DEPRESSION STRIKES AGAIN
As we age, we develop chronic medical diagnoses that affect our quality of life. These investigators quantified the life quality burden of 15 common chronic conditions such as stroke, cancer, diabetes, and arthritis, alone and in combination, among persons 65 years of age and older. Ninety percent of this cohort had at least one chronic medical problem. Along with congestive heart failure, depression produced the greatest decrement in health. Programs designed to improve health at the individual and societal levels must address depression, a modifiable but undertreated condition.
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PREVENTIVE CARE DEFICIT
According to the Centers for Disease Control and Prevention, seven out of 10 Americans die from chronic diseases like diabetes, heart disease, and cancer. Costs associated with using preventive services may deter people from getting screened for these conditions. Globally, other industrialized countries have fewer financial barriers to prenatal, pediatric, and other types of primary care.
Routine primary health care is critical to preventing or identifying illness in early stages when it can be treated. It has also been a core objective of population health since the 1978 Alma Ata Health for All Declaration. But research on the use of such care in the United States has focused on specific services like colorectal cancer screening and flu vaccination. Borsky et al. developed a new, more comprehensive method to measure how many adults use the high priority preventive services recommended for them. Their survey asks participants about 15 types of evidence-based, clinically relevant preventive care, and accounted for inappropriate use and overuse.
The figure shows that, as of 2015, only 8% of all adults age 35 and older received all recommended high-priority clinical preventive services. This measure reflects the survey’s assessment of multiple types of preventive care. Taking a deeper look, Borsky and colleagues found 22.4% of surveyed adults received at least 76% of the recommended care. Compared to women, men were more likely to receive up to 25% of suggested preventive care services. Only 4.7% of all participants did not receive any recommended services. Blood pressure screenings were most commonly received, and shingles vaccinations least.
The researchers argue that the comprehensive nature of their survey instrument will be useful for health systems to assess the preventive services they offer and their receipt. The authors also emphasize that their questionnaire can be used at both the national and practice-specific level to help identify the impact of changes to local and national policy on preventive service use.—Sampada Nandyala, PHP Fellow
Graph: Health Affairs Vol. 37, NO. 6: Hospitals, Primary Care & More Datawatch, “Few Americans Receive All High-Priority, Appropriate Clinical Preventive Services” by Amanda Borsky, Chunliu Zhan, Therese Miller, Quyen Ngo-Metzger, Arlene S. Bierman, and David Meyers.
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