Healthcare Assignment

The access to comprehensive and contemporary healthcare services is essential for enhancing and managing health along with accomplishing prevention and control of diseases. In this essay, the key aim is to critically discuss the key contemporary health issues experienced in the United States of America (USA). A historical account of the main health trends in the USA and the evolution of the health system in the country are to be discussed. Moreover, prediction for the future health of the public in the USA by use of relevant health indicators is to be done. The healthcare system in the US is mainly publicly funded with half of the expenses being paid by the federal government through Medicare, Medicaid and other programs (Zhou et al. 2016). In 2019, the USA government spend 17.7% of the GDP on the healthcare management in the country which is 4.6% more than the previous year and it is expected to spend 19.4% of the GDP for healthcare by 2027 (CMS, 2019). This indicates that huge expenses are made by the US government in healthcare system for its enhanced management at the present. In the USA, few of leading contemporary health issues is type-2 diabetes, heart diseases, hypertension, cancer and others (CDC, 2017). In 2017, it was reported that heart diseases and stroke due to hypertension was the leading cause of death in the country and type-2 diabetes considered to be seventh leading cause of death in the USA (CDC, 2017). The health challenges faced by people suffering from type-2 diabetes in the USA includes feeling of fatigue, nerve damage in the eye and kidney, sexual problems, leg ulcer and others (Arredondo et al. 2019). This is because increased presence of sugar in the blood cause damages to the blood vessels supplying nutrients to vital organs that in turn increases worsening of body functioning (Molayaghobi et al. 2019). In the US, hypertension among the people leads them to face damage of the heart, blood vessels and others which causes coronary heart diseases and stroke (Togliatto et al. 2017). This is because hypertension raises the overall pressure of the blood flowing through the arteries which destroy the smooth muscle cells and endothelial cells in the blood vessels. It leads to development of clot formation causing barriers to smooth blood flow in the brain and heart for supporting their effective functioning (Delles et al. 2018). The prevalence of hypertension that leads to cause heart disease and stroke in social groups within the USA is seen to increase with age which is evident as 7.5% of the adults of 18-39 years, 33.2% within 40-45 years of age and 63.1% within 60 and over age are seen to be affected by the disease (CDC, 2017). This indicates that hypertension is mostly prevalent among adults .


and older population compared to children in society. In respect to social groups, it is seen that white 54% of the non-Hispanic black adults and 46% of non-Hispanic white adults are at increased risk of developing hypertension (CDC, 2017a). However, in case of type-2 diabetes, it is seen to be most prevalent among American Indians (14.7%), people with Hispanic (12.5%) and non-Hispanic black (11.7%) individuals (CDC, 2020). This indicates that the lower ethnic groups in the USA are more prone to get affected by contemporary diseases such as diabetes and hypertension. Moreover, the CDC reports that people of the lower socio-economic status in the USA are likely to suffer from increased rate of hypertension (14% higher odds) and type-2 diabetes compared to the elite class (Fan et al. 2015). This is because they have lower availability of enhanced food and effective employment leading them to have deteriorated health and increased stress that are leading for contemporary diseases. The contemporary health issues such as type-2 diabetes and hypertension are tackled by the USA government by providing advanced treatment, implementing better screening programs and healthcare management. This is evident as in the USA for type-2 diabetes management wide number of medications such as DPP-4 inhibitors, Alpha-glucosidase inhibitors, dopamine-2 agonists and others are made available for the population (, 2019). Moreover, under the National Diabetes Screening Program, the public and private organisation in the USA have introduced wide screening programs to be availed by all people (CDC, 2019). In respect to hypertension, greater awareness regarding the health issue is promoted by the USA government to made people educated regarding the symptoms of disease. The US government with the help of US Preventive Services Tasks Force has introduced various recommendations to be followed by clinicians in appropriately and timely detect hypertension in people in the country to provide timely care and control the increased prevalence of the disease (USPSTF, 2015). The healthcare system in the USA evolved from home remedies and itinerant doctors in 1750 to advanced healthcare with the active involvement of the federal government in the 20th century. In the 21st century, with the help of the progressive government in the USA, effective set of research institute and organisation are made which led to develop various life-saving practices to be adopted in the healthcare field in promoting better well0being of individuals (Niles, 2019). Further, with advancement in medical technology and its introduction in the hospitals and clinics in the USA promoted the health condition in the country. The increased implementation of

regular screening programs, health awareness campaign, better healthcare facility and others from the 20th century lead to enhanced healthcare management in the USA (Barr, 2016). In 1933, president Roosevelt for the first time tried to include a publicly funded healthcare program in the country but was rejected. In the following years, many proposals for universal healthcare establishment in the US was tried to be made and in 196 through Social securities Act the Medicare and Medicaid programs for public healthcare were introduced. In 2010, the president Barack Obama introduced the Affordable care Act which led to create opportunity for the public to receive healthcare under low cost and high-quality in the country that was not previously available (Niles, 2019). According to WHO, the position of the US regarding healthcare management in the world is 37th (WHO, 2019). This indicates that the country is lagging to most extent compared to other European countries such as UK, France, Italy and others. The future health condition in the US indicates that by 2030 the prevalence of type-2 diabetes is going to increase by 54% and diabetes-related death will rise by 38% with 53% rise in diabetes care to be faced by public compared to the present (Rowley et al. 2017). In respect to hypertension and heart diseases, it is predicted by the American Heart Association that hypertension will rise by 7.2% in 2030 compared to the present condition (, 2015). In 2019, the life expectancy in the USA was found to be 78.87 years which expressed an increased by 0.08% in 2018 However, the life expectancy of individuals in the US was 78.39 years in 2009 (CNBC, 2019;, 2009). This indicates that overall improvement in the healthcare management in the country is executed that led to increase the life expectancy of the people suffering from different diseases. In the US, 6.86% of population are considered to be diagnosed with mainly type-2 diabetes in 2009 whereas in 2019 the rate is found to be 10.9% of the population (CDC, 2017d, CDC, 2020). In 2009, within the US rate of hypertension was 28.6% of the adult population however in 2019, it is seen that 45% of the adult population are affected by hypertension in the country (CDC, 2012;, 2019). This indicates that health of the population irrespective of new reforms and advanced medical care in the USA regarding diabetes and hypertension which also leads to heart disease has worsened with more people being affected the diseases. The growing complication of type-2 diabetes and hypertension in the USA is mainly caused by staff shortage, availability of funding and others. It is evident as in the US; there are 52% .

shortage of nurses reported in 2019 with 2.3 million requirements of nurses and healthcare professionals by 2025 (, 2019). The nursing shortage has happened in the US due to rise of increased number of adults with complex disease that lowered the balance between nurse-patient ratio and increased demand of healthcare staff that are unable to be fulfilled (, 2019). In 2017, it was reported that total estimated cost for diabetes management in the US per person each year is $16,752 which is required to be spent from own expenses (, 2019). Thus, the lack of supportive funding from the US government and increased cost management of diabetes has raised the prevalence of the disease among the population. This is because many of the people are unable to avail the healthcare required to overcome the disease due to financial constraints. In the US, the National Diabetes Prevention Program has been introduced by the government to supporboth private and public organisation to prevent or delay rise of type-2 diabetes among individual. The government through the program try to reach to the public to educate them regarding causes and risk of diabetes to initiate behaviour change among the population to control prevalence of the health issue (CDC, 2019). Moreover, the US has introduced the National High Blood Pressure Education Program in the country through which they try to educate people regarding the way hypertension is to be avoided and controlled (Sharma et al. 2018). These two programs are effective to provide knowledge to the US population regarding the behaviour change, activities, roles in everyday life and others to be to avoid getting affected by type-2 diabetes and hypertension. The above discussion informs that hypertension and type-2 diabetes are two key contemporary health issues in the US. The lack of presence of government funding and rise of adults with diseases has led to increased cost of healthcare and staff shortage to manage the contemporary diseases. .

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References 2019, Nursing Shortage, Available at: [Accessed on: 5 August 2020] Arredondo, A., Orozco, E., Duarte, M.B., Cuadra, M., Recaman, A.L. and Azar, A., 2019. Trends and challenges in diabetes for middle-income countries: Evidence from Mexico. Global public health, 14(2), pp.227-240. Barr, D.A., 2016. Introduction to US Health Policy: the organization, financing, and delivery of health care in America. JHU Press. CDC 2012, Hypertension, Available at: CDC 2017, What was the prevalence of hypertension among adults during 2015–2016?, Available at: CDC 2017a, Facts About Hypertension in the United States, Available at: [Accessed on: 5 August 2020] CDC 2017d, Long-term Trends in Diabetes, Available at: [Accessed on: 5 August 2020] CDC 2019, National Diabetes Prevention Program, Available at: [Accessed on: 5 August 2020] .

CDC 2020, National Diabetes Statistics Report 2020, Available at: [Accessed on: 5 August 2020] CMS 2019, National Health Expenditure Projections 2018-2027, Available at: [Accessed on: 5 August 2020] cnbc 2019, US life expectancy has been declining. Here’s why, Available at: [Accessed on: 5 August 2020] Delles, C., Carrick, E., Graham, D. and Nicklin, S.A., 2018. Utilizing proteomics to understand and define hypertension: where are we and where do we go?. Expert review of proteomics, 15(7), pp.581-592. 2019, Medication Management of Type-2 Diabetes, 2019, The Cost of Diabetes, Available at: Fan, A.Z., Strasser, S.M., Zhang, X., Fang, J. and Crawford, C.G., 2015. State socioeconomic indicators and self-reported hypertension among US adults, 2011 behavioral risk factor surveillance system.Preventing Chronic Diseases.12.pp.23-67. 2015, High Blood Pressure, Available at: [Accessed on: 5 August 2020] 2020, Estimated Hypertension Prevalence, Treatment, and Control Among U.S. Adults, Available at: [Accessed on: 5 August 2020] .

Molayaghobi, N.S., Abazari, P., Taleghani, F. and Iraj, B., 2019. Diabetes management challenges in Iran: A qualitative content analysis. Journal of Nursing Management, 27(6), pp.1091-1097. Niles, N.J., 2019. Basics of the US health care system. Jones & Bartlett Learning. Rowley, W.R., Bezold, C., Arikan, Y., Byrne, E. and Krohe, S., 2017. Diabetes 2030: insights from yesterday, today, and future trends. Population health management, 20(1), pp.6-12. Sharma, A.K., Metzger, D.L. and Rodd, C.J., 2018. Prevalence and severity of high blood pressure among children based on the 2017 American Academy of Pediatrics Guidelines. JAMA pediatrics, 172(6), pp.557-565. Togliatto, G., Lombardo, G. and Brizzi, M.F., 2017. The future challenge of reactive oxygen species (ROS) in hypertension: from bench to bed side. International Journal of Molecular Sciences, 18(9), p.1988. USPSTF 2015, High Blood Pressure in Adults: Screening, Available at: WHO 2020, World Health Organisation: Health Data, Available at: [Accessed on: 5 August 2020] 2009, Life Expectancy, Available at: [Accessed on: 5 August 2020] Zhou, L., Dhopeshwarkar, N., Blumenthal, K.G., Goss, F., Topaz, M., Slight, S.P. and Bates, D.W., 2016. Drug allergies documented in electronic health records of a large healthcare system. Allergy, 71(9), pp.1305-1313. .

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