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Analyses CVD As An Alarming Health Issue
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Analyses CVD As An Alarming Health Issue
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Question:
Analyse CVD as an alarming health-issue among obese young adults population of Australia.
Answer:
Introduction
The chosen health care concern for this essay is cardio-vascular disease (CVD). The rationale behind the selection of this health anomaly as the principal health concern because CVD is the leading cause of disease burden and death in Australia (The Department of Health Australia 2016). At present, the total number of people who are living with CVD is increasing dramatically both in Australia and in other parts of the world. The major risk factors associated with CVD is advancing age, genetic predisposition, ethnicity and gender. However, these are all non-modifiable risk factors. Certain modifiable risk factors which are associated with CVD include obesity, physical inactivity, unhealthy diet, alcohol consumption and tobacco smoking. Among the modifiable risk factors, obesity plays a significant role in the disease development. This is because; obesity increases the susceptibility of the biomedical risk factors of CVD like high blood pressure and high cholesterol. These two biomedical factors along with obesity further increase the overall severity of the disease (The Department of Health Australia 2016). According to Waters et al. (2013), CVD is the main cause of hospitalization among 490,000 people in Australia during 2014 to 2015. Waters et al. (2013) is of the opinion that the despite notable improvements in the overall cardio vascular health Australians in recent tenure, CVD still continues to impose health burden over the young adults of Australian. This health burden comes in the form of illness, premature death and disability. Waters et al. (2013) further argued that though the rate of CVD has decreased dramatically, the overall CVD threats have increased among the young adults. Among these young adult groups of population, the majority are obese. This high rate of hospitalization along with morbidity and mortality rate increase the overall disease burden among the Australian populations (Waters et al., 2013).
The following essay aims to analyses CVD as an alarming health-issue among obese young adults population of Australia. The essay will initiate via providing brief a description of the significance of the health issue (CVD) in relation to the chosen population (obese young adults of Australia). Upon discussing it, the essay will aim to highlight relevant determinants of health associated with CVD. The essay will then attempt to throw light over the importance epidemiological and statistical terms which are important in describing CVD in relation to obesity in a comprehensive manner. The second part of the essay will analyse one current strategy which will be sued to address the use in the state levels of Australia. At the end, the essays will argument about the importance of collaboration, sustainability and capacity building in CVD control among the obese group of population.
Significance of the Topic in Relation to Chosen Population
The prevalence of obesity has increased drastically throughout the world during the last few decades. At present it has increased to an epidemic proportion. According to the World Health Organisation at least 35% of adults who are above 20 years of age (34% men and 35% men) are obese. Such growing concerns of obesity are associated with negative consequences in health. According to the review article by Bastien et al. (2014), high level of BMI is common among obese young adults. This high BMI is associated with the development of cardiovascular (CV) risk factors like hypertension, insulin resistance, diabetes and dyslipidemia leading to the development of CV diseases like coronary heart disease (CHD) and ischemic heart disease. Bastien et al. (2014) further argued that the high level of BMI is significantly associated with CVD manifestations like angina, heart failure, myocardial infarction and death. The increase incidence of CVD events among the obese individual is associated with the endothelial dysfunction along with sub-clinical inflammation which further worsens the CVD risk factor. Obesity also increase the chance of developing arthrosclerosis at an younger age of life which in turn is regarded as the principal risk factor behind the development of CVD among young adults of Australia (Bastien et al. 2014).
The review article published by Alpert et al. (2014) mainly highlighted over the heart failure (HF) one of the leading form of CVD. The review of Alpert et al. (2014) highlighted one study which showed that among 6076 young individuals hospitalised and discharged with diagnosed HF, 41.4% were obese. The review further highlighted that the obesity is presented in up to 86% of all the individuals with HF and among them half of the population is young (18 to 30 years). Alpert et al. (2014) mainly highlighted class II obesity as the principal factor behind CVD – HF among young adults even under the absence of co-morbidities like systematic hypertension (HRN). The chances of occurrence of CVD –HF increases considerably when the duration of obesity exceed over 10 years. Alpert et al. (2014) stated that the prevalence rate CVD – HF is 70% among the individuals who are obese for the last 20 years and 90% who are obese for the last 30 years. Thus as an obese young adult ages, the chances of developing CVD also increases (Alpert et al. 2014).
Skinner et al. (2015) undertook cross-sectional analysis of data analysis from the data of overweight obese young adults. The analysis highlighted that the obese young adults have high body mass index (BMI) especially the men. The young adults with high BMI have greater chances of developing obesity because they have low blood level concentration of high density lipo-protein (HDL), high systolic and diastolic pressure, high level of glycosylated haemoglobin and tri-glycerides. All these factors increase the susceptibility of developing CVD among the young adults (Skinner et al. 2015).
Common Social Determinants of Health in Relation to Obesity
According to the WHO, social determinants of health is defined as the factors or the circumstances under which people live, work, age, deals with illness and die. In relation to obesity, Australian young adults and CVD common social determinants of health are socio-economic position, early life and employment (Australian Institute of Health and Welfare (AIHW) 2016a). According to the reports published by AIHW (2016b), among the total obese population residing in Australia, a significant percentage is young adults and 66% belongs from the poor socio-economic group. Poor socio-economic group signifies poor exposure to education, job and financial status. All these create a sense of depression leading to the development of obesity at an younger age in life (Chung et al. 2016). The reports published by the Australian Government Department of Health (2017) in the domain of early life of a child recognised the importance of adequate sleep, physical activity and reduction of screen time. Sedentary life and lack of inadequate sleep at night increase the tendency of developing obesity. Sedentary mode lifestyle from the early age in life increases the tendency of developing adiposity thereby increasing the risk of obesity associated CVD (Heinonen et al. 2013). Australian Government Department of Health (2017) stated that the majority of Australian children have tendency to lead a sedentary life via staying indoors, indulged in computers and mobile phones. This unhealthy life style increases the tendency of developing obesity during the younger stage of life. Reports published by the BBC News (2015) highlighted that the young Australian have a tendency of consuming junk food at least three times more than the recommended daily intake. This unhealthy lifestyle habits during the early stages in life makes them susceptible towards uncontrolled weight gain. According to AIHW (2016a), unemployed people have higher chances of death and have tendency of developing chronic illness in comparison to the employed people of same age. According to the Australian Institute of Family Studies (AIFS) (2017), the rate of youth unemployment is twice greater than the general unemployment rate. At least 1 out of 5 unemployment youth in Australia are long term unemployed. AIFS is of the opinion that the young adults in Australia experience several barriers in obtaining environment. This unemployed youth suffers from depression and indulge in alcohol and tobacco addiction. According to Backhans et al. (2016) unemployment is a risk factor for hospitalization due to excessive alcohol intake. This addiction towards alcohol increases the tendency of gaining weight. Moreover, excessive alcohol intake is also associated with the threats of developing CVD (Holmes et al. 2014).
Epidemiological and Statistical Terms
The epidemiological and statistical terms, which are common in both the three identified literary articles, include morbidity, mortality rate, prevalence rate, risk factors and p-values. Morbidity (illness) is used to define the amount of CVD among a particular group of population. Skinner et al. (2015) has used to term morbidity in order to define the existence of disease (CVD) or the symptoms of disease within population. Bastien et al. (2014) have used the term “mortality rate” in order to describe the total number of death arising out of CVD in comparison to total number of population living with CVD (illness). Bastien et al. (2014) have used “prevalence rate” in order to define the proportion of individuals residing in a population who have developed CVD during young age for being over-weight. Bastien et al. (2014) have utilized the term “risk factor” in order to describe the factor, which increases the risk of developing CVD among the obese individuals like hypertension, insulin resistance and dyslipidemia. Skinner et al. (2015) have used P-value in order to highlight the marginal significance of the probability of obese individuals towards developing high cholesterol, tri-glycerides, and hypertension. Significant p-value is again linked with the development CVD (Skinner et al. 2015).
Current strategy at state level
Common Wealth of Australia has drafted National Strategy for Heart Stroke and Vascular Health in Australia (NSHSVHA) with an aim to deliver a blueprint for improving the cardiovascular health of the Australians along with reducing the overall prevalence of heart, stroke and vascular disease. There are several strategies underlying the NSHSVHA. One of the important strategies, which are relevant under this context, is the strategy three. Its goal is to maximize the opportunities for the overall prevention of cardio vascular disease, stroke and heart attack via using key evidence-based messages and strategies, which are specifically tailored towards the people or the group of population who are at high risk of developing CVD. The chosen target group of population includes population who smokes tobacco; population inactive physically; and population suffering from high blood pressure and is obese/ over-weight. Apart from providing healthy interventions among the group of population who are at increased risk developing CVD, this strategy also targets people with known diseases like individuals who are already suffering from CVD (Common Wealth of Australia 2004). The main approaches undertaken in order to deal with the population who are already residing with disease include development of support system in the healthcare domain for proper risk factor monitoring and effective disease management. The strategy also aims to implement specific approaches in order to identify the adequately address barriers to improved recognition, treatment and management of depression in individual with CVD (Common Wealth of Australia 2004).
Argument
Collaboration
According to Feigin et al. (2014) population based strategies which are applied at the state level demand active collaboration and support from both the service users and service givers. This NSHSVHA strategy is link in with and at the same time support coordinated initiatives towards promoting physical activity, healthy eating and healthy weight gain in the target group of population thereby minimizing the overall risk of CVD disease and its associated complications like stroke or ischemic heart. The strategy also demands support initiatives in order to improve the overall food supply management in the rural and the remote areas in order to facilitate healthy eating and nutrition.
Importance of promoting physical activity and healthy eating as the main goals behind CVD risk reduction, is also acknowledged by Bleich et al.(2013). In their study, Bleich et al. (2013) reported positive evidences in the domain of combined diet and physical activity interventions at community level is effective in preventing obesity and over-weight tendency among the young adults. However, this spontaneous participation from both the service users and service givers are hindered at certain levels. Smith et al. (2014) highlighted lack of commitment; timing and inaccessible location might hinder comprehensive participation in community level, healthy life style programs. So in order to remove the barriers of location, such group-based activities must be staged in schools/ parks/colleges and offices. This will help to attract more and more young adults who are susceptible in developing the disease (CVD). In order to overcome the lack of commitment, the government of Australia must come up with population directed disease education program. This educational program will help in the generation of disease awareness thereby increasing spontaneous community level participation (Smith et al. 2014).
Apart from the community level collaboration, Feigin et al. (2014) also highlighted the importance of the collaboration among the healthcare professionals. Feigin et al. (2014) is of the opinion that the absence intra-professional collaboration among the doctors and the nurses results in the increase possibility of errors and negligence in the overall policy procurement and level of patient care. Thus Feigin et al. (2014) stressed over the acknowledgment of the effective communication among the nurses and the physicians via inter-professional teamwork. Moreover, nurses who spent majority of the time with the affected individuals are required to consolidate their role in the overall decision-making process in the providing patient care and education.
Sustainability
Sustainability in the healthcare design deals with the achieving the health and safety goals while maintaining the economic viability and limiting overall consumption of resources (Sagha Zadeh, Xuan and Shepley 2016). However, Sagha Zadeh, Xuan and Shepley (2016) is of the opinion that the healthcare professionals experience multiple hurdles in maintaining the suitability. The important barrier is the financial burden. van Hoof and Verkerk (2013) are of the opinion that in order to develop a health care strategy which is cost-effective and at the same time, is effective in generating successful results, the healthcare officials who are employed in strategy planning abide by few guidelines. First is thorough understanding about how the system of healthcare operates and the nature of maintenance that will be required to stringently manage the strategy. According to Fuster (2014) in order to make a CVD prevention health strategy a success, the healthcare officials who are involved in the strategy planning should not specifically concentrate on the strategy implementation but also indulge in monitoring the overall outcome of the implementation. Effective monitoring of the strategy outcome will help in further reframing of the healthcare strategy and thereby helping to make it more target-oriented and cost-effective. Therefore, in the domain obesity and CVD management among young Australian adults, proper monitoring of obesity rate and reduction in the rate of occurrence of CVD among the younger adults must be undertaken effectively (Fuster 2014). According to the AIHW (2017), the obesity rate among the young population of Australian has increased in during 2014 to 2015 and margin of increase is 19% from 1995. This increase in obesity has increased the overall disease burden by 5%. AIHW also highlighted that people who are 18 to 21 years old (born between 1994 to 1997) are abnormally obese in comparison to those born during 1974 to 1977 (variance rate is 16.5%). Thus, obesity control and CDV prevention strategy targeted towards young adults drafted on 2004 is not successful in the long-run. However, weight loss surgeries have also increased in 2014 to 2015 in comparison to 2005 to 2006. Thus, people are aware of obesity related risk of CVD but are unable to undertake healthy approaches for weight loss.
Capacity building
Capacity building is a process of improving skills, tools, knowledge and resources so that the organisation or the individuals working in that organisation is capable or comprehensively achieving their target. Schell et al. (2013) is of the opinion that effective capacity building enables a program to leverage resources to successfully implement and maintain evidence-based activities and policies. The capacity building is critical for maintaining sustainability of healthcare programs. If a program lags on sustainability capacity, it is bound to waste resources and money. This will in turn lead to the destruction of trust between the community and the program and thereby limiting the ability of the program to achieve its goals in public health (Schell et al. 2013). Therefore, proper skills that will be essential for capacity building in CVD control among obese population include skills to designing community levels programs that will facilitate active participation of the young adults. Resources and tools that will be important include a multidisciplinary team consisting of dietician, cardiologist, psychologist and nurse. They will work as a team and will help an obese individual to recover from gain gaining tendency while reducing the risk factors associated with CVD. Among the multidisciplinary team, the role of a nurse cannot be neglected. Nurses here will be responsible for counselling of the younger adults who are facing weight gain issues out of sheer depression (Rusch et al. 2015).
Conclusion
Thus from the above discussion it can be concluded that the CVD is a growing concern among the younger adults in Australia. The epidemiological evidences suggest that the obesity is associated with the development of high blood pressure, cholesterol and diabetes which increases the risk of developing CVD. The main social determinants of health which are associated with the development of the cardiovascular disease among the young adult population of Australia include lack of proper employment, poor lifestyle habits from the very early tenure in life and poor socio-economic position. The analysis of the second part of the assignment lead to the elucidation that government of Australia have target-population directed health care strategy in order to fight against the CDV and its associated disease burden. However, the plan drafted in 2004, is not successful in the present day scenario. This is because, though the plan supports active collaboration and community level participation, it lacks sustainable implementation. This lack of sustainable implementation has lead to increase in the obesity rate during 2014 to 2015. So in order to effectively prevent obesity associated CVD among the younger adults of Australia, proper suitable strategy with effective capacity building must be drafted and this will in turn promote to decrease the disease burden among the Australian youth. Rütten and Gelius (2013) further argued that apart from resources and skills, effective capacity building of healthcare policy must encompass an interactive approach. This will help to link knowledge to action towards the process of health promotion.
References
Alpert, M.A., Lavie, C.J., Agrawal, H., Aggarwal, K.B. and Kumar, S.A., 2014. Obesity and heart failure: epidemiology, pathophysiology, clinical manifestations, and management. Translational Research, 164(4), pp.345-356.
Australian Government Department of Health. 2017. Research and Statistics. Access date: 25th May 2018. Retrieved from: https://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-active-evidence.htm
Australian Institute of Family Studies. 2017. Report—Reality bites: Australia’s youth unemployment in a millennial era. Access date: 25th May 2018. Retrieved from: https://aifs.gov.au/cfca/2017/12/05/report-reality-bites-australias-youth-unemployment-millennial-era
Australian Institute of Health and Welfare. 2017. Over weight and Obesity. Access date: 25th May 2018. Retrieved from: https://www.aihw.gov.au/reports-statistics/behaviours-risk-factors/overweight-obesity/overview
Australian Institute of Health and Welfare., 2016a. Determinants of Health. Access date: 25th May 2018. Retrieved from: https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/determinants
Australian Institute of Health and Welfare., 2016b. Health of population group. Access date: 25th May 2018. Retrieved from: https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/population-groups
Backhans, M.C., Balliu, N., Lundin, A. and Hemmingsson, T., 2016. Unemployment is a risk factor for hospitalization due to alcohol problems: a longitudinal study based on the Stockholm Public Health Cohort (SPHC). Journal of studies on alcohol and drugs, 77(6), pp.936-942.
Bastien, M., Poirier, P., Lemieux, I. and Després, J.P., 2014. Overview of epidemiology and contribution of obesity to cardiovascular disease. Progress in cardiovascular diseases, 56(4), pp.369-381.
BBC News. 2015. Australians eating too much junk food, report finds. Access date: 25th May 2018. Retrieved from: https://www.bbc.com/news/world-australia-33843857
Bleich, S.N., Segal, J., Wu, Y., Wilson, R. and Wang, Y., 2013. Systematic review of community-based childhood obesity prevention studies. Pediatrics, 132(1), pp.e201-e210.
Chung, A., Backholer, K., Wong, E., Palermo, C., Keating, C. and Peeters, A., 2016. Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review. Obesity reviews, 17(3), pp.276-295.
Feigin, V.L., Forouzanfar, M.H., Krishnamurthi, R., Mensah, G.A., Connor, M., Bennett, D.A., Moran, A.E., Sacco, R.L., Anderson, L., Truelsen, T. and O’Donnell, M., 2014. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet, 383(9913), pp.245-255.
Fuster, V., 2014. Global burden of cardiovascular disease: time to implement feasible strategies and to monitor results.
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Holmes, M.V., Dale, C.E., Zuccolo, L., Silverwood, R.J., Guo, Y., Ye, Z., Prieto-Merino, D., Dehghan, A., Trompet, S., Wong, A. and Cavadino, A., 2014. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. Bmj, 349, p.g4164.
Rusch, D., Frazier, S.L. and Atkins, M., 2015. Building capacity within community-based organizations: New directions for mental health promotion for Latino immigrant families in urban poverty. Administration and Policy in Mental Health and Mental Health Services Research, 42(1), pp.1-5.
Rütten, A. and Gelius, P., 2013. Building policy capacities: an interactive approach for linking knowledge to action in health promotion. Health promotion international, 29(3), pp.569-582.
Sagha Zadeh, R., Xuan, X. and Shepley, M.M., 2016. Sustainable healthcare design: Existing challenges and future directions for an environmental, economic, and social approach to sustainability. Facilities, 34(5/6), pp.264-288.
Schell, S.F., Luke, D.A., Schooley, M.W., Elliott, M.B., Herbers, S.H., Mueller, N.B. and Bunger, A.C., 2013. Public health program capacity for sustainability: a new framework. Implementation Science, 8(1), p.15.
Skinner, A. C., Perrin, E. M., Moss, L. A., & Skelton, J. A. (2015). Cardiometabolic risks and severity of obesity in children and young adults. New England Journal of Medicine, 373(14), 1307-1317.
Smith, K.L., Straker, L.M., McManus, A. and Fenner, A.A., 2014. Barriers and enablers for participation in healthy lifestyle programs by adolescents who are overweight: a qualitative study of the opinions of adolescents, their parents and community stakeholders. BMC pediatrics, 14(1), p.53.
The Department of Health Australia. 2016. Cardiovascular Disease. Access date: 25th May 2018. Retrieved from: https://www.health.gov.au/internet/main/publishing.nsf/content/chronic-cardio
van Hoof, J. and Verkerk, M.J., 2013. Developing an integrated design model incorporating technology philosophy for the design of healthcare environments: A case analysis of facilities for psychogeriatric and psychiatric care in The Netherlands. Technology in Society, 35(1), pp.1-13.
Waters, A.M., Trinh, L., Chau, T., Bourchier, M. and Moon, L., 2013. Latest statistics on cardiovascular disease in Australia. Clinical and Experimental Pharmacology and Physiology, 40(6), pp.347-356.
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