Learning Outcomes:
By the end of this chapter, the student will be able to:
1. describe the burden of non-communicable diseases on mortality and morbidity in the United States.
2. describe the ideal criteria for a screening program.
3. explain why two or more tests are nearly always required to screen for asymptomatic disease.
4. explain the multiple risk factor intervention approach to control a noncommunicable disease.
5. describe the meaning of “cost-effectiveness.”
6. describe several ways that genetic interventions can affect the burden of non-communicable diseases.
7. describe approaches to reducing the adverse impacts of treatments including overdoses of prescription drugs.
8. describe ways that population interventions can be combined with individual interventions to more effectively reduce the burden of non-communicable diseases.
Sasha did not want to think about the possibility of breast cancer, but as she turned 50, she agreed to have a mammogram which, as she feared, was positive or “suspicious,” as her doctor put it. Waiting for the results of the follow-up biopsy was the worst part, but the relief she felt when the results were negative brought tears of joy to her and her family. Then she wondered: Is it common to have a positive mammogram when no cancer is present?
The first sign of Michael’s coronary heart disease was his heart attack. Looking back, he had been at high risk for many years because he smoked and had high blood pressure and high bad cholesterol. His lack of exercise and obesity only made the situation worse. Michael asked: What are the risk factors for coronary heart disease, and what can be done to identify and address these factors for me and my family?
John’s knee injury from skiing continued to produce swelling and pain, greatly limiting his activities. His physician informed him that the standard procedure today is to look inside with flexible scope and do any surgery that is needed through the scope. It is simpler and cheaper and does not even require hospitalization. “We call it ‘cost-effective,’” his doctor said. John wondered: What does “cost-effective” really mean?
