Submitted to Dr Sarah Combs in partial fulfillment of NR-466R Community Health Nursing Regis University February 2, 2013
2 Epidemiology Part 1
EPIDEMIOLGY OF HEART DISEASE
INTRODUCTION
Using a descriptive epidemiology approach, this paper will define heart disease and identify the problems of this disease on a local, state, and national level. The objectives of heart disease will be discussed and explored according to health data sources. Also, the impact of the effectiveness of the interventional programs that are designed and implemented to treat and prevent heart disease will be evaluated and discussed, as well.
WHAT IS EPIDEMIOLOGY? In layman’s terms, epidemiology can be defined as the study of anything that happens or befalls men. According to Stanhope & Lancaster (2010), “epidemiology is the science that explains the strength of association between exposures and health effects in human populations.” This study deals with distribution and determinants of health related states and the purpose of these studies are to control health. The goal of epidemiology is to identify and understand the casual factors and mechanism of disease, disability, and injuries so that effective programs and interventions can be designed to prevent the occurrences of these disease processes before they begin or progress, (Stanhope & Lancaster, 2010).
3 Epidemiology Part 1 DESCRIPTIVE EPIDEMIOLOGY APPROACH OF HEART DISEASE
Up to Date (2013) defines coronary heart disease as a pathological process that affects the coronary arteries and the entire arterial circulation. Coronary heart disease and cardiovascular disease are sometimes used synonymously together. These diseases include morbid diagnoses of stroke, hypertension, coronary heart disease, heart attacks, angina, and limb ischemia. However, when an outbreak of a disease occurs, the CDC (2013) must consider what is known about that particular disease by using a descriptive epidemiology approach. “The Center for Disease Control uses the 5W’s of descriptive epidemiology, as follows: * WHAT- the health issue of concern * WHO- person/group, who is getting the disease (age, sex, & race) * WHERE- geographic location where the rates are higher or lower * WHEN- time when disease occurred or occurs (seasonal , temporal, or ranges from hours to decades * WHY & HOW- causes , risk factors, & modes of transportation”
The Who,The Place, & Time
Wilson and Douglas (2013) reported at Up to Date that heart disease is a major cause of death and disability throughout the world. Its mortality rate has declined over the past four decade in the United States but remains responsible for about one-third of all the deaths over age 35. It has been estimated that nearly one-half of all the middle-aged men and one-third of middle-aged women in the United States will develop some manifestation of heart disease. 4 Epidemiology Part 1 According to the Mississippi State Plan for Heart Disease and Stroke Prevention Control (2004-2013), “special concern for residents of Mississippi is those with lower economic status, in rural areas or underserved counties, women, and African-Americans. Another mentioned group where those with under lying medical conditions that predisposed them to heart disease and stroke, particularly those with high blood pressure, high cholesterol, diabetes, and obesity.” Contributing to the needs of these individuals in the priority populations in Mississippi are factors such as education, poverty, and access to quality health care. The social nature of these factors limits the inclusion of any significant intervention strategies within the CVD Plan; however, identification of the magnitude of the problems and recognition of their contribution to the disparities in heart disease mortality will assist in the development of strategies to address the needs of these populations, (MS State Plan, 2004-2013)
LOCAL, STATE, & NATIONAL LEVEL OF HEART DISEASE Wilson & Douglas (2013) used population-based epidemiologic data to provide the way a disease evolves, progress, and terminates within any geographical location. However, prevalence and incidence are epidemiologic data that is pertinent to clinical data. “Incidence and prevalence are measures of disease that burdens a population. Up to Date, (2013) defines prevalence as the number of existing cases of a disease divided by the total population at a point in time and incidence defines the number of new cases of a disease over a period of time divided by the population at risk. These data are necessary to determine morbidity and mortality.
5 Epidemiology Part 1
However, the Third National Health and Nutrition Examination Survey, hypertension is nearly 40 percent greater in blacks than in whites (Burt, 1995), “but is more frequent and severe in blacks. Nationwide the prevalence of overweight and obesity combined is greatest in African-American, Native American women, and Hispanic with 66 percent of them falling in the overweight or obesity range. The prevalence of obesity is 37 % and is the greatest in African-American women than any other group.” The MS State Plan (2004-2013) to reduce these disparities among racial, socioeconomic, and geographical populations, approaches implemented in the general population will involve global and local approaches with effective planning and intervening.
OBJECTIVES RELATED TO HEART DISEASE Healthy People (2010) provide an abundant of objectives related to heart disease. The main three areas where my concern lies are as follows: * 12.1 Reduce coronary heart disease death. * 12.2 Increase the proportion of adults aged 20 years and older who are aware of the early warning signs and symptoms of a heart attack and the importance of accessing rapid emergency care by calling 911. * 12.9 Reduce the proportion of adults with high blood pressure.
6 Epidemiology Part 1
These objectives will require well developed collaboration and information to assist in promoting quality and education in this proportion of health.
CONCLUSION
The purpose of epidemiology is to find the causes of diseases that affect a population. Clinical data and public health are needed to create a descriptive epidemiology approach involving any disease. Appropriate data such as incidence, prevalence, morbidity, mortality, etc. play vital roles to study the risk and health related issues within a specific population. The task to promote healing and prevention in regards to heart disease and any other illness must be approached systematically in all populations to meet their objectives and to accomplish positive outcomes.
7 REFERENCES 1. Burt VL, Whelton P., Rochella EJ, et al. (1995). Prevalence of Hypertension in the U.S. adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1994 Hypertesion 25 (3): 305-313.
2. Douglas, Pamela S., and Wilson, Peter, (2013) Epidemiology of Coronary Heart Disease (2013), Retrieved from www.uptodate.com. 3. Stanhope, Marcia and Lancaster, Jeanette, (2010, pgs 86, 163) Foundations of Nursing in the Community Orientated Practice 3rd ed. Mosby Elsevier St. Louis, Missouri.
4. What is Heart Disease? Retrieved from www.gov/heartdisease 5. Objectives of Heart Disease, Retrieved from www.healthypeople2020.gov 6. Mississippi State Plan for Heart Disease and Stroke (2004-2013) Retrieved from www.msdh.state.MS.us/mddsite/states/resources/1670.pdf
