Free «Global Perspectives on Chronic Cardiovascular Diseases» Essay Paper

Today, a great number of chronic illnesses, including certain deadly cardiovascular diseases, hurts the health of people across the planet. According to Holtz (2016), global health refers to the civic variable related to the health of the planet, which goes beyond all political and geographical boundaries. Cardiovascular diseases (CVDs) are a significant contributor to the growing epidemic of non-communicable chronic diseases affecting the health of the public, with most of the burden affecting older adults above the age of 70, both in low and middle-income economies (Yeates et al., 2015). According to Yeates et al. (2015), the global threat of CVDs has major implications for the prevention and detection of the diseases, as well as the treatment of non-communicable illnesses as a whole. Therefore, it is paramount to curb this global health problem by understanding its historical perspective regarding the learning of nursing, healthcare disparities, formalized regulatory guidelines, moral and legal issues, the chronic burden of care, and the effect on economic costs and health care productivity.

Historical Perspectives on Chronic Cardiovascular Diseases

The history of chronic diseases, including CVD, spans several centuries as far as nursing and the entire health system are concerned. Bynum (2015) explains that dividing diseases into two categories (acute and chronic) is an old medical practice that dates as far back as the 16^th century, when the renowned English physician Thomas Sydenham first started differentiating between them. According to Sydenham’s classification, acute illnesses were caused by God while humans caused the chronic ones. Several years later, it was noted by physicians that some of the chronic illnesses could be treated if diagnosed during the early stages of disease; late identification could result in illnesses developing beyond the capabilities of human intervention (Bynum, 2015). Yeates et al. (2015) reiterate that when it comes to prevention of chronic cardiovascular diseases the focus should be on mitigating risk factors and early disease diagnosis to initiate appropriate treatment interventions. Basically, chronic illnesses were seen as an outcome of human behaviors that could be modified to enhance prevention and facilitate early treatment, which is still a relevant aspect of modern medicine.

Furthermore, the 19^th and 20^th centuries were full of significant historical milestones connected to non-communicable illnesses, including CVDs. Herbert Spencer, a 19^th-century evolutionary philosopher, advised his fellow humans to acquire chronic illnesses and nurse them as a way of seeking longevity, which was obviously paradoxical (Bynum, 2015). This position directly contradicted the 20^th century American chronic disease initiative; the relevant officials viewed chronic CVDs and other non-communicable illnesses as health problems that required prevention and treatment instead of simply consequences of aging (Bynum, 2015). In support of this stance, Pearson (2007) and Holtz (2016) state that chronic illnesses are preventable since they are less common among people without risk factors such as smoking, hypertension, diabetes mellitus, and hypercholesteremia. Such American clinicians as nurses pioneered periodic examination inspired by the belief that earlier diagnosis of chronic illnesses could reduce healthcare costs and increase life expectancy (Bynum, 2015). Additionally, insurance companies utilized medical examinations in order to screen for the risk factors of these diseases before setting appropriate premiums. Primarily, these improvements became so widespread due to the effects of globalization, something that was associated with marked progress in dealing with the menace of chronic CVDs.

The American chronic disease movement and the subsequent reclassification of chronic illnesses entirely transformed the global views on CVDs. This movement attracted the attention of public health experts and epidemiologists and triggered health care reforms to uncover chronic diseases across all age groups; eventually, most of the CVDs and other chronic diseases were found to be a major burden on the health of the aged population, which is a relevant phenomenon to this day. The Committee on Chronic Diseases (CCD) proceeded by adding the issue of chronic illnesses to the national health agenda after World War II; further, chronic disease hospitals were set up with clinicians such as nurses to take charge of patients who participated in rehabilitation programs for diseases like ischemic stroke (Bynum, 2015). All around the country, people initiated campaigns to curb chronic illnesses resulting in structural breakthroughs, such as the training of nurses and other clinicians on how to mitigate this health menace. Subsequently, chronic diseases were not classified into different groups with congenital illnesses, dementia, heart diseases, and tuberculosis; however, further classification differentiated cardiovascular conditions from cancers and many other lifelong health problems (Bynum, 2015). Therefore, CVDs are currently a specific class of chronic conditions affecting the cardiovascular system with their own particular risk factors and prevention and treatment interventions; as such, clinicians are learning and caring for patients, using modern treatments and prevention modalities.

Importance of Healthcare Disparities

Both health and healthcare are unevenly distributed not only in the United States but the world as a whole due to the demarcation of populations based on race, gender, and socioeconomic status. Graham (2015) explains that, according to the Institute of Medicine, health disparities are a result of quality healthcare differences, including access-related factors and clinical preferences, needs, and intervention appropriateness. In the United States, these disparities exist in terms of socioeconomic status, race or ethnicity, and gender with the overall costs associated with these disparities hitting the $1.24 trillion mark (Graham, 2015). Holtz (2016) reiterates that minorities and other underrepresented populations are more likely to have fewer healthcare access opportunities, worse socioeconomic status, and worse health outcomes than their counterparts. For instance, Asians and African Americans have fewer cardiovascular interventions and procedures in primary care settings than the white majority, which is an indicator of health inequality (Holtz, 2016).

Poverty and gender are some of the major causes of healthcare disparities with the disadvantaged population groups displaying unfavourable health outcomes attributed to unhealthy lifestyle choices and reduced access to healthcare access due to poverty. Non-communicable diseases are the most significant threat to the health of women since it causes nearly 65% of all female deaths in the world; CVDs was the leading cause of these deaths. Essentially, CVDs accounted for more than 33% of all female deaths in 2008 followed by parasitic and infectious diseases (13.9%) and neoplasms (13%) (Yeates et al., 2015). The prevalence, morbidity, and mortality rates of these chronic illnesses are higher in women as compared to their male colleagues, making the very fact of being a female into a risk factor for CVDs. Additionally, the lesbian, gay, bisexual, and transgender (LBGT) community, which cuts across religions, age, gender, and socioeconomic status, is at a higher risk of chronic CVDs than the general population (Hafeez, Zeshan, Tahir, Jahan, & Naveed, 2017). Moreover, this community receives low-quality care from clinicians lacking the necessary awareness specific to this population despite the prevalent risks of non-communicable conditions such as obesity (Hafeez et al., 2017). As such, much is required to curb the risk factors, both among females and LBGT groups, in addition to screening and diagnosing new cases for early treatment and better prognosis.

Non-communicable diseases, including debilitating CVDs, are associated with poverty and regional development across countries and populations. According to Yeates et al. (2015), people who live in poverty-stricken neighborhoods lack adequate financial resources to foster a healthy lifestyle, making low and middle-income populations the most vulnerable and least resilient to CVDs. These people face many challenges, including maternal health problems and communicable diseases that exhaust their meager health resources, which could have otherwise been utilized for curbing CVDs and other chronic illnesses (Yeates et al., 2015). That notwithstanding, adopting healthy living behavior patterns, such as eating in a balanced way and performing regular physical exercises become a problem; the burden of CVDs worsens when the poor are required to cover the treatments costs out of their pockets. Basically, poverty, which is rampant in low and middle-income economies, predisposes the underprivileged members of population to chronic CVDs, resulting in higher morbidity and mortality rates than in wealthier groups.

Formalized Regulatory Guidelines

Healthy People 2020 created regulatory guidelines for cardiovascular illnesses, including heart disease and strokes, aiming to curb all aspects of these health problems such as disease treatment and prevention. According to Healthy People 2020 (2017), these guidelines aim to improve the health and quality of life for all Americans through the prevention, detection, and treatment of cardiovascular diseases. Risk factors were created with the intention of reducing the associated morbidities and mortalities. Some of the modifiable risk factors for CVD disease that the Healthy People 2020 regulatory guidelines aim to mitigate include hypertension, cigarette smoking, diabetes, high cholesterol levels in the blood, excessive weight and obesity, and unhealthy eating and physical inactivity (Healthy People 2020, 2017). Therefore, the primary aim of these guidelines is to provide the framework for curbing the menace of chronic CVDs through treatment and prevention.

Moreover, different countries and regions in the world have created regulatory guidelines to show clinicians and the general population how to prevent, screen and identify, and treat chronic CVDs. In the United States, the American Heart Association guidelines for CVDs provide a crucial framework for the prevention of non-communicable diseases (Pearson, 2007). Through these guidelines, the association was able to set goals for physiologic and behavioral risk factors as well as prophylactic interventions in the functioning of patients suffering from CVDs. Further, these guidelines contain recommendations for primary, secondary, and tertiary prevention of a number of CVD aspects including hypertension, smoking, weight and diabetes management, and physical inactivity (Pearson, 2007). Additionally, Europe formulated the 2016 guidelines on CVDs prevention for clinicians as a framework for use in healthcare systems (Piepoli et al., 2016). Basically, many other regions have created and formulated regulatory guidelines on the prevention, diagnosis, and treatment of CVDs.

Ethical-Legal Issues in Global Healthcare for Chronic Cardiovascular Diseases

Chronic cardiovascular disease treatment and prevention are associated with a variety of ethical and legal issues that hinder the smooth delivery of high-quality care by nurses and other clinicians. Most of the ethical and legal issues revolve around the principles of non-maleficence, justice, and autonomy (MacKenzie & de Melo-Martin, 2015). For instance, health activities for preventing CVDs and other chronic illnesses are targeting unhealthy behaviors that include not only smoking and alcohol drinking, but also physical inactivity (World Health Organization, 2015). However, adults, who are the principal victims of CVDs, are legally permitted to engage in unhealthy behaviors as long as they do not harm other parties; as such, governments and health organizations face an ethical and legal dilemma on how they can infringe upon this right. Furthermore, chronically ill people have the right to information privacy, which health stakeholders may understand to be a discussion on whether or not to share patient information to facilitate disease surveillance and resource allocation efforts. Additionally, the World Health Organization (2015) explains that, due to the demand for allocating health care resources and the perceived benefits of disease prevention as compared to treatment, health financiers may find it better to allocate more resources on prevention. However, this may violate the principle of distributive justice since both the sick and the at-risk groups require similar attention. Therefore, the menace of chronic CVDs is coupled with a number of moral and legal issues and limits the optimal delivery of high-quality care.

Burden of Chronic Care

The burden of chronic care is often added to the costs associated with the treatment and prevention of CVDs and subsequent morbidities and mortalities. Hospitals and other primary care institutions face the considerable burden of providing care for many people with these chronic conditions. For instance, the American Heart Association (2017) states that in the United States individuals at the age of 24 have a 24% risk of falling ill with a CVD, which is lower than 50% and 90% for the 45 and 80 year-olds respectively, meaning that the chronic disease burden is higher for older adults. Since the elderly population is enormous, the burden of chronic care for CVDs is equally immense. Furthermore, CVDs are among the most potent global killers that deprive the healthcare system of qualified clinicians who could offset the shortage of care provider, a problem that adds to the care burden. In 2013, Roth et al. (2015) stated that 17 million out of 54 million deaths caused by non-communicable illnesses were attributed to CVDs; basically, care providers could not be spared. Financial estimations of the burden of chronic care reveal that CVDs cost the United States $555 billion in 2016, a figure that is likely to hit the $1.1 trillion mark by 2035 (American Heart Association, 2017). Essentially, the burden of chronic care for CVDs is vast due to the associated difficulties, impacting care provider shortages and the costs of treatment and support.

Healthcare Productivity and Economic Costs

The healthcare productivity costs as well as the economic costs of chronic CVDs manifest through both direct and indirect costs of care. The American Heart Association (2017) explains that direct medical costs associated with CVDs are more extensive and include the money spent on hospital services, follow-up costs, medical services through clinicians, the purchase of medication, etc. On the other hand, indirect costs are related to the loss of workplace productivity through morbidity as well as premature mortalities attributed to these chronic illnesses. Furthermore, morbidity costs are related to the days of work employees lose, as well as home productivity losses and absenteeism for the sick individuals (American Heart Association, 2017). As such, the economy loses financial and human resources that could have been utilized in other economic development activities. Most importantly, the households of the chronically ill individuals struggle due to the channeling of resources towards the care for their loved ones. Additionally, family income is lost immediately on disability and mortality, which often occur due to chronic illnesses. Therefore, the economic and health productivity costs associated with the menace of CVDs affect the financial and economic status of households and countries.

Conclusion

Chronic CVDs are a major killer and have a considerable effect on the burden to the economy and healthcare systems. It is critical to not only understand the associated historical perspectives and healthcare disparities but also identify the ethical and legal issues that hinder the quality of care provision so as to improve health outcomes by using formalized regulatory guidelines. Historically, much has been achieved, including the classification of chronic diseases, the significance of the invention, and early diagnosis and treatment for better prognosis. However, racial, gender, and socioeconomic disparities, as well as the moral and legal challenges associated with chronic CVDs, are a major obstacle that should be addressed through formalized regulatory guidelines. Addressing this chronic health challenge will not only reduce the burden of chronic care but the economic and health care productivity costs. Therefore, both the United States and many other countries across the planet should work hard to mitigate CVDs to create a healthy society; this will inevitably lead to massive economic growth and development.