Chronic Health Condition Consumers

Part
01
of seven
Part
01

Chronic Health Condition Demographic Profile

The demographic profile of a typical U.S. consumer who is at risk for chronic health conditions is that of an African American woman over the age of 65 who lives in a rural area, has an income of under $35,000 per year, and has a lower education level.

Age

  • In 2017, the average prevalence rate for eight major chronic disorders was 28.1% for people over the age of 65 and 24.1% for people under the age of 65.
  • The prevalence of most chronic health conditions is higher in older people than in younger people:
    • For arthritis, the prevalence rate in people over the age of 65 is 34.3% compared to 27.1% in people under the age of 65.
    • For asthma, the prevalence rate in people over the age of 65 is 4.6% compared to 7.9% in people under the age of 65.
    • For chronic obstructive pulmonary disease (COPD), the prevalence rate in people over the age of 65 is 11.6% compared to 12.4% in people under the age of 65.
    • For depressive disorder, the prevalence rate in people over the age of 65 is 15.4% compared to 31.2% in people under the age of 65.
    • For diabetes, the prevalence rate in people over the age of 65 is 27.4% compared to 26.6% in people under the age of 65.
    • For heart disease, the prevalence rate in people over the age of 65 is 28.8% compared to 16.9% in people under the age of 65.
    • For hyperlipidemia (high cholesterol), the prevalence rate in people over the age of 65 is 43.0% compared to 28.4% in people under the age of 65.
    • For hypertension (high blood pressure), the prevalence rate in people over the age of 65 is 59.9% compared to 42.6% in people under the age of 65.

Gender

  • Females in the U.S. are at higher risk of chronic health conditions than males.
  • In 2017, males had an average prevalence rate for eight major chronic disorders of 26.4% compared with 28.3% for females.
  • The prevalence of most chronic health conditions is higher in females than in males:
    • For arthritis, the prevalence rate in U.S. males is 26.7% compared to 38.4% in U.S. females
    • For asthma, the prevalence rate in U.S. males is 3.4% compared to 6.6% in U.S. females.
    • For chronic obstructive pulmonary disease (COPD), the prevalence rate is the same for both U.S. males and females (11.7%).
    • For depressive disorder, the prevalence rate in U.S. males is 13.0% compared to 22.0% in U.S. females.
    • For diabetes, the prevalence rate in U.S. males is 28.0% compared to 25.9% in U.S. females.
    • For heart disease, the prevalence rate in U.S. males is 32.4% compared to 22.4% in U.S. females.
    • For hyperlipidemia (high cholesterol), the prevalence rate in U.S. males is 40.7% compared to 40.6% in U.S. females.
    • For hypertension (high blood pressure), the prevalence rate in U.S. males is 55.6% compared to 58.4% in U.S. females.

Location

  • People living in rural areas are at higher risk of chronic health conditions than people living in metropolitan areas.
  • In 2016, 22.6% of people living in rural areas in the U.S. had 2-3 chronic conditions compared to 18.9% of people living in urban areas.
  • The prevalence of most chronic conditions (except asthma) is higher in rural areas than in urban areas:
    • In rural areas, 31.1% of people have arthritis compared with 25.1% of people in urban areas.
    • In rural areas, 13.9% of people have asthma compared with 14.0% of people in urban areas.
    • In rural areas, 8.7% of people have chronic obstructive pulmonary disease (COPD) compared with 6.3% of people in urban areas.
    • In rural areas, 20.1% of people have depressive disorder compared with 17.5% of people in urban areas.
    • In rural areas, 12.0% of people have diabetes compared with 10.4% of people in urban areas.
    • In rural areas, 8.6% of people have heart disease compared with 6.5% of people in urban areas.
    • In rural areas, 42.4% of people have hyperlipidemia (high cholesterol) compared with 38.8% of people in urban areas.
    • In rural areas, 38.1% of people have hypertension (high blood pressure) compared with 32.6% of people in urban areas.

Ethnicity/Race

  • African Americans are at a higher risk of chronic health conditions than Asians/Pacific Islanders, white non-Hispanics, American Indians/Alaskan Natives, and Hispanics.
  • In 2017, African Americans had an average prevalence rate for eight chronic health conditions of 28.7% compared to 26.0% for Asians/Pacific Islanders, 27.6% for white non-Hispanics, 27.7% for American Indians/Alaskan Natives, and 27.8% for Hispanics.
  • The prevalence of most chronic conditions is higher in African Americans than in other ethnicities and races:
    • For arthritis, the prevalence rate in white non-Hispanics was 33.9% compared to 32.3% in African Americans, 30.2% in Hispanics, 25.6% in Asians/Pacific Islanders, and 32.1% in American Indians/Alaskan Natives.
    • For asthma, the prevalence rate in white non-Hispanics was 4.9% compared to 7.1% in African Americans, 6.1% in Hispanics, 5.0% in Asians/Pacific Islanders, and 6.4% in American Indians/Alaskan Natives.
    • For chronic obstructive pulmonary disease (COPD), the prevalence rate in white non-Hispanics was 12.4% compared to 10.6% in African Americans, 8.5% in Hispanics, 7.0% in Asians/Pacific Islanders, and 13.0% in American Indians/Alaskan Natives.
    • For depressive disorder, the prevalence rate in white non-Hispanics was 18.7% compared to 15.3% in African Americans, 17.9% in Hispanics, 9.6% in Asians/Pacific Islanders, and 19.8% in American Indians/Alaskan Natives.
    • For diabetes, the prevalence rate in white non-Hispanics was 24.9% compared to 37.9% in African Americans, 38.8% in Hispanics, 36.8% in Asians/Pacific Islanders, and 39.6% in American Indians/Alaskan Natives.
    • For heart disease, the prevalence rate in white non-Hispanics was 27.7% compared to 24.4% in African Americans, 24.8% in Hispanics, 23.1% in Asians/Pacific Islanders, and 24.8% in American Indians/Alaskan Natives.
    • For hyperlipidemia (high cholesterol), the prevalence rate in white non-Hispanics was 41.3% compared to 37.0% in African Americans, 40.1% in Hispanics, 43.5% in Asians/Pacific Islanders, and 31.3% in American Indians/Alaskan Natives.
    • For hypertension (high blood pressure), the prevalence rate in white non-Hispanics was 56.7% compared to 64.9% of African Americans, 55.6% in Hispanics, 57.2% in Asians/Pacific Islanders, and 54.2% in American Indians/Alaskan Natives.

Income Level

  • Poor adults in the United States are "five times as likely as those with incomes above 400 percent of the federal poverty level to report being in poor or fair health."
  • Low-income Americans have higher prevalence rates of heart disease, diabetes, and other chronic conditions compared to higher-income Americans.
  • People in the U.S. earning $35,000 or less are four times more likely to report being nervous and five times as likely to report being sad compared with people earning $100,000 or more.
  • Lower-income Americans have higher rates of behavioral risk factors like smoking, obesity, and drug abuse than higher-income Americans.

Education Level

  • According to Healthy People 2020, the "risk for chronic health conditions such as heart disease, diabetes, and obesity is higher among those with the lowest income and education levels."
  • More educated Americans tend to "have less anxiety and depression, have fewer functional limitations, and are less likely to have a serious health condition like diabetes, cardiovascular disease or asthma."

Research Strategy

To find the demographic profile of U.S. consumers who are at risk for chronic health conditions, we began by searching official government reports or analysis of official government reports. This provided us with information on age, gender, location, and ethnicity. However, the data for location was limited to eight chronic conditions, which are arthritis, asthma, chronic obstructive pulmonary disease (COPD), depressive disorder, diabetes, heart disease, hyperlipidemia (high cholesterol), and hypertension (high blood pressure). As a result, we elected to only provide data on those eight conditions for the other characteristics to maintain consistency across analysis. The income level and education level were obtained from analyses of various government reports that are older, but remain relevant since they are still being used in current assessments. Note that the relevant Excel tables on the CMS website were converted to a shareable Google spreadsheet so they could be attached and cited in this research.

Calculations

To obtain the average prevalence rate for chronic conditions for people over the age of 65, we added all prevalence rates for the eight chronic conditions and divided by eight:

34.3% + 4.6% + 11.6% + 15.4% + 27.4% + 28.8% + 43.0% + 59.9% = 225 / 8 = 28.1%

To obtain the average prevalence rate for chronic conditions for people under the age of 65, we added all prevalence rates for the eight chronic conditions and divided by eight:

27.1% + 7.9% + 12.4% + 31.2% + 26.6% + 16.9% + 28.4% + 42.6% = 193.1 / 8 = 24.1%

To obtain the average prevalence rate for chronic conditions for males, we added all prevalence rates for the eight chronic conditions and divided by eight:

26.7% + 3.4% + 11.7% + 13.0% + 28.0% + 32.4% + 40.7% + 55.6% = 211.5 / 8 = 26.4%

To obtain the average prevalence rate for chronic conditions for females, we added all prevalence rates for the eight chronic conditions and divided by eight:

38.4% + 6.6% + 11.7% + 22.0% + 25.9% + 22.4% + 40.6% + 58.4% = 226 / 8 = 28.3%

To obtain the average prevalence rate for chronic conditions for whites non-Hispanics, we added all prevalence rates for the eight chronic conditions and divided by eight:

33.9% + 4.9% + 12.4% + 18.7% + 24.9% + 27.7% + 41.3% + 56.7% = 220.5 / 8 = 27.6%

To obtain the average prevalence rate for chronic conditions for African Americans, we added all prevalence rates for the eight chronic conditions and divided by eight:

32.3% + 7.1% + 10.6% + 15.3% + 37.9% + 24.4% + 37.0% + 64.9% = 229.5 / 8 = 28.7%

To obtain the average prevalence rate for chronic conditions for Hispanics, we added all prevalence rates for the eight chronic conditions and divided by eight:

30.2% + 6.1% + 8.5% + 17.9% + 38.8% + 24.8% + 40.1% + 55.6% = 222 / 8 = 27.8%

To obtain the average prevalence rate for chronic conditions for Asians/Pacific Islanders, we added all prevalence rates for the eight chronic conditions and divided by eight:

25.6% + 5.0% + 7.0% + 9.6% + 36.8% + 23.1% + 43.5% + 57.2% = 207.8 / 8 = 26.0%

To obtain the average prevalence rate for chronic conditions for American Indians/Alaskan Natives, we added all prevalence rates for the eight chronic conditions and divided by eight:

32.1% + 6.4% + 13.0% + 19.8% + 39.6% + 24.8% + 31.3% + 54.2% = 221.2 / 8 = 27.7%
Part
02
of seven
Part
02

Chronic Health Condition Psychographic Profile

Individuals who are most at-risk for chronic conditions are older individuals who have low-incomes and live in rural areas. A psychographic profile of this cohort has been compiled which examines their general habits, values, spending habits, and media consumption habits. A deep dive into this profile has been provided below:

U.S. Consumers at Risk for Chronic Health Conditions

  • Previous research has determined that individuals in the U.S. who are at a higher risk for chronic health conditions are older individuals (baby boomers), individuals living in rural areas, and those with lower levels of income.
  • Based on these findings, the psychographic profile for U.S. consumers who are at-risk for chronic health conditions will revolve around this demographic set.

General Habits

Baby Boomers

  • Baby boomers are conversationalists and prefer being social.
  • Reliability is a key trait among baby boomers, and they consider themselves to be down-to-earth and friendly.
  • 82% of baby boomers drink coffee on a regular basis, and 32% like having their coffee at home.

People in Rural Areas

  • Drug addiction and abuse is considered to be one of the biggest issues facing rural populations.
  • 52% of rural Americans say that they actively work to solve problems in their local communities.

Lower-Income Levels

  • Individuals with lower income levels have significantly higher obesity rates.
  • Lower-income individuals 'go out' (i.e. a fun outing) less often. This includes for hospitality, travel, and entertainment.

Values

Baby Boomers

  • Baby boomers value positivity, relationships, and hard-work.
  • They have high expectations for their retirement years and enjoy new experiences.

People in Rural Areas

  • Americans in rural areas have "strong ties to local communities," with 62% saying they feel attached to the community and their neighbors.
  • Rural Americans value their work, family, and life.

Lower-Income Levels

  • Individuals with lower-incomes value smaller homes as they "require less money to support the same lifestyle as larger ones."
  • Low-income earners likely live paycheck-to-paycheck and value taking care of their families and doing what they can to keep their homes going.
  • Low-income earners may develop psychological stress due to their financial situation which results in them not setting goals and not planning for/thinking about their future.
  • Low-income earners may suffer from the burden of scarcity which causes them to worry about paying bills and not be able to focus on many other things.

Spending Habits

Baby Boomers

  • Many boomers are still in the workforce due to financial struggles and many have trouble paying for their important expenses, such as medical bills.
  • Boomers are avid online shoppers. They spend money on their pets (making up 46.8% of total pet spending), health products, and housing.
  • Boomers also spend money on travel and retirement savings, however, almost 70% expect to be working past the age of 65.
  • 55% of boomers have money saved for retirement and put 9-10% of their savings in retirement.

People in Rural Areas

  • Individuals in rural areas spend less money on groceries than urban and suburban dwellers.
  • In general, the amount of shopping done by individuals in rural areas has declined since 2017.

Lower-Income Levels

  • In the United States, "the bottom 40% of earners had less discretionary income in 2017 than they did 10 years ago."
  • Individuals with lower-income levels are more likely to be obese. In tandem with this, obese individuals spend 42% more money on health care costs.
  • Low-income individuals are living under more financial pressure than low-income cohorts did 30 years ago.
  • Low-income individuals spend about 19% of their money online.

Media Consumption Habits

Baby Boomers

  • Boomers are a primary consumer of online content, and 80% use the internet on a daily basis.
  • Since 2006, the use of social media among individuals over the age of 50 has increased 1000%.
  • 80% of boomers research products on the internet and they respond well to storytelling, testimonials, and analytical content.

People in Rural Areas

  • 65% of rural individuals in the U.S. have broadband service at home as of 2019. Likewise, 71% have a smartphone, 49% have a tablet, and 69% have a computer.
  • 75% use the internet on a daily basis, while only 15% say they never use the internet.

Lower-Income Levels

  • 29% of low-income Americans do not have a smartphone, while 44% don't have in-home broadband. Additionally, 46% don't have a computer, the majority do not own a tablet. This suggests that the majority of low-income individuals do have smartphones, broadband access, and computers.
  • 68% of low-income Americans use social media as of 2019.
Part
03
of seven
Part
03

Companies Approaching Consumers with Chronic Diseases

Organizations and companies use different approaches to U.S. consumers who are at-risk for chronic health conditions by using multimedia campaigns, offering community programs, online community forums, telephone help centers, and events.

Multimedia Campaigns (Commercial Ads)

  • National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) helps Americans to live a quality life by staying healthy and reducing the impact of chronic diseases.
  • From its media campaigns, it targets not only those who have chronic diseases, but also those at risk of suffering from them (chronic-related diseases). The campaign targets current smokers, Americans who are at risk suffering from Type 2 diabetes, and adults aged 40-64, because they are vulnerable to arthritis.
  • The commercial ad, “Tips From Former Smokers”, targets smokers by showing stories of Americans suffering from smoking-related diseases. On the CDC campaign page, there are other commercials and videos the company has released relating to "how to stay healthy and avoid chronic diseases".
  • Another move of NCCDPHP’s efforts is using multimedia tools and platforms, such as social media (Facebook and Twitter), podcasts, and content syndication, as part of its information dissemination to reach Americans.

Online Community Forums

  • The American Diabetes Association offers risk tests for Americans who are at risk to get diabetes. The at-risk population includes individuals who are 45 years old and over, have a family member who already has diabetes, overweight, physically inactive, pregnant, among others.
  • Also, the association has an online community that serves as a forum on topics surrounding diabetes. Here, those who are at-risk or already have diabetes can ask, share, listen, and learn from each other.
  • The same can be seen in an organization named the Obesity Action Coalition. It's an online membership-community where members find educational resources, public and private resources, programs and events, and online forums about obesity.

Community Programs

Help Center via Telephone

  • Mental Health America organization reach out to Americans who are at risk or already have behavioral health conditions. The company offers telephone counseling, which is available 24 hours per day, to affected people.
  • For those who are at risk, such as someone who is showing symptoms or feeling that something is 'not right', MHA offers a mental health screen.
  • Also, various organizations, including Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, and Centers for Disease Control and Prevention have joined efforts, have joined efforts to reach out to Americans who are at risk for chronic diseases via telephone help center called Quitline.
  • Quitline provides counseling, support, and other services for smokers to quit smoking.

Events

  • Miller Children’s & Women’s Hospital Long Beach and the University of California, nonprofits organizations, held an annual Super Kids Saturday 5K & Fun Run event to raise awareness of childhood obesity. The event also promoted a healthy lifestyle and tips to stay fit. It (event) targeted the families with children who were at risk for obesity.
  • Nonprofits Aztlan Athletic Foundation and Friendship Academies partnered to host an Annual 5K Run/Walk & Stroller Roll for children, families, and the community to promote physical activity. This event targets families with children who are at risk for obesity so that they can be educated and encouraged to engage in physical activities and adhere to healthier choices and habits.
  • According to the Friendship website, 1 in 3 children in the United States is overweight, which puts him/her at risk for chronic health conditions such as asthma, cholesterol, and heart diseases.
Part
04
of seven
Part
04

Consumers With Chronic Conditions: Managing Their Disease

The burden of chronic disease is substantial, with many consumers affected. US consumers who are at risk of chronic disease manage their conditions through a range of behavioral and pharmacological interventions. Although many of the management techniques adopted are cliche, they do work and have considerable research behind them that attests to their efficacy.

Get Screened

  • The World Health Organization (WHO) is the global leader in public health and health responses. They have produced a comprehensive report detailing the best ways to prevent and minimize the progression of chronic disease in at-risk populations. It identifies screening as a positive way to manage the risk of chronic disease.
  • Screening is the "systemic application of a test to identify individuals at risk of a specific disease." It allows early detection and treatment. Screen testing can limit progression, improve quality of life, and limit health costs.
  • Cardiovascular disease, diabetes, hyperlipemia, kidney disease, and a range of cancers are all chronic diseases that have screening tests.
  • A recent study evaluated the laboratory results of 35,254 employees of a company that had participated in health screenings since 2017. Testing detected 1,185 cases of prediabetes, 287 cases of diabetes, 73 cases of chronic kidney disease, 669 positive colorectal screening tests per 10,000 people assessed.
  • Early detection resulted in delaying 34 cases of end-stage kidney disease and diabetes complications, 210 incidences of diabetes, and 3 cases of late-stage colorectal cancer per 1,000 cases identified.
  • The study concluded that pathways that detect disease that was previously unrecognized and early-stage disease have the potential to positively impact the health trajectories of individuals within 1 to 5 years.

Know Family History

  • Individuals that have a family history of chronic disease, including cardiovascular disease, diabetes, cancer, and osteoporosis, have a higher risk of developing that condition compared to those individuals with no family history.
  • Forewarned is forearmed. If an individual is aware of their family history, they can work with the doctors to take all available steps to minimize the risk of development. Risk minimization could include pharmacological or behavioral interventions.
  • The 3 major causes of death in the US annually are diabetes, cardiovascular disease, and cancer. All of these diseases have strong genetic links. By being aware of the genetic risk factors, an individual can adopt strategies to minimize the risk.
  • Public health is increasingly seeing the benefits of implementing strategies and behavioral modifications in groups of individuals with a known family history of chronic health conditions.

Adopt a Healthy Lifestyle Including Physical Activity and a Healthy Diet

  • A WHO study with participants in the US, Finland, and China found that eating a healthy diet and undertaking regular physical activity can prevent type 2 diabetes in a relatively short space of time. Blood pressure, cholesterol, and triglycerides, and blood glucose levels all improved within one year of implementing the diet and exercise plans in study participants. The improvements continued over the 6 years studied, with a 60% reduction in diabetes among the participants in the US.
  • In another study, a healthy diet and physical exercise were shown to decrease the risk of chronic heart disease in men aged 40 by 50%, while at age 70, there is a 20% reduction.
  • Public health initiatives, which include healthy eating and physical activity in the US, has resulted in a steady decline in chronic heart disease.
  • Research has shown a causal link between poor diet and lack of exercise and the development and progression of chronic mental illness. A healthy diet and regular exercise are well-established elements of a treatment plan for depression and anxiety.
  • Only 50% of American adults currently meet the weekly guidelines for aerobic exercise. Only 20% meet the weekly guidelines for aerobic exercise and resistance training.

Get Enough Sleep

  • The link between sleep deprivation and chronic illness has grown significantly, with the CDC linking lack of sleep to diabetes, obesity, cardiovascular disease, and depression.
  • Sleep deprivation is linked to the development of type II diabetes as it affects the ability of the body to process glucose. Adults that do not have 5 hours of sleep per night have an increased incidence of diabetes. By improving the quality of sleep, blood sugar control enhances.
  • A recent study found that for those with preexisting hypertension, as little as one miserable night's sleep can elevate blood pressure levels.
  • When a person has less than 5 hours of sleep per night, feelings of anger and stress increase. They experience declining feelings of optimism and mental exhaustion.
  • For an adult, the optimal amount of sleep is 7 to 9 hours per night. Older adults can manage with 7 to 8 hours per night.

Stop Smoking

  • More people are addicted to nicotine than any other drug in the US. Smoking is responsible for nearly 480,000 deaths each year in the US. The most common chronic diseases associated with smoking are cardiovascular disease, lung disease, and several cancers. There is a causal link between smoking and a worsening outcome in several chronic conditions.
  • Smoking cessation accompanied with a healthy diet and exercise results in a risk reduction of 60% in people with established cardiovascular disease. It contributes to glucose control in those at risk of diabetes.
  • The resulting chronic disease from smoking can result in a lower life expectancy of up to 10 years compared to non-smokers.
  • People at risk of chronic pulmonary disease need to abstain from smoking to stop the disease progression completely. It is difficult to reverse the effects of lung disease and the associated symptoms like cough, wheeze, and shortness of breath, but it has been shown to slow or stop the progression of disease when compared to ongoing smokers.
  • Health benefits, including the risk of chronic disease, start in as little as one hour after the last cigarette with a reduction in heart rate, lowering of blood pressure, and improved circulation.

Use Pharmacological Interventions

  • An individual with a significant risk of chronic disease can be prescribed medications that will reduce their risk of the disease developing.
  • Aspirin, cholesterol-lowering (statin), and blood pressure-lowering (Beta Blocker/ACE Inhibitor) medications have been shown to reduce the risk of cardiovascular disease by 75%.

Research Strategy

We extensively searched a range of medical publications, scholarly articles, health promotion guidelines, pharmacological guidelines, and public health reports to determine the ways that consumers who are at risk of chronic health conditions manage their conditions. We were able to identify several key ways. All the interventions we identified are widely supported, well-implemented nationally, and have proven results.
Part
05
of seven
Part
05

Effective Management Programs for People with Chronic Conditions

The Chronic Care Model involves six components for effective chronic illness management, but clinical information systems and self-management support are the two components that have been shown to have the biggest impact on positive patient outcomes. Some self-management elements that are important are patient relationships and environmental factors.

Chronic Care Model

  • The chronic care model was initially created in the mid 1990s and was updated in 1997, 1998, and again in 2003. The model contains six components that are important for the management of chronic illness.

Health System/Organizational Support

  • The patient's provider needs to ensure that high quality care is prioritized by dealing with errors openly and coordinating care with all providers, whether in the same medical system or not.

Clinical Information Systems

  • Having a system in place for managing data allows for improved management of care as well.
  • A strong data system allows for tracking patient care, easy communication with patients, and efficient management of treatment plans.
  • Studies show this component results in positive impacts for both patients and practices.

Delivery System Design

  • Designing a care plan that meets patients' needs and utilizes evidence-based care is a critical component to effectively manage chronic conditions. The design should include details on who is providing different aspects of the care, when follow-up will occur, and how the case will be managed.
  • A review of over 150 studies that were done on the effectiveness of the Chronic Care Model, that was published in 2018, found that effective delivery system design resulted in positive professional and patient outcomes, but only for management of type 2 diabetes and hypertension.

Decision Support

  • It is critical that there is a plan in place for how care decisions are made. This could include decisions on when to involve a specialist, how to provide education related to care, and how to ensure that decisions are made using evidence-based guidelines.
  • A review of studies related to decision support found that the positive outcomes from this component was limited to the professional practice and did not directly impact patient outcomes.

Self-Management Support

  • Another important element of effective management of chronic illnesses is ensuring that patients have the tools they need to self-manage their condition. This includes things such as providing patients with needed resources, empowering patients to take responsibility for their care, and providing support to patients throughout the process.
  • A 2018 study that examined about 150 studies that were published between 2006 and 2014 found that self-management support was the component that most consistently resulted in improved patient outcomes.

Community Resources

  • This involves not only ensuring that patients know about the resources that are available to them, but also actively working to create partnerships and policies that may provide assistance and interventions that are not currently available for patients.

Self- Management Components

  • Since self-management support was shown to be the most effective component for positive patient outcomes, some elements that have been shown to be effective in self-managing chronic illness are being included.

Strong Relationships

  • Studies show that patients with strong relationships with their medical providers (primarily nurses), as well as with family and friends, are able to better manage chronic diseases.

Chronic Disease Self-Management Program (CDSMP)

  • The CDSMP is a program that has been shown to be effective by multiple research studies.
  • Program participants attend a 2.5 hour workshop each week for six weeks and are taught techniques for managing their illness. The techniques are put into practice by tackling problems such as pain, depression, fitness, nutrition, medication, and communication.

Environmental Factors

  • Ensuring that the tools needed by the patient are easily available either at home or at locations that are easily accessible by the patient have been shown to improve adherence to treatment plans. This could include things such as fitness facilities, grocery stores, and medical accessories.
Part
06
of seven
Part
06

Barriers to Treatment of Chronic Conditions

Some of the barriers to treatment of chronic health conditions include the lack of access to health care services and resources, the lack of primary care providers, the lack of an integrated approach to care, the lack of support and advocacy, mental health issues, and low income/poverty.

BARRIERS TO TREATMENT OF CHRONIC CONDITIONS

1. Lack of awareness of and access to health care services and resources

  • The lack of sufficient information about the condition makes it difficult for patients to fully understand the complexities of their chronic disease as well as its treatment plan, which creates a barrier by limiting their access to easily reachable resources that can help manage their chronic conditions.
  • The lack of knowledge about alternative strategies and therapies to treat chronic diseases is also another barrier as it impedes the proper management of the chronic conditions.
  • Accessing reliable information can be a barrier to managing chronic conditions especially in the age of “Google”. This makes finding good information difficult, as people could choose treatment options and alternative therapies that risk their health.
  • In fact, physicians also lack an understanding of the resources available for chronic diseases, which limits their ability to recommend a proper approach to treating the chronic condition.

2. Lack of primary care providers

  • A significant barrier to the self management of chronic disease is patients not having a primary care provider, which prevents them from accessing vital health services and specialists.
  • In fact, many doctors do not accept new patients that have a chronic disease.
  • Many patients are afraid to ask questions about their condition because they are embarrassed about their symptoms, which subsequently creates a barrier between them and their health care providers and impacts the management and successful follow through on treatment plans.

3. Lack of an integrated approach to care

  • The fragmented nature of chronic care services is a barrier for individuals who live far from the centers or for those that travel. This is a barrier because the patients may require care and support from other specialists but since their care isn’t integrated they need to go through their primary physician.
  • The referral process also creates problems for patients who have to repeatedly go back and forth between family doctors and specialists.
  • Reliance on doctors, specialists and the belief that only doctors can address issues can be a barrier to accessing primary care as it limits the patients' ability to collaborate with other alternative professionals like nurse practitioners.

4. Lack of support and advocacy

  • Some people experience a lack of support, understanding, and acceptance of their chronic disease from family, friends, their employers, doctors, and insurance companies, which impacts their ability to manage their chronic condition effectively.
  • Not having a supportive employer who allows time off for medical appointments and sick days can become a significant barrier as it can have a negative impact on an individual with a chronic disease.
  • The lack of trust, empathy, understanding of patient’s barriers, and the attitude of "caring for" them instead of "supporting them can negatively affect the relationship between the health care provider and the patient.

5. Mental health issues

  • Depression and anxiety can lead to a lack of motivation, the feeling of loss of control, and helplessness, which can negatively impact the proper management of a chronic condition.
  • Self denial and anger can make the patient resistant to taking the necessary medication because they are under the belief that they have no chronic illness, which can worsen their condition.

6. Low Income/poverty

  • Having a low income can be a barrier as it limits the patients' ability to follow through on their treatment plan due to the expenses involved in buying nutritious groceries, prescriptions, medical devices, and fitness program fees.
  • Low income can also be a barrier as some may find it difficult to access transportation to get to appointments, resources, and programs.
  • Poverty can also become a barrier as it affects people’s ability to have a proper diet and exercise regime to keep their chronic disease in check. In addition, groceries available at food banks often do not include enough fruits and vegetables.
  • The episodic nature of chronic disease makes people more vulnerable to losing their jobs.

Part
07
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Part
07

Major Players in Chronic Healthcare

Avanos and Nextgen Healthcare are two examples of major players in the chronic health care industry. Both companies focus on chronic care management by providing chronic care management products and solutions. Full details on each company are provided below, including information about the chronic care solutions they offer and their value proposition.

Avanos

Nextgen Healthcare, Inc.

  • Nextgen Healthcare Inc. is among the top players in global chronic care management solutions. The company is a leading provider of chronic care management solutions, including information on reimbursement, chronic care plans, etc.
  • The company offers many solutions for different specialties, including ambulatory surgery, cardiovascular surgery, urgent care, primary care, etc.
  • Nextgen's value proposition is that its "comprehensive, integrated technology and services platform" can manage both ambulatory and specialty care services of all sizes. It also claims to support ambulatory care providers and the individuals they care for.
  • Nextgen Healthcare Inc. has an estimated annual revenue of $529 million. It is considered a key player in chronic disease care management by industry reports such as those published by Business Wire.
  • Importantly, Nextgen Healthcare Inc. provides care management services for numerous chronic conditions. Likewise, it also offers digital solutions to help manage chronic health conditions.

Research Methodology

To determine the two major players in the chronic health care industry in the U.S., your research team leveraged findings in reports focusing on global chronic disease management. On that note, we examined reports published by Business Wire, Grand View Research, Investopedia, and MedTech Outlook. In these reports were many examples; however, we had to benchmark them based on their annual revenues to remain with the top players only. While the world's top healthcare companies offer chronic care management services, we found out that they also provide many other healthcare services; therefore, we decided to focus on companies that either focus on chronic conditions only, i.e., Avanos, or offer a mix of services with increased focus on chronic health conditions; for instance, Nextgen Healthcare inc. Overall, we relied on industry reports identifying the top players in the chronic health care industry in the U.S. and avoided those top companies that manufacture products for the health industry as well as for other industries. The aim was to remain with healthcare-focused companies, which earn their revenue from the health care industry, as opposed to a mix of industries.
Sources
Sources