Series: Sciencious Medical Writing Conference
Introduction
Chronic disease is the leading cause of death amongst people within the state of New York, with heart disease being at the forefront followed by cancer and lower respiratory diseases. More than 40% of New York adults are diagnosed with a long-term illness and six out of every 10 deaths is attributed to a chronic disorder. Finally, to fully highlight the issue, 23% of all hospitalizations are deemed to be caused by a continuous, prolonged condition. Though they are notably common within New York, many chronic conditions are considered preventable and avoidable, so long as the average person is making the correct lifestyle choices. However, many New Yorkers are unable to make the right decisions for themselves due to conditions that have long been afflicting the population, namely, poverty. The instability, food insecurity and environmental conditions that accompany poverty facilitate the growth of chronic illness in lower-income communities.
How Poverty Contributes To Disease
It is an unfortunate truth that when living in impoverished conditions you are more exposed to risk factors for noncommunicable diseases. Noncommunicable diseases, or NCDs are diseases that are not spread through infection or through other people. These include illnesses such as cancer, diabetes, heart disease etc. In addition to an overexposure of risk factors, those in poverty are extremely limited in adopting behaviors that promote health as they can’t change their environment. Environmental factors play a huge role in the development of NCDs, and in some cases can be the primary reason for their growth, as is the case with certain forms of cancer. For example, mesothelioma is the result of consuming asbestos fibers and is not caused by any genetic or biological reason. Poorer and marginalized communities also face significant barriers to preventative, primary and/or acute care and a late diagnosis can often lead to premature mortality as opposed to if the person had received earlier treatment. To conclude, poverty facilitates chronic illness due to individuals being overexposed to risk factors, unable to adopt healthy habits, and having inadequate access to healthcare.
Monitoring and Understanding Risk Factors
The first step to lowering and eventually preventing chronic disease in vulnerable communities is through assessing what exactly puts them at risk. Through surveillance and epidemiology, we can pinpoint the exact reason why incidences of chronic illness appear more frequently within poorer areas. For starters, it’s possible to gather information from multiple data sources such as behavioral risk factor surveys, registries of chronic illness related deaths, and birth and death certificates. This would give us three different pieces of information : how many people are partaking in behavior that increases the risk of developing a noncommunicable disease, what specific noncommunicable disease they are at risk of, and the average age of death. Secondly, taking a look at issues that are more related to the environment along with some social factors that influence health would be greatly beneficial. We can use quantitative statistics such as how many fast food restaurants are located in the community or how many people are smokers within said area. In addition to that, we can measure the number of community members who are receiving healthcare preventative services, such as cancer screenings and/or stroke prevention. Finally, we can track policies/laws that affect community health, namely water fluoridation levels and smokefree air.
Environmental Approaches
A study provided by the Center on Budget and Policy Priorities showed that adults in households with very low food security are at least 40% more likely to be diagnosed with a chronic condition. These conditions include but are not limited to hypertension, coronary heart disease, hepatitis and stroke. Naturally, steps should be taken to lowering food insecurity in low income establishments, especially since it’s been proven that dietary habits affect your risk for disease. Establishing statewide nutrition programs and limiting the amount of fast food available can increase people’s consumption of healthy foods. In addition to that, healthy school meal programs can bring children nutrition that they don’t receive in their home. Passing smokefree air laws can also limit the amount of people inhaling cigarette smoke and hopefully lower incidences of lung cancer. Lastly, fluoridating water systems can also work to preserve dental health and lower the incidence of lesions within the mouth.
Interventions In The Healthcare System
The final, but perhaps the most important step in this plan of action would be to intervene in the healthcare system. With healthcare in the United States not being free, those from poorer communities are prevented from receiving healthcare that can prevent them from developing a noncommunicable disease. Due to this, making preventive care such as cancer screenings and stroke prevention more available becomes a priority. Advocating for health insurance to be extended towards prevention care can greatly benefit marginalized communities. In addition to that, increasing the use of health information technology such as clinical decision support and bringing awareness to their existence can ensure that people are receiving medical help even without the presence of a professional. In conclusion, through these initiatives, we can help impoverished communities in getting the resources needed to battle chronic illness.
References:
“Chronic Disease Disparities by County Economic Status and Metropolitan Classification, Behavioral Risk Factor Surveillance System, 2013.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 Sept. 2016, www.cdc.gov/pcd/issues/2016/16_0088.htm.
“How We Prevent Chronic Diseases and Promote Health.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 Apr. 2021, www.cdc.gov/chronicdisease/center/nccdphp/how.htm.
“Simple Digital Technologies Can Reduce Health Care Costs.” Harvard Business Review, 5 Apr. 2017, hbr.org/2016/11/simple-digital-technologies-can-reduce-health-care-costs.
“How Can Healthcare Technologies Help the Poor, The Forgotten Billion?” Dr. Hempel Digital Health Network, 15 Mar. 2018, www.dr-hempel-network.com/health-policies-in-india/healthcare-technologies-help-the-poor/.
