Aging Council Issues Call-to-Action for Chronic Care Reform
A new survey commissioned by the non-profit National Council on Aging (NCOA), with support from The Atlantic Philanthropies and the California HealthCare Foundation (CHCF), reveals a bleak and broken health care system for millions of Americans suffering from a variety of chronic conditions. The results of the Re-Forming Health Care: Americans Speak Out about Chronic Conditions and the Pursuit of Healthier Lives survey shows many chronic disease sufferers are delaying health care due to cost, living in pain and feeling abandoned by their health care providers.
The survey of over 1,000 Americans 44 and older with a chronic illness such as heart disease, arthritis, hypertension, and diabetes found that more than two-thirds (68 percent) have two or more chronic conditions – and 20 percent have four or more chronic conditions. Alarmingly, one in four (25 percent) survey respondents have delayed health care or not filled much-needed prescriptions due to cost in the past year, despite the fact that they are frequently or sometimes living in pain (71 percent), stressed (65 percent), or depressed (50 percent).
While most survey respondents say they rely on the health care system for ongoing help, many feel as if they are not getting the support they need. Over half (57 percent) of Americans surveyed say their health care providers have not asked whether they have help to manage their problems and 45 percent say that they rarely or never receive referrals to resources such as classes, counselors, dieticians and health educators. Over one-third (38 percent) say they don't have the money it takes to do things that will improve their health, and this percent is much higher among Latinos (63 percent), African Americans (58 percent), people with annual household incomes below $20,000 (65 percent), and people with four or more chronic conditions (59 percent).
With chronic conditions as the central challenge to American health care today, the NCOA seeks to identify gaps in appropriate chronic care, including self-care, to inform the national conversation about health care reform. The survey examines the attitudes of Americans with chronic conditions and explores their quality of life, health needs and experiences with the health care system. The survey also identifies barriers to self-care and what is needed to better manage overall health.
"Chronic disease accounts for more than 75 percent of the nation's $2 trillion medical care costs. In order to truly help direct health reform efforts, NCOA listened to those most affected to get a better understanding of their challenges and what they need to better manage their health,” said Nancy Whitelaw, Senior Vice President, Center for Healthy Aging with NCOA. "Given what the survey participants told us, we identified three areas of focus necessary for re-forming the health care system in order to support Americans with chronic conditions.”
The NCOA characterizes the following three areas of focus as:
- Policy: The federal government needs to make investments in community-based programs, and in primary care and hospital settings to ensure team-based, coordinated care across all settings.
- Practice: Health care professionals have a responsibility to connect their patients to effective community self-care programs, as well as improve the quality and coordination of care to people with chronic conditions.
- Personal Skills: Americans with chronic conditions need to develop the skills and confidence to manage their health and to advocate for the help and support they need.
According to NCOA, a key element for success resides in community-based programs that focus on self care, which includes teaching problem-solving, decision-making and communication skills that are needed by people with chronic conditions to manage their own health outside of the clinical setting.
"It is important for Americans with chronic conditions, especially older adults, to seek support programs in their local areas to better manage their health,” said Chad Boult, MD, Professor of Public Health, Johns Hopkins Geriatric Education Center Consortium. "Participating in programs, like the Baltimore, Maryland and Washington, DC Guided Care Program, can educate them on their conditions and help build confidence and skills to empower them to take control of their health.”
Evidence-based health programs can result in significant improvements in energy, health status, social activities, less fatigue and lower use of the hospital and/or emergency room. NCOA supports a variety of self-care programs throughout the United States including Stanford's Chronic Disease Self-Management Program, Living Well with Chronic Conditions, Enhance Fitness, Matter of Balance, Healthy IDEAS and Active Living Every Day. For more information, please visit www.healthyagingprograms.org.