Tackling Chronic Disease In Europe

Chronic conditions and diseases are the leading cause of mortality and morbidity in Europe, accounting for 86% of total premature deaths, and research suggests that complex conditions such as diabetes and depression will impose an even greater health burden in the future - and not only for the rich and elderly in high-income countries, but increasingly for the poor as well as low- and middle-income countries. The epidemiologic and economic analyses in the first part of the book suggest that policy-makers should make chronic disease a priority. This book highlights the issues and focuses on the strategies and interventions that policy-makers have at their disposal to tackle this increasing challenge. Strategic discussed in the second part of this volume include (1) prevention and early detection, (2) new provider qualifications (e.g. nurse practitioners) and settings, (3) disease management programmes and (4) integrated care models. But choosing the right strategies will be difficult, particularly given the limited evidence on effectiveness and cost-effectiveness. In the third part, the book therefore outlines and discusses institutional and organizational challenges for policy-makers and managers: (1) stimulating the development of new effective pharmaceuticals and medical devices, (2) designing appropriate financial incentives, (3) improving coordination, (4) using information and communication technology, and (5) ensuring evaluation. To tackle these challenges successfully, key policy recommendations are made.

Noncommunicable diseases pose the greatest threat to the health of the people in the WHO European Region, yet this is an area where the greatest health gains are available at relatively modest cost. This book gives detailed insight into policy development in eight European countries over several decades to address the challenge of noncommunicable diseases, and draws out the main themes to assist policy-makers in formulating their own responses. While originally developed to support countries in implementing the WHO European Strategy for the Prevention and Control of Noncommunicable Diseases, the insights are likely to be of benefit to a much wider audience.

This publication explores some of the key issues, ranging from interpreting the evidence base to assessing the policy context for, and approaches to, chronic disease management across Europe. Drawing on 12 detailed country reports (available in a second, online volume), the study provides insights into the range of care models and the people involved in delivering these; payment mechanisms and service user access; and challenges faced by countries in the implementation and evaluation of these novel approaches.

This Open Access book highlights the ethical issues and dilemmas that arise in the practice of public health. It is also a tool to support instruction, debate, and dialogue regarding public health ethics. Although the practice of public health has always included consideration of ethical issues, the field of public health ethics as a discipline is a relatively new and emerging area. There are few practical training resources for public health practitioners, especially resources which include discussion of realistic cases which are likely to arise in the practice of public health. This work discusses these issues on a case to case basis and helps create awareness and understanding of the ethics of public health care. The main audience for the casebook is public health practitioners, including front-line workers, field epidemiology trainers and trainees, managers, planners, and decision makers who have an interest in learning about how to integrate ethical analysis into their day to day public health practice. The casebook is also useful to schools of public health and public health students as well as to academic ethicists who can use the book to teach public health ethics and distinguish it from clinical and research ethics.

Cardiovascular disease (CVD), once thought to be confined primarily to industrialized nations, has emerged as a major health threat in developing countries. Cardiovascular disease now accounts for nearly 30 percent of deaths in low and middle income countries each year, and is accompanied by significant economic repercussions. Yet most governments, global health institutions, and development agencies have largely overlooked CVD as they have invested in health in developing countries. Recognizing the gap between the compelling evidence of the global CVD burden and the investment needed to prevent and control CVD, the National Heart, Lung, and Blood Institute (NHLBI) turned to the IOM for advice on how to catalyze change. In this report, the IOM recommends that the NHLBI, development agencies, nongovernmental organizations, and governments work toward two essential goals: creating environments that promote heart healthy lifestyle choices and help reduce the risk of chronic diseases, and building public health infrastructure and health systems with the capacity to implement programs that will effectively detect and reduce risk and manage CVD. To meet these goals, the IOM recommends several steps, including improving cooperation and collaboration; implementing effective and feasible strategies; and informing efforts through research and health surveillance. Without better efforts to promote cardiovascular health, global health as a whole will be undermined.

The book discusses how labour law and welfare systems will be affected by the ongoing transformation of work. The first section considers demography from two different perspectives. On the one hand, it focuses on chronic diseases and their impact on work, emphasising the role and the regulation of welfare systems. On the other, attention is given to youth unemployment and to those forms of employment which might have an impact on young people. Section II touches upon the relationship between the environment and industrial relations, while the third part broaches the topic of the impact of technology in the context of the Fourth Industrial Revolution, also known as Industry 4.0. As such, this volume provides an exhaustive picture of the changes currently underway, considering all the aspects which will affect work now and in the future.

It is common for a doctor or healthcare professional to see an individual with a chronic health condition only a few times a year for a brief office appointment. Yet, the individual has to live with the health condition 24 hours a day, 7 days a week. So, who really is in charge of managing the health condition? The individual has to "micro-manage" their condition, while healthcare professionals can provide advice on treatment approaches or the "macro-management" of the chronic health condition. Promoting Self-Management of Chronic Health Conditions covers a range of topics related to self-management-theories and practice, interventions that have been scientifically tested, and information that individuals with specific conditions should know (or be taught by healthcare professionals). Data suggest that currently a majority of individuals in the U.S. has a chronic health condition, and as society ages and healthcare continues to improve individuals' life-spans, more people will experience a chronic health condition. Health systems need to shift from an acute care model of treatment to a chronic care treatment model, in view of this trend. The expanding need for the development and scientific analysis of formal self-management programs accompany this increase in chronic health conditions. This book serves the critical purpose of helping to increase understanding of self-management and how healthcare providers can empower individuals with chronic health conditions to self-manage.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.