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Chapter 5. The Presidents Recommendations for Prevention
Get Preventive Screenings
Preventive screenings and tests save lives. Unfortunately, many Americans do not routinely follow some basic health screening recommendations. Routine screenings can identify a previously undiagnosed condition or risk of condition. This allows physicians to intervene early with treatments and therapies to control the condition or inform the individual of lifestyle changes that can be taken to improve health outcomes and costs.
For example, screening for high blood pressure and high blood cholesterol is an important first step in identifying individuals who are at risk for chronic diseases but may be undiagnosed. Screening and appropriate follow-up for high blood pressure and elevated cholesterol can also save the lives of those at risk for heart disease. Early detection and treatment for diabetes can improve health, and the CDC recommends health professionals screen high-risk patients periodically, even when those individuals are visiting their doctor for another reason. Such opportunistic screenings can alert a health professional to troubling results requiring follow-up care.
Many studies have shown that dietary changes and therapies can dramatically reduce the risk of heart disease and stroke, especially when these modifications reduce high blood pressure and high blood cholesterol. When coupled with lifestyle changes, these therapies can be even more effective in lowering the risk of a heart attack or stroke. About 90 percent of all adults now have their blood pressure measured at least once every two years. In 1998, only 67 percent of adults had had their blood cholesterol checked within the preceding five years. Of the estimated 17 million people with diabetes in the country, about 5.9 million are undiagnosed. Without effective diagnosis and treatment, diabetes becomes a leading cause of blindness, kidney failure, heart disease, and stroke.
There are additional simple, preventive measures many Americans can take to reduce bad health outcomes. Pneumonia and influenza are responsible for more than 30,000 deaths among older adults each year. Immunization can substantially reduce the severity, risk of hospitalization, and risk of death from these diseases.
The Presidents Challenge:
Basic preventive health services such as health screenings are the most important health information Americans can receive about their current health status. Regular screenings can motivate individuals to modify their current activities and behaviors to improve their overall health. And seeking follow-up care based on basic preventive screenings can save lives. Every little bit of effort counts:
Promoting Preventive Health: Administration Actions
Healthy Communities Innovations Initiative--$25 million has been included in the Fiscal Year 2003 Budget for the development of best practices in communities to improve the health of their citizens and to prevent diabetes, asthma, and obesity. The Healthy Communities Innovation Initiative will fund demonstration projects in five communities to enhance access to services, encourage positive behavioral changes, and improve community health.
The Initiative will build partnerships at the local level and will match Federal with local resources to improve prevention and treatment activities. It will be administered by the HHS Health Resources and Services Administration in collaboration with the CDC and the Office of Disease Prevention and Health Promotion.
Diabetes Screening and Awareness--HHS is partnering with several medical and private organizations to increase the utilization of important diabetes screening tools. The Food and Drug Administration, the American Diabetic Association (ADA), and the National Association of Chain Drug Stores have partnered in a nationwide "Take Time to Care" campaign to raise the awareness of diabetes among women, who are at a greater risk for the disease. Distributing information at grocery stores, pharmacies, and other public places, the campaign highlights the warning signs that women need to recognize; the literature identifies all the screening services that are available. The program aims to arm women with key facts about preventing diabetes and guide them to appropriate, effective treatments once diagnosed.
HHS and ADA also have unveiled a new expert panels recommendations about pre-diabetes. Pre-diabetes is a condition affecting nearly 16 million Americans where blood glucose levels are higher than normal, sharply raising the risk for developing type 2 diabetes, but the individual does not yet have diabetes. The panels new recommendations call for physicians to begin screening overweight people age 45 and older for pre-diabetes and to counsel their patients about the high risk of getting diabetes.
Strengthening and Improving Medicare--Medicare+Choice plans are an increasingly reliable source for quality screening and prevention services. As a part of the Presidents broader initiative to improve the Medicare program, Medicare+Choice plans would be strengthened and made available to more beneficiaries. In addition to being more affordable and providing prescription drug coverage, Medicare+Choice plans provide extra benefits to support seniors with serious and chronic health conditions, such as programs to help patients with diabetes and cancer avoid complications. Medicare+Choice plans also provide innovative health care services that are generally not available in the traditional Medicare plan, such as annual checkups to catch health problems early, exercise and wellness programs, and programs to improve patient safety. Making Medicare+Choice plans more available would give seniors access to modern, reliable coverage options, similar to those available to all Federal employees through the Federal Employee Health Benefits Program.
Recommended Preventative Health Screenings
Age: 19 to 39
Age: 40 to 64
Age 65 and older
|Comprehensive screening exam||To promote wellness||Frequency should be tailored to age and health status. Consult your health professional.|
|Blood Pressure||To identify high blood pressure||Every 2 years for all ages|
|Cholesterol||To reduce risk of heart disease||
At least every 5 years
|To test for diabetes||Depends on risk factors and age. Consult with your health professional.|
|Colon cancer screening: Options include: Stool blood (fecal test) Sigmoidoscopy, Colonoscopy, Barium enema||To detect colorectal cancer||
After age 50: frequency depends on test:
FOBT: every year
Sigmoidoscopy: every 5 years
Colonoscopy: every 10 years
Barium enema: every 5 years
|Sigmoidoscopy or colonoscopy||To detect colorectal cancer or large polyps||Every 5 years beginning at age 50|
|Vision exam||To test vision and screen for glaucoma||Discuss with your health professional.|
|Hearing test||To monitor hearing||Every 10 years||Hearing loss increases at age 50 so discuss frequency of tests with your health professional.|
|Prostate-specific antigen (PSA)/DRE for prostate cancer||Blood test to detect prostate cancer||Guidelines vary. Discuss with your health professional.|
|Mammogram and clinical breast exam||Early detection of cancer||Every 1 to 2 years starting at age 40|
|Cervical cancer screening/pelvic exam||To detect cervical and ovarian cancer||Every 1-3 years depending on risk||Every 1-3 years depending on risk. Over age 65, if negative on previous screens, at your health professionals discretion.|
|Rubella antibody||To determine rubella immunity||One time prior to first pregnancy|
|Osteoporosis||To identify those at risk||At least once after age 65; earlier for high risk women|
Sources: U.S. Preventative Services Task Force