Common chronic diseases

Many people will live with a chronic illness eventually. Some of these diseases affect one body system, and some may affect multiple. The medical and health professions may still be learning about some of these groups of conditions.

Cardiovascular diseases – these are diseases that affect the heart or blood vessels. The most common of these is coronary artery disease caused by the narrowing or blockage of the arteries which supply blood to the heart. Others include: heart failure, high blood pressure (hypertension), arrhythmia, congenital heart disease, and even cerebrovascular disease or stroke. Learn more here. https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease.

Autoimmune disorders – this is a group of several different disorders in which the immune system of the body attacks its own cells. The symptoms may vary based on which cells are being attacked. Some examples include Type I diabetes, multiple sclerosis, lupus, and others. Women are more at risk of having these disorders. https://www.healthline.com/health/autoimmune-disorders

Respiratory disorders – these diseases affect the respiratory system and can include things like asthma, chronic bronchitis, chronic obstructive pulmonary disease and so on. In some cases, these disorders may be triggered by environmental factors – this includes infectious diseases like flu and RSV, as well as tobacco smoke, allergens, occupational exposures and so on. https://www.healthline.com/health/common-respiratory-diseases#common-respiratory-diseases

Diabetes – there are several types of diabetes, including type I and II, as well as gestational. In general, these diseases happen because of too high blood sugar, though causes vary from type to type. Treatments are available for diabetes, and in some cases, it can be prevented if detected in the early stages like prediabetes. https://my.clevelandclinic.org/health/diseases/7104-diabetes

Chronic kidney disease – this disorder results from damage to the kidneys, which will be unable to filter the blood effectively. It can result from people having other chronic diseases like hypertension, diabetes, or family or personal history. When the kidneys no longer function properly, people may need to get regular kidney dialysis. https://www.kidney.org/atoz/content/about-chronic-kidney-disease

Alzheimer’s disease – this disorder is the most common form of dementia. The biggest risk factor for developing it is advanced age. Common symptoms include memory loss, difficulty completing familiar tasks, and changes in mood, personality, and behavior. https://www.cdc.gov/aging/aginginfo/alzheimers.htm

HIV – infection with the human immunodeficiency virus has become a chronic disease. Many people live long healthy lives while HIV positive. There are medications available to suppress the virus to very low levels, as well as prophylactic medications people can take to prevent infection. https://www.cdc.gov/hiv/about/index.html

What is health?

How would you define health? There are several interconnected and related
dimensions of wellness that are dynamic – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508938. We can describe them as physical, emotional, mental/intellectual, social, spiritual, environmental, financial, and occupational.

Model of determinants of health. In the middle of the image are biological factors, then individual lifestyle behaviors, then social and community networks, then socio-economic, cultural and environmental factors

What makes your health better or worse? All of the factors that influence
your health for better or worse, including your genetic code, your behaviors, and your environment, are called the determinants of health – https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

Social determinants of health – https://www.cdc.gov/socialdeterminants/index.htm

To learn more about how social determinants of health can impact our lives,
watch this movie (this is optional). Go to the BMCC Library website – https://www.bmcc.cuny.edu/library/ and click on Databases. Select Video Databases, then select Kanopy Streaming Videos. If you are not on campus, you will have to log in with your BMCC log-on (the same credentials you use to log into computers on campus). When you are in the Kanopy database, search for Unnatural Causes. Your result will say Collection on it. Watch the movie titled In Sickness and in Wealth.

Is the United States a healthy country? Many studies show that the United States spends a lot of money on average per person, but that health outcomes tend to be worse than similarly economically developed countries around the world. There are also many differences among individuals in health status in the US based on historic and current discrimination. Read more here – https://www.apha.org/topics-and-issues/health-rankings.

Leading causes of death

One way to track the health of the nation every year is with the leading causes of death which can be found here https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm for all ages in the United States. The rate of death is called mortality.

It takes time to fully finalize leading causes of death and the final figure for 2023 is not yet available. Patterns of leading causes of death have been changing with the arrival of COVID-19, which was was the third or fourth leading cause of death in the US since 2020.

We can also see how long people are expected to live – this is called life expectancy. Right now the average life expectancy is 77.5 years according to the CDC. You can also see differences by sex and ethnicity here – https://www.cdc.gov/nchs/products/databriefs/db328.htm.

Generally, life expectancy has been on the rise across most of the world, reflecting advances in medicine. However, in the US life expectancy has declined several years in a row, first as a result of the opiate epidemic, and then because of COVID-19 –https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/.

In the Untied States, there exist health disparities – differences in health status and health outcomes in different groups. One of the missions of HealthyPeople 2030 is to achieve health equity, that is the improve health for all groups and to close the gaps that currently exist between groups. The CDC in partnership with many organizations, both public and private, work to reach health equity – find more information here https://www.cdc.gov/minority-health/racism-health/index-1.html.


Healthy People 2020 and 2030

Our government and many health-related organizations put together a plan every 10 years to improve the health of the nation. This decade’s plan is called HealthyPeople 2030 – https://health.gov/healthypeople/about

Some of the main goals and target areas that Healthy People 2030 focuses on are:

  • Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.
  • Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
  • Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.
  • Promote healthy development, healthy behaviors, and well-being across all life stages.
  • Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.

From: https://health.gov/healthypeople/about/healthy-people-2030-framework

It is important that we can measure how well the nation is achieving these goals. There are overall health and well-being measures, like life expectancy – https://health.gov/healthypeople/objectives-and-data/overall-health-and-well-being-measures; social determinants of health – https://health.gov/healthypeople/objectives-and-data/social-determinants-health; and leading health indicators – https://health.gov/healthypeople/objectives-and-data/leading-health-indicators.

Suicide

Content warning: suicide and self-harm

When people direct harm against themselves and die because of it, this is called suicide. Suicide is the second leading cause of death for people aged 19-24 and the third leading cause of death for children aged 15-18.

There are many risk factors for suicide, including a history or family history of mental illness, family violence, and having a gun in the home – read more here https://www.nimh.nih.gov/health/publications/suicide-faq/index.shtml.

Often, people thinking about harming themselves give indications, whether directly or indirectly. They may talk about planning something, or make references to harming themselves. Their moods and behaviors may change. They may start to use alcohol and drugs more.

If you or someone you know is experiencing these thoughts or feelings, getting help right away is vital. The National Suicide Prevention Lifeline can be found here https://988lifeline.org/ and at the phone number 988. This was recently changed so that could easily dial this number to get help at any time. To find a mental health provider near you, go to SAMHSA’s site – https://findtreatment.samhsa.gov/ or check with your health insurance.

What is sexuality?

We each have a unique understanding of our sexuality and it includes a number of different aspects of our lives, including relationships and intimacy, sexual health and reproduction, sexual identity and others. Sexuality is something we have and develop throughout our lifetime. Look over the link for other definitions related to sexuality.

One holistic model of sexuality was created by Dr. Dennis Dailey and it’s called the 5 circles of sexuality.

Five overlapping circles: sensuality, intimacy, sexual identity, sexual health and reproduction, and sexualization. Sensuality - acceptance of one's own body, enjoyment of one's own body and the bodies of others. Intimacy - ability and need to experience emotional closeness to another human being. Sexual identity - development of who you are, including sex, gender, sexual orientation. Sexual health - attitudes and behaviors related to producing children, care and maintenance of sex and reproductive organs, health consequences of sexual behavior. Sexualization - use of sexuality to influence, control and manipulate others.
From Dennis Dailey, PHD (1981) Sexual expression and aging.

Read more about each circle of sexuality here – https://www.health.state.mn.us/people/sexualhealth/circlesofsexuality.pdf.

Stigma and mental illness

Content warning: suicide and abuse

There are certain times when mental illness becomes national news – when a celebrity or someone with a high profile mentions they are suffering, when someone in the public eye dies by suicide, and when there are news of mass shootings. While it is important that people speak up about and normalize their mental health, just like any other dimensions of their health, the fact is that a societal stigma against people with mental illness persists.

Dr. Freidman writes about mental illness stigma and why it needs to be a national priority here – https://www.psychologytoday.com/us/blog/brick-brick/201405/the-stigma-mental-illness-is-making-us-sicker .

Stereotypes about people suffering with mental illness persist and can lead to a delay in people seeking help, social isolation, and a higher risk of suicide. Check your understanding about mental illness with this quiz.

You can help combat stigma by speaking up when you hear harmful stereotypes about people with mental illness, and by reaching out to those in your life who may be in need of support.

Mental illness

Mental illnesses are medical conditions that affect a person’s thoughts, feelings, moods and behaviors. Find out more about mental health basics here https://www.cdc.gov/mentalhealth/learn/index.htm. Make sure to click through Mental Health Basics, Types of Mental Illness, and Fast Facts.

There are many classified mental disorders – these are described in detail in the Diagnostic and Statistical Manual, the DSM-V. Some of the more common ones include anxiety disorders, mood disorders, attention-deficit/ hyperactivity disorder, post-traumatic stress disorder, and many others.

Mental disorders are quite common in the United States – about one in five adults live with mental illness. It is also likely that people are struggling with their mental health more in the times of living with a pandemic, economic uncertainty, and other big challenges. Read more about the prevalence of these conditions here at the National Institute of Mental Health https://www.nimh.nih.gov/health/statistics/mental-illness.shtml. Some more facts are found here – https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers . It’s important to note that many people living with mental illness do not get treatment. Also, note that people who are homeless, incarcerated, and suffering substance use disorder are more likely to have mental illness.

Some of the causes and risk factors of mental illness may be traumatic life events, biological factors like age and sex, heredity (family history), chronic health conditions like diabetes or cancer, and feeling socially isolated.

Treatment for mental illness is possible. There are many professionals who can help. If you want to seek help, this guide can help – https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider/index.shtml . You can start with your primary care provider, and they may then refer you to a specialist. This may be a psychiatrist – a medical doctor who can prescribe appropriate medications, should they be necessary. It may also be a psychologist, licensed counselor, or social worker, depending on the type of help you may need.

How do we improve our psychological health?

Psychological or mental health is thought to encompass intellectual, social, emotional and spiritual well-being. These four dimensions of health are highly interrelated, and also have an effect on our physical health.

To review – intellectual health deals with how we think, make decisions, and problem solve. Emotional health is about understanding, expressing and/or controlling your emotions. Social health is concerned with our relationships with others. Spiritual health is about finding your purpose in life and acting in a way that is consistent with your beliefs and values.

What are some things you like to do to improve these dimensions of your health?

Here are some ideas to improve your mental wellness.

Sleep

One important way to help deal with stress is by getting enough sleep. We are all familiar with how our bodies and minds feel when our sleep was interrupted or just too short – we feel clumsy, inattentive, moody, fatigued, unable to focus or remember.

There are several stages of sleep and two types of sleep.

Image showing the four stages of sleep in a sleep cycle: light sleep (when we are just falling asleep), main sleep (body and brain least active), REM sleep (dreaming), and slow-wave sleep (memory consolidation).

Throughout the night, we go through several sleep cycles. At the beginning of the night, we have deeper sleep – more non-REM sleep. Toward the end of the night, the sleep cycles consist mainly of REM sleep.

Image showing 8 hours of sleep with alternating REM and non-REM sleep.

Studies show the many benefits, both physical, mental and emotional, of getting enough sleep.

How can you get good sleep? Avoid eating, exercising or drinking caffeine too close to bedtime. Try to go to sleep and wake up at the same time every day. Have a restful place to sleep – dark, quiet, and cool. Here are more ideas, from NPR – https://www.npr.org/podcasts/510336/sleepbetter .

As with everything, it is possible for sleep to be disordered. Read about sleep disorders here – https://medlineplus.gov/sleepdisorders.html