Health for life

While the population health management service industry has a successful track record when it comes to chronic heart failure, diabetes and asthma, the Disease Management Care Blog thinks, after a quick scan of the literature, that there are fewer studies of its impact on hypertension.

 A recent Morbidity and Mortality Weekly Report (MMWR) reminds us that thats a problem.

The National Health and Nutrition Examination Survey(NHANES) performs interviews and physical examinations of a representative sample of U.S. households.  This particular report on the prevalence and treatment of high blood pressure was based on a sample of 20,811 individuals from four 2-year survey cycles that were performed from 2003 to 2010.

Extrapolating from the sample, 66.9 million persons or 30.4% of the U.S. populationn have high blood pressure. Of this population, just over half (54% or 35.8 million) have uncontrolled hypertension.  Of these persons, 31 million (or 88%) had been seen by a health care provider in the preceding year. The prevalence of uncontrolled hypertension among those hypertensives with Medicare was 52%. Not having health insurance or having seen a health care provider in the past year increased the risk of untreated and uncontrolled high blood pressure.

Whats more, the DMCB discovered control of hypertension doesnt appear to be getting better over time.

The good news is that the treatment of high blood pressure is not all that complicated and that team-based non-physicians can play an important role.  Patients should be engaged on weight control, a DASH diet, restricting salt, exercise and moderating alcohol intake. Medication therapy can be individualized and tailored to meet mutually agreed-upon goals and to minimize any barriers.  Check out this MMWR table and youll see erences to "lifestyle counseling," "self monitoring," "self-management education."

Given the looming shortage of primary care care settings and the coming influx of newly insured persons, the DMCB believes population health management will need to be part of the solution.  In addition to the established science, the industry 1) understands the importance of risk stratification, 2) can be bolted onto accountable care arrangements and 3) understands that optimal outcomes are somewhere between 46% and 100% control.

Hopefully, given the relative dearth of high quality studies, this opportunity will be accompanied by ongoing studies of outcomes.

Sweet readers! Hi there. It’s Kris. And I have a favor to ask yis.

First, some background: We’re all about life changes at the CHG Mansion lately. HOTUS and I are still cleaning up from the wedding. I started a new job last week. We’re buying a car, even though I’ve driven exactly once since 2004. Our cat barfed.

And now, the latest, most unexpected (but happy) development: we’re moving right after Thanksgiving.

As they say in France, LES YIKES.

Among many other fabulous things, this means theres not much time to blog, much less pack, much less see the new Harry Potter. (Crap!) Leigh and Jaime are taking up some of the slack, but we’re gonna need backup. So, I was wondering if any of y’all would be interested in providing it. With guest posts, I mean.

If you’re not interested, no worries. We’ll catch up over a few drinks later.

If you are interested, yay! I kiss you.

Here are the details: We’re looking for fun, original, grammatically sound recipe posts and CHG-esque articles. They can be personal accounts, experiments, Top 10s, or anything really, as long as the topics generally adhere to CHGs usual subject matter (cheap n healthy food). Also, taking a look at this Guest Submission Guideline post from Get Rich Slowly might be a good idea.

In return, we can offer you a fair amount of publicity for your own blog, website, small business, or backwoods militia. Our RSS feed is up over 10,000 these days, and we’re getting between 4,000 and 5,000 hits off of various search engines and links daily. So there’s that.

Should this sound like a fun idea, shoot me an e-mail at


to discuss a potential post, as well as a few blogging rules and regulations (formatting, recipes instruction rewrites, etc.). We’ll take the best ideas and run with ‘em, and see how it all ends up.

If you don’t receive a reply within a few days, I apologize, and will hopefully get to everybody as soon as possible. In the meantime, thank you for being more wonderful than an evening with Ina Garten, Tina Fey, and Eddie Vedder combined.

Now, off to clean up some cat barf.

Last October, the American Diabetes Association (ADA) distributed results of a government study which showed a rise in cases of diabetes:

"Newly released statistics from the Centers for Disease Control and Prevention (CDC) illustrate that diabetes has risen by over 14 percent in the last two years. The CDC estimates that 20.8 million Americans – 7 percent of the U.S. population – have diabetes, up from 18.2 million in 2003."
- ADA press release - October 26, 2005

Despite that news, when Congress passed its 2006 appropriations bill last year, it:

• Cut funding to the CDC’s Division of Diabetes Translation by $300,000. This marked the first time this divisions funding was cut.
  
  
• Cut funding to the NIHs National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) by $9 million.
  - ADA press release - December 22, 2005

Unfortunately, the White Houses proposed budget for 2007 continues to slash funds for these programs:

" ... the Bush Administration recently proposed a budget that would cut funding for diabetes prevention at CDC for the second straight year."

"The Administration also proposed in its budget an $11 million cut to the NIDDK."
- ADA press release - March 30, 2006

Hearings to address diabetes funding are ongoing. The ADAs "Call to Congress", a notable event that rounds up grassroots support, will rally in Washington this June:

"Throughout the year, policy makers will hear from diabetes advocates, including at the ADA’s “Call to Congress,” June 7-9, when hundreds of diabetes advocates from across the country will meet with members of Congress to urge an increase in funding for diabetes research and prevention."
- ADA press release - March 30, 2006

If youd like to take part in this years Call to Congress, visit the ADAs information and registration page.

________
ADA press release October 26, 2005 (pdf)
Newly-released CDC Study on Diabetes Reflects Growing Diabetes Epidemic

ADA press release December 22, 2005 (pdf)
Year in Review: Federal Commitment to Diabetes Prevention Falters in 2005 as Diabetes Epidemic Grows

ADA press release March 30, 2006 (pdf)
American Diabetes Association Urges Congress to Increase CDC Diabetes Prevention Funding by $20.8 Million: One Dollar for Every American with Diabetes

ADAs Call to Congress info and registration:
Call to Congress: Conquer Diabetes An event bringing Diabetes Advocates and their elected officials together in Washington, DC