Program Planning for Target Population

Program Planning for Target Population

There are millions of deaths each year in the United States of which can be sorted in just about every way possible. Mortality is the number of deaths (from a disease or in general) per 1000 people and typically reported on an annual basis. We will explore the leading causes of death for those individuals who are between the ages of 35 and 44, to include all races, men and women who died between 1999 - 2002. We will also look at prevention programs that are in place for the leading cause of death.

Top 5 Leading Causes of Death

It truly is amazing how the leading cause of death can vary so much when age or race is factored in or out. The top 5 causes of death for individuals between the ages of 35 - 44 are as follows starting at: number 5:

# 5 = Accidental poisoning by and exposure to narcotics and psychodysleptics (hallucinogens), essentially over dosing on drugs.

# 4 = Atherosclerotic heart disease - Atherosclerosis is really a part of the disease process known as arteriosclerosis. Arteriosclerosis means hardening of the arteries and is divided into three variants (Doctor 2003)

# 3 = Bronchus or lung, unspecified - Malignant neoplasm of trachea, bronchus, and lung (ICD9 2003).

# 2 = Breast, unspecified - Breast Caner which was the number one cause of death in women ages 35 - 41 (ICD9 2003).

# 1 = Acute Myocardial Infarction (MI) - This is essentially a heart attack.

* Approximately 500,000-700,000 deaths caused by ischemic heart disease occur in the United States alone.

* More than one half of deaths occur in the pre-hospital setting.

* In-hospital fatalities account for 10% of all deaths. An additional 10% of deaths occur in the first year after an MI...

* Male predilection exists in persons aged 40-70 years.

* In persons older than 70 years, no sex predilection exists.

* An MI occurs most frequently in persons older than 45 years. (Stahmer 2005)

Causes:

* The predominant cause is a rupture of an atherosclerotic plaque with subsequent spasm and clot formation.

* Hypoxia due to carbon monoxide poisoning or acute pulmonary disorders Emboli to coronary arteries, which may be due to cholesterol or infectious causes

* Coronary artery vasospasm

* Arteritis

* Coronary anomalies, including aneurysms of the coronary arteries

* Excessive use of cocaine, amphetamines, and ephedrine

* Risk factors for atherosclerotic plaque formation include the following:

o Age (Usually greater than 45yrs old)

o Being male and younger than 70 years

o Smoking

o Hypercholesterolemia and hypertriglyceridemia

o Diabetes mellitus

o Poorly controlled hypertension

o Type A personality

o Family history

o Sedentary lifestyle (Stahmer 2005)

Patient Education:

* For excellent patient education resources. There is eMedicine's Cholesterol Center. Also, there will be patient education articles, Chest Pain, Coronary Heart Disease, and Heart Attack.

Education:

* Sponsor public awareness campaigns to raise awareness about signs and symptoms of heart disease and stroke and the importance of calling 9-1-1 when such symptoms appear.

* Implement informational campaigns to educate the public that high blood pressure is a major modifiable risk factor for heart disease and stroke, and that having blood pressure checked is an important first step in identifying and controlling high blood pressure and reducing the risk of heart disease and stroke.

* Promote professional education and training programs on systems that support quality health care.

* Strengthen prevention efforts through increased awareness and education about risk factor and lifestyle changes that affect high blood pressure, high cholesterol, diabetes, and smoking.

Policy:

* Promote development of policies to increase adherence to national guidelines for the prevention and control of high blood pressure.

* Support state-based policy development for universal 9-1-1 coverage.

* Promote enhanced policies for treating stroke as an acute emergency.

* Strengthen policies in a variety of settings that encourage healthy lifestyles (CVH 2006).

* Until fiscal year 1998, no federal funding had been directed to states to specifically target heart disease and stroke. Most state funds came through the general Preventive Health.(CDC 2005)

* Heart attacks and strokes can be prevented or delayed if the knowledge we already have is put into action now. In fact, a broad coalition of national organizations and federal health agencies have already adopted a comprehensive goal for preventing heart disease and stroke as part of the Healthy People 2010 national health goals. CDC and NIH have been assigned responsibility as co-lead agencies to head the nation's effort to attain the Healthy People 2010 goal for preventing heart disease and stroke. Congress charged CDC in 1998 to develop and implement state-based cardiovascular disease prevention programs in every state and U.S. territory. These recent mandates create a need and responsibility to formulate a long-range strategy to guide the public health community in preventing heart disease and stroke. Accordingly, in December 2001, CDC initiated a planning process that included an intensive series of expert consultations as the basis for developing this Action Plan (CVH