Chronic Health Disease Essay

apa format, use references from last five years

7-10 page paper

please look at guidelines and rubric

Requirements:
This paper should clearly and comprehensively identify the chronic health disease chosen. Select a topic from the following list (topics rotate):Chronic Health Disease Essay

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• Polycythemia Vera
• Alcohol Addiction
• Prostate or Breast Cancer
• Epilepsy/Seizure Disorders
• Obsessive Compulsive Disorder (OCD) (Select childhood or adulthood for the OCD topic)
The paper should be organized into the following sections:
1. Introduction (Identification of the problem) with a clear presentation of the problem as well as the significance and a scholarly overview of the paper’s content. No heading is used for the Introduction per APA current edition.
2. Background and Significance of the disease, to include: Definition, description, signs and symptoms, and current incidence and/or prevalence statistics by state with a comparison to national statistics pertaining to the disease.  Create a table of incidence or prevalence rates by your geographic county/city or state (Miami, FL) with a comparison to national statistics. Use the APA text for formatting guidelines (tables). This is a table that you create using relevant data, it should not be a table from another source using copy/paste.
3. Surveillance and Reporting: Current surveillance methods and mandated reporting processes as related to the chronic health condition chosen should be specific.Chronic Health Disease Essay
4. Epidemiological Analysis: Conduct a descriptive epidemiology analysis of the health condition. Be sure to include all of the 5 W’s: What, Who, Where, When, Why. Use details associated with all of the W’s, such as the “Who” which should include an analysis of the determinants of health. Include costs (both financial and social) associated with the disease or problem.
5. Screening and Guidelines: Review how the disease is diagnosed and current national standards (guidelines). Pick one screening test (review Week 2 Discussion Board) and review its sensitivity, specificity, predictive value, and cost.
6. Plan: Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence – connected to a resource such as a scholarly piece of research.
7. Summary/Conclusion: Conclude in a clear manner with a brief overview of the keys points from each section of the paper utilizing integration of resources.
8. The paper should be formatted and organized into the following sections which focus on the chosen chronic health condition.
9. Adhere to all paper preparation guidelines (see below).
Preparing the Paper:
1. Page length: 7-10 pages, excluding title page and references.
2. APA format current edition
3. Include scholarly in-text references throughout and a reference list.

4. Include at least one table that the student creates to present information. Please refer to the “Requirements” or rubric for further details. APA formatting required.Chronic Health Disease Essay
ASSIGNMENT CONTENT
Category Pts % Description
Identification of the Health Problem 15 7.5% Comprehensively and succinctly states the problem/concern. Clear presentation of the problem as well as the significance with a scholarly overview of the paper’s content.
Background and Significance of the Health Problem 30 15% Background and significance is complete, presents risks, disease impact and includes a review of incidence and prevalence of the disease within the student’s state compared to national data. Evidence supports background. A student created table is included using APA format.
Current Surveillance and Reporting Methods 30 15% Current state and national disease surveillance methods are reviewed along with currently gathered types of statistics and information on whether the disease is mandated for reporting. Supported by evidence.
Descriptive Epidemiological Analysis of Health Problem 35 17% Comprehensive review and analysis of descriptive epidemiological points for the chronic health problem. The 5 W’s of epidemiological analysis should be fully identified. Supported by scholarly evidence.
Screening, Diagnosis, Guidelines 30 15% Review of current guidelines for screening and diagnosis. Screening tool statistics related to validity, predictive value, and reliability of screening tests are presented.Chronic Health Disease Essay
Plan of Action 30 15% Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence – connected to a resource such as a scholarly piece of research.
Conclusion 15 7.5% The conclusion thoroughly, clearly, succinctly, and logically presents major points of the paper with clear direction for action. Includes scholarly references
185 92% Total CONTENT Points=185 pts
ASSIGNMENT FORMAT
Category Points % Description
APA current ed. 10 5% APA is consistently utilized according to the current edition throughout the paper.Chronic Health Disease Essay

Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 185 Points
Introduction of Healthcare Problem/Concern 15.0 pts
Excellent
Comprehensively and succinctly states the problem/concern. Clear presentation of the problem as well as the significance with a scholarly overview of the paper’s content. 14.0 pts
V. Good
Identifies the problem/concern with adequate but not in-depth presentation. 12.0 pts
Satisfactory
Identification of problem/concern is limited. 8.0 pts
Needs Improvement
Improvement- Identification of problem/concern is unclear. 0.0 pts
Unsatisfactory
Improvement- Identification of problem/concern is unclear.
15.0 pts
This criterion is linked to a Learning OutcomeBackground/Significance 30.0 pts
Excellent
Background and significance is complete, presents risks, disease impact and includes a review of incidence and prevalence of the disease within the student’s state compared to national data. Evidence supports background. A student created table is included. 27.0 pts Chronic Health Disease Essay
V. Good
Background is complete, presents risk, disease impact and at least one set of incidence and prevalence statistics supported by evidence, for instance state data or national data is presented, but not both. Or, full data is presented but student table is not included. 26.0 pts
Satisfactory

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Background missing one or more key points and at least one set of incidence and prevalence statistics are presented. Lack of evidence or limited presentation of the background. A table is included which may or may not be student created; may be limited in data. 15.0 pts
Needs Improvement
Background missing more than one key point and at least one set of incidence and prevalence statistics are presented, or there is no supported evidence. Unclear conclusions or presentation. No student created table is included; or if included is limited in scope or is not student created. 0.0 pts
Unsatisfactory
Background and significance of the disease is not provided.
30.0 pts
This criterion is linked to a Learning OutcomeSurveillance and Reporting 30.0 pts Chronic Health Disease Essay
Excellent
Current state and national disease surveillance methods are reviewed along with currently gathered types of statistics and information on whether the disease is mandated for reporting. All writing is supported by evidence. 27.0 pts
V. Good
State and national disease surveillance methods are reviewed, currently gathered types of statistics is scant, reporting requirements discussed. All writing is supported by evidence. 26.0 pts
Satisfactory
State or national surveillance statistics are discussed as an overview, lacking detail / depth. Mandated reporting may be absent. Writing is supported by evidence but may be inconsistent. 15.0 pts
Needs Improvement
One of either state or national disease surveillance methods reviewed; currently gathered types of statistics may be missing or information on whether the disease is mandated for reporting is missing. There is a lack of depth with inconsistent use of evidence. 0.0 pts
Unsatisfactory
Content not discussed.Chronic Health Disease Essay
30.0 pts
This criterion is linked to a Learning OutcomeDescriptive Epidemiology 35.0 pts
Excellent
Comprehensive review and analysis of descriptive epidemiological points for the chronic health problem. The 5 W’s of epidemiological analysis should be fully identified. Supported by scholarly evidence. 32.0 pts
V. Good
Review and analysis has depth in general but may be missing one of the 5 W’s OR may be scant in one area of the 5 W’s. All writing is supported by evidence. 29.0 pts
Satisfactory
Review and analysis superficial in all of the 5 W’s OR may be scant or missing 2 or more of the W’s. Evidence is present but may not be throughout all content areas. 18.0 pts
Needs Improvement
Review and analysis is missing depth throughout all of the content areas. Evidence may or may not support the writing. Chronic Health Disease Essay 0.0 pts
Unsatisfactory
No analysis provided.
35.0 pts
This criterion is linked to a Learning OutcomeScreening, Diagnosis, Guidelines 30.0 pts
Excellent
Comprehensive review of current guidelines for screening and diagnosis. Screening tool statistics related to validity, predictive value, and reliability of screening tests are presented. 27.0 pts
V. Good
Adequate review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests is presented. 26.0 pts
Satisfactory
Limited review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. 15.0 pts
Needs Improvement
Minimal or unclear review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. There is a lack of depth with inconsistent use of evidence. 0.0 pts
Unsatisfactory
Review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests not provided.Chronic Health Disease Essay
30.0 pts
This criterion is linked to a Learning OutcomePlan 30.0 pts
Excellent
Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note:  Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence – connected to a resource such as a scholarly piece of research. 27.0 pts
V. Good
An adequate, but not fully comprehensive, plan of action specific to the problem, and the geographic area is presented with 3 evidenced based actions that will be taken to address the impact, outcomes, or prevalence of the disease. 26.0 pts
Satisfactory
A limited plan of action specific to the problem, and the geographic area, outcomes, or prevalence of the disease. Three actions or less may be presented with limited or little evidence. 15.0 pts
Needs Improvement
Minimal or unclear review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. Actions are minimal or unclear, or lack specificity, are not supported directly by evidence or are not direct actions the student can take in practice. There is a lack of depth with inconsistent use of evidence. 0.0 pts Chronic Health Disease Essay
Unsatisfactory
Plan of action not provided.
30.0 pts
This criterion is linked to a Learning OutcomeSummary/Conclusion = 185 Points 15.0 pts
Excellent
The conclusion thoroughly, clearly, succinctly, and logically presents major points of the paper with clear direction for action. Includes scholarly references. 14.0 pts
V. Good
The conclusion adequately and logically presents major points of the paper with clear direction for action, but lacks one major point or is not succinct. Includes scholarly references. 12.0 pts
Satisfactory
The conclusion is a limited review of key points of the paper, is not succinct, or lacks one or more major points of the paper or clear direction for action. Scholarly references may or may not be included. 8.0 pts
Needs Improvement
Conclusion is unclear or significantly limited in overview of the paper. Scholarly references may or may not be included. 0.0 pts
Unsatisfactory
No Summary/conclusion is included.Chronic Health Disease Essay
15.0 pts
This criterion is linked to a Learning OutcomeAssignment Format Possible Points =15 Points
APA 6th ed. 10.0 pts
Excellent
APA is consistently utilized according to the 6th edition throughout the paper. 9.0 pts
V. Good
One or two errors in APA format 8.0 pts
Satisfactory
Three-Five errors in APA format 5.0 pts
Needs Improvement
Six errors in APA format 0.0 pts
Unsatisfactory
Greater than six errors in APA formatting.
10.0 pts

According to the World Health Organization (WHO, 2002) definition; chronic diseases are diseases characterized by their permanency and their capacity of leaving residual disability. These diseases are caused by non-reversible pathological alteration and do require special training of the patient for proper rehabilitation, or may be expected to require a long period of supervision, observation or care. The Australian Institute of Health and Welfare (AIHW, 2001) lists twelve chronic diseases that have the greatest repercussions on the Australian health care system. They include coronary heart disease, stroke, lung cancer, colorectal cancer, depression, diabetes, asthma, chronic obstructive pulmonary disease, chronic kidney disease, oral diseases, arthritis and osteoporosis. Chronic Health Disease Essay Because of the increase of chronic disease cases there is an urgency to stop and reverse the ever rising threats of the ailments, another measure that needs to be embraced is the dismissal of the elongated misunderstandings about these diseases.

A conceptual framework provided by the Chronic Care Model (CCM) is therefore useful for understanding the elements considered essential for the management of chronic disease and the interplay between the elements (Zwar, 2009). (wafula, 1999) However, not all of the elements of the Chronic Care Model can be assessed experimentally for their effectiveness or efficiency and this is illustrated by the lack of research evidence to support the role of health care organizations and community resources. Significant of the evidence presented in this critical analysis refers to the management of adults with type 2 diabetes, Chronic Kidney Disease (CKD) and may not be applicable to all chronic diseases. Therefore this paper is going to discuss the issue of chronic disease based on early detection and early treatment of a chronic disease based on the Australian government’s 2005 national chronic disease strategy. The paper will touch on the issues about prevention across the continuum, early detection and early treatment, integration and continuity of prevention and care and self management measures. it will then conclude by showing what needs to be embraced in trying to mitigate this diseases.Chronic Health Disease Essay

Prevention across the continuum

Significant gains can be made by focusing on the risk factors that underlie chronic disease in a systematic and well-integrated manner. The range of risk factors amenable to intervention can be broadly grouped into two categories, behavioral and social risk factors, and biomedical risk factors (NCDS, 2005).

Cancer, cardiovascular disease, chronic obstructive pulmonary disease and type 2 diabetes have common and modifiable risk factors, notably high blood pressure, high blood cholesterol and obesity/overweight. They are also linked by three related major behavioural risk factors, namely unhealthy diet, physical activity and tobacco use. Psychosocial health can also impact on chronic diseases, including for peoples capacity to maintain healthy lifestyle approaches. Making an early diagnosis is the key to optimizing prognosis. This is as per the National Chronic Disease Strategy which states that:Chronic Health Disease Essay

Australia’s health system must be able to respond in an appropriate and cost effective way to this challenge. Failure to prevent, detect and treat chronic disease at an optimal stage in its course impacts on affected individuals and their families and cares in terms of pain and suffering, and on the whole Australian community in productivity losses and high health care costs (National Health Priority Action Council 2006).

Early detection and early treatment

In Australia Not all chronic diseases are detected as early as possible. It is estimated for example, that only half of the people with Type 2 Diabetes are actually diagnosed and receiving treatment (AIHW, 2004). Furthermore, many chronic diseases are diagnosed at advanced stages of the disease which can compromise overall health outcomes of an individual.Chronic Health Disease Essay

According to NCDS (2005) undetected, undiagnosed and untreated chronic disease can reflect, Lack of knowledge or poor health literacy by consumers about the risks and/or symptoms of a chronic disease, lack of recognition and the appropriate follow up response by health care providers to the risk factors for chronic disease and the manifestation or symptoms of disease, and Poor access to, or use of, health care interventions (i.e. both diagnostic and treatment) at the asymptomatic and symptomatic stages. Early detection and early treatment, where appropriate, can offer significant benefits at both an individual and population level and is a critical area in which to identify practical approaches under the NCDS.

For instance, Timothy (2009) said that early detection of chronic kidney disease (CKD) followed by appropriate clinical management appears the only means by which the increasing burden on the health-care system and affected individuals will be reduced.Chronic Health Disease Essay

Governance structures are required to oversee the continuation of the Strategy and support the change-management required to reshape the health system in Queensland. This is to ensure that the work outlined under the Strategy that occurs within agreed timeframes, ongoing governance arrangements at the federal, state, regional and local levels are required to guide implementation (Queensland Strategy for Chronic Disease 2005-2015). This can be done through local partnership an integrated health service delivery involving the range of health service professionals, agencies and consumers in planning and developing local options. Additionally, with the Australian Government to shape national health policy and funding models for primary health care services, pharmaceutical benefits and aged care services need to be embraced.Chronic Health Disease Essay

In the current increasingly fragmented health care systems, older patients suffering from different chronic conditions consume a large range of medicines. The medicines which are given by one or several providers apply evidence-based medicine (EBM) without coordination; this in turn leads to potential adverse drug events (ADE) (Pierre, 2010).

Piere (2010) in this context, special attention must be given to better and standardized potentially inappropriate medication (PIM). A prescribing medication is potentially inappropriate if the risk of ADE outweighs the clinical benefit, particularly when a safer or more effective alternative therapy is readily available for the same condition.Chronic Health Disease Essay

Most prevalent co-morbidities in the population studied were vascular diseases (cerebrovascular disease 31%, ischaemic heart disease 10%); diabetes mellitus (14%); chronic pulmonary disease (13%); chronic kidney disease (13%), defined as serum creatinine > 150 µmol/l or estimated GFR < 50 ml/min; and congestive heart failure (12%) this is according to Cockcroft and Gault (19).

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Self-management System (SMS)Chronic Health Disease Essay

Self management is a care model where the patient is actively engaged in and takes responsibility their healthcare. This model requires an informed, motivated and skilled patient with very good negotiation and communication skills to see them through the health system in sickness and in health (yes, possibly a bit like a marriage). Fundamentals to self-management are that, people with a chronic disease are able to undertake the health care actions that optimize their well-being. This means facilitating a situation where people have the knowledge, skills and confidence to identify their health needs and take action to address them in the most appropriate way. Importantly, self-management is not the sole responsibility of the person with the chronic disease. It is the role of the health professional to assist the person with a range of tasks that will promote effective self-management, based on the person’s goals, wishes and capacities.Chronic Health Disease Essay

To support self-management the health structure must provide ready access to appropriate systems of self-management support that are evidence based, and adequately resourced with trained staff. Staff must be culturally sensitive to the person’s needs and support the belief in the person’s ability to learn self-management skills (Brunson, 1995).Chronic Health Disease Essay

The aim of self-management support is to develop skills and confidence within patients and their families so that they can take responsibility for their own care (Wagner, 1996, and WHO, 2002). The self-management support strategies that were found to be most effective were those that developed self-efficacy in relation to specific behaviors such as diet, exercises physical and diabetes rather than those that were more general. Self efficacy theory underpins this process and this can only be interpreted and measured in regard to specific behaviours, such as diabetes self management or diet and exercise behaviors but not broadly in relation to a range of behaviours such as chronic diseases and self management in general (Bandura ,1977& Collins ,2005).

While the literature review did not identify any experimental evidence assessing the impact of self-management support in Indigenous communities, Collins (2005) reveals that in an evaluation report from the Eyre Peninsula suggests that chronic disease self management can be effectively delivered to Aboriginal populations by Aboriginal health workers.Chronic Health Disease Essay

Delivery system design (DSD)

Zwar and Abija (2006) asserted that among other management models the Delivery system design (DSD) is more effective in improving patient use of services, patient outcomes and health professional adherence to guidelines particularly for heart disease, diabetes and asthma. Zwar and Abija continued by showing that:

In combination with self-management support it was effective in improving physiological measures of disease, health and functional status and quality of life particularly for hypertension and diabetes. Nurses acting as case managers were effective in diabetes when combined with self-management support.Chronic Health Disease Essay

The delivery system design interventions that were found to be most effective included the development of multidisciplinary team care especially in the role of practice of nurses, use of patient reminders and proactive follow up which are central to the switch from acute to chronic care. The National Chronic Disease Strategy (NCDS) lists several recommendations that target delivery system design in primary care under the proposals for integration and continuity of care. These include risk stratification and case management where routine care planning and self management are insufficient. There is also a need to develop the funding structures to support multidisciplinary care and care planning more effectively to overcome the fragmented nature of the Australian healthcare system (NCDS, 2005).Chronic Health Disease Essay

There is also another need for greater coordination between the services especially to improve the referral pathways between services. Delivery system design is of particular importance in Aboriginal health to overcome the problems of healthcare delivery in remote areas and barriers to access even in urban areas. With involvement of the whole community there have been improvements in patient outcomes associated with secondary prevention interventions such as dietary interventions in remote communities (Rowly,2000 and 2001). Much of the indigenous literature has been focused on interventions in remote communities and more research is required to support urban populations who also experience considerable morbidity and mortality.

Management of Type 2 diabetes requires adhering to multiple lifestyle and medical surveillance self-care behaviors to achieve and sustain optimal glycemic control and behaviors that are inherently modifiable. Individuals are expected to quickly integrate these behaviors, which are the cornerstones of treatment and often the most difficult components of self-management. Of these major lifestyle changes, one of the most difficult behaviors is adhering to increased exercise (Pierre, 2010). Exercise has significant physiological and psychological benefits for individuals with diabetes. For example, exercise significantly decreases hemoglobin A1C, an index of blood glucose control.Chronic Health Disease Essay

Ganny (2010) pointed out that in addition to improving cardiovascular risk factors, joint flexibility and quality of life despite the obvious benefits of exercise, many individuals with diabetes failed to initiate and/or adhere to a regular exercise program. An estimated 37-60% of individuals with diabetes do not exercise and more often than not the majority of individuals who do exercises discontinue the program within 3-6 months (Willis, 1992).

The management of Type 2 diabetes requires a considerable amount of effort to achieve and sustain optimal glycemic control. Individuals living with diabetes must assume responsibility for their management, which is achieved through self-care behaviors, including medical surveillance (i.e. taking needed medications and maintaining proper foot care), blood glucose testing, adherence to a healthful diet, embracing routine exercises and increased physical activity.Chronic Health Disease Essay

The various state Governments in Australia, through, have identified the prevention and management of chronic diseases as one of its major strategic priorities for the coming decade. In Queensland for instance ,cardiovascular disease (coronary heart disease, heart failure and stroke), chronic respiratory disease (chronic obstructive pulmonary disease (COPD) and asthma), type 2 diabetes mellitus, and renal disease account for a significant proportion of morbidity experienced by the population and for more than one-third of all deaths in the state. Depression as a co-morbidity to these chronic diseases also affects the functioning and quality of life of affected people. Poor nutrition, physical inactivity, tobacco smoking and alcohol misuse are four common underlying risk factors associated with these diseases. The Strategy will manage the current and growing pressures on the health care system both now and in the future, and address the impact of chronic diseases and risk factors on individuals, families and communities in Queensland from 2005 to 2015. A significant priority is to better manage the care for people who already have chronic diseases and avoid hospitalization wherever possible. Concurrent investment is also required around the strategies to achieve longer-term outcomes of reduced prevalence and incidence.Chronic Health Disease Essay

According Lee (2009) “80% of chronic disease deaths occur in low and middle income countries and these deaths happen in equal numbers among men and women; the threat is growing; the number of people, families and communities afflicted is increasing”. “This growing threat is an under-appreciated cause of poverty and hinders the economic development of many countries; Interventions to reduce risk and prevent disease are working in many countries; Governments need to provide leadership to address chronic diseases (Lee, 2009). A sequence of low cost actions can be put in practice in a stepwise approach to mitigate this issue.Chronic Health Disease Essay

Conclusion

High level of cooperation is therefore necessitated through funds pooling and strategic planning between federal government and the state or territory governments are required. In addition, training and support to health care professionals, sitting targeted goals, and collaboration between practitioners and their patients are key elements to a successful. A research carried out by Bluff (2005) on chronic diseases shows the following:Chronic Health Disease Essay

Chronic diseases such as heart disease, diabetes, high blood pressure, high cholesterol and obesity are the leading cause of pain, suffering and death in many countries today. In Australia alone an estimated number of more than ten million Australians live with a chronic condition. Studies reveal again that 60% of all deaths are to chronic diseases. Financially again these diseases are the primary cause of our escalating health costs which account for more than seventy five percent of the country’s overall medical costs. Research all over the globe has shown that healthy lifestyle modifications can ultimately reverse the progression of chronic diseases. In Australia a large study found that in about 6 weeks of healthy eating, increasing physical activities levels and reducing levels of stress, high blood pressure dropped to normal ranges. Additional benefits including weight loss, increased energy and an increased sense of well being were realized. Healthy lifestyle modifications affect the body, mind and the spirit, increasing a person’s well being.Chronic Health Disease Essay

Therefore as shown in this paper, each nation, despite the consequences of its resources, has the prospective of making a considerable improvement in the preventing and curbing of chronic diseases. Better achievements as far as chronic diseases are concerned can be achieved with good leadership, embracing healthy practices, being strict on medication, seeking health advise and services, getting involved in exercises and governments low cost intervention measures.Chronic Health Disease Essay

Seven in ten deaths in the United States, are attributable to chronic disease (“Leading Causes” 1). These diseases are not on account of bacteria or viruses, which could be treated with an appropriate prescription or vaccine. Chronic conditions are developed through unhealthy lifestyles and behaviors such as a lack of exercise, poor nutrition, poor sleeping habits, and substance use (e.g. tobacco). Consequently, seven in ten of every death can be prevented with changes in lifestyle. The CDC states that these conditions, “are among the most common, costly, and preventable of all health problems” (“Chronic Disease” 1). Although these conditions have clear and definite causes (knowing the exact reason and “cure” for them), they are becoming more prevalent rather than domesticated. According to Wu and Green, “Between 2000 and 2030 the number of Americans with chronic conditions will increase by 37 percent, an increase of 46 million people” (1). This increase comes with an increase in health care costs: the CDC reported that the U.S.  Chronic Health Disease Essay