycemic agents, and if insulin is indicated, it should be administered. These steps will go a long way in reducing the complications arising from these conditions.
In the future, because of the increasingly aged population. Certain adaptations need to be made in order to cope with the situation. The aged are mostly confronted with chronic diseases like heart disease, osteoporosis and Alzheimer’s disease. This should shift the focus from the current management of acute illnesses to chronic illnesses like the above mentioned. The system would need to develop interventions that cater for patients with multiple diseases and disabilities. There would also need to be a focus on long-term relationships between health care service providers and patients. The patient would need to be taught how to cope with these chronic conditions and not cure, which is the focus of the management of acute illnesses. Nursing homes would play a more prominent role in the managing of these elderly patients. Therefore, a way to integrate long term managed services and mainstream health care would need to be developed.
In line with this, the future supply of long-term care workers would need to be taken into serious consideration, as these workers would tend to an increasing number of aged people. There would also be a need for the government to examine its program for the long-term care and support of the elderly since the number would be increasing.
The health care delivery system would, in the future, need to adapt to provide care for obesity-related health issues by expanding public programmes aimed at managing the condition. More emphasis would be placed on the development of treatment options for managing these conditions in the elderly, as these diseases are not curable.
References
Grayson, Vincent & Victoria, Velkoff (2010). The Next Four Decades: The Older Population in the United States: 2010 to 2050. Population Estimates and Projections. United States Department of Commerce, Economics and Statistics Administration. US Census Bureau. P25-1138
Laura, Heisler (2001). The Changing Demographic Profile of the United States.CRS Report for Congress. Congressional Research Service. RL23701
Ogden CL, Carroll MD, Kit BK, Flegal KM (2012). Prevalence of obesity in the United States, 2009–2010. NCHS data brief, no 82. Hyattsville, MD: National Center for Health Statistics. 2012.
U. S. Census Bureau (2000). Projections of the Resident Population by Age, Sex, Race and Hispanic Origin: 199 to 2100. NP-D1-A. Population Projections Program
U. S. Census Bureau (2000). America at the Dawn of a New Century. Population Profile of the United States: 2000 (Internet Release). United States Census Bureau
