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Building Healthy Communities Companion

Welcome to the third edition of Building Healthy Communities through Medical-Religious Partnerships' supplemental website. The primary objective of this website is to provide easy access to materials that can be used in congregational and community health programs.

 

Resources

Building Healthy Communities Through Medical-Religious Partnerships cover

An instructor's guide with general guidelines and resources to assist in organizing your health education programs.

Health topic overviews, handouts and PowerPoint slides for most of the health topics covered in Building Healthy Communities through Medical-Religious Partnerships. These materials may be reproduced and distributed during health education programs, used as bulletin inserts, or shared with family, friends and community members. 

Links to the Johns Hopkins Medicine Health Library and other helpful websites and resources.

Examples of successful congregational and community health programs. From time to time, we will be adding more examples of programs. If you have had a program you would like to share, please contact Kimberly Monson

Building Healthy Communities through Medical-Religious Partnerships

Health topic overviews, handouts and PowerPoint slides for most of the health topics covered in Building Healthy Communities through Medical-Religious Partnerships. These materials may be reproduced and distributed during health education programs, used as bulletin inserts, or shared with family, friends and community members. 

  • Coronary artery disease (also known as coronary heart disease) is the most common type of heart disease and is the leading cause of death in both men and women in the United States. Each year, more than 700,000 Americans suffer a heart attack. Heart attacks occur when arterial (blood vessel) blockages stop blood and oxygen from reaching the heart muscle – as when a clogged fuel line stops a car engine. The blockage of the coronary arteries is commonly due to atherosclerosis, or a buildup of plaque in the arteries. The process of plaque building up and causing a thickening and narrowing of the arteries begins long before a heart attack occurs. In fact, it is a gradual process that may start as early as childhood.

    Coronary artery disease is also the leading cause of heart failure, a condition where the heart does not pump blood effectively. Heart failure can develop after a heart attack as heart muscle becomes injured; scar tissue replaces functional muscle; and the main heart chamber, or left ventricle, is thereby weakened and less able to pump blood forward. Over time, the weakened heart will struggle to keep up with the normal demands of the body in regard to blood flow and oxygen delivery. 

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    Recipes

  • Hypertension, also known as high blood pressure, is a common condition in the twenty-first century. Blood pressure refers to the force of the blood against the walls of arteries. The more blood a heart is pumping into narrowed arteries, the higher the blood pressure will be. Two numbers are used to evaluate blood pressure – systolic and diastolic. Systolic blood pressure is the pressure when the heart is contracting, sending blood forward, and thus represents the higher blood pressure value. Diastolic blood pressure is the pressure when the heart is relaxed and filling with blood, and thus represents the lower blood pressure value. High blood pressure is generally defined as a systolic pressure of 130 mm Hg (millimeters of mercury) or higher or a diastolic pressure of 80 mm Hg or higher.

    Hypertension affects nearly half of American adults, meaning more than 100 million adults have this serious condition. The likelihood of developing hypertension increases with age, with more than three-fourths of adults 65 years of age or older affected by it. Other risk factors for developing hypertension include race/ethnicity (African Americans have the greatest risk), a family history of hypertension, and overweight/obesity. 

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  • Lung diseases have a significant impact on the health of the United States population. The most common lung diseases are asthma and chronic obstructive pulmonary disease (COPD). Both of these respiratory conditions can result in significant shortness of breath mainly caused by narrowing of the airways (the bronchi of the lungs) or, in the case of emphysema (a disease that can cause COPD), destruction of the alveoli (the sacs where oxygen is taken up by the blood). Asthma is an episodic problem, and during an attack, the muscles of the bronchi constrict, leading to narrowing of the airways. This narrowing can be so severe that shortness of breath occurs even at rest. In COPD, the smaller airways are usually narrowed because of excess inflammation and mucus production (as seen in chronic bronchitis, a disease that can cause COPD), and in addition, in some cases there is destruction of lung tissue (as seen in emphysema). So patients with COPD can be short of breath all of the time, while also experiencing exacerbations or flares related to episodic increases in small airway inflammation that can be brought on by infections or exposure to irritants. 

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  • The number of Americans with diabetes mellitus, a condition defined by abnormally high levels of glucose (a natural sugar) in the blood, has grown dramatically in recent decades. In 1980, fewer than six million Americans were living with diagnosed diabetes. By 2015, that number had climbed to more than 23 million, and each year there are almost 1.5 million new cases of diabetes diagnosed. Also alarming is the statistic that about eight million people with diabetes do not know they have the disease.

    Diabetes impacts some groups more than others. For instance, 25 percent of adults age 65 or older have diabetes. The prevalence rates are even higher among Hispanic/Latino Americans and African Americans. Besides those diagnosed with diabetes, more than 85 million other Americans have prediabetes, or evidence of problems controlling glucose levels that increases their risk of developing diabetes and other serious health problems, including heart disease and stroke.

    Type 1 diabetes, also known as insulin dependent diabetes or juvenile diabetes, accounts for five percent of all diagnosed cases of diabetes in US adults. While type 1 diabetes can occur at any age, it is most likely to occur in persons under 20 years of age. There is no known way to prevent type 1 diabetes. Type 2 diabetes is more common and is also known as adult-onset diabetes, as it is generally found in persons 40 years of age or older. Weight is a significant risk factor for type 2 diabetes, with overweight and obese adults at higher risk to develop this disorder. 

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  • The kidneys as best known for their ability to filter wastes and excess fluids from blood, which are then excreted in urine, but they also help regulate blood pressure, maintain electrolyte and mineral balance, produce a form of vitamin D, and even help the body produce red blood cells. A diagnosis of kidney disease (often called renal disease or renal failure) means that a person’s kidneys are damaged, resulting in their inability to filter blood effectively. Chronic kidney disease or chronic renal failure develops over many years and can lead to end-stage kidney disease, resulting in the need for dialysis or a kidney transplant. Chronic kidney disease affects approximately one of every seven Americans, with higher rates found among African Americans and Hispanic/Latino Americans. The rates of chronic kidney disease are also higher among women than among men.

    The two most common causes of chronic kidney disease are diabetes and high blood pressure. Having a family member with kidney disease can also raise a person’s chance of developing it. The encouraging news is that with proper control of one’s blood sugar and blood pressure, kidney disease can often be prevented or the impact of kidney disease can be minimized. 

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  • There are more than 100 types of cancer, all characterized by the uncontrolled growth and spread of abnormal cells that have the potential to invade and destroy normal body tissue. At first, most solid cancers are localized, with cancer cells confined to their original site. However, over time, these cancer cells may spread, or metastasize, to other parts of the body. Some less common cancers of the bloodstream, such as leukemia, involve the body more generally at the time of presentation. The most common cancer types that lead to death include lungbreastcolorectal, and prostate. Treatments for cancer can be most effective when the cancer is localized; once cancer has spread, treatment is more difficult and less effective.

    More than 1.6 million new cases of cancer are diagnosed in the United States each year, and close to 600,000 Americans die from cancer annually. Deaths from cancer have decreased over the last 20 years (by 1.8 percent among men and 1.4 percent among women) but still remain higher for African Americans than for non-Hispanic/Latino whites, reflecting differences in genetics, environmental exposure related to socioeconomic status, and health care disparities. Paralleling these differences, the five-year survival rate for cancer in African Americans is significantly lower than for non-Hispanic/Latino whites, due in large part to diagnosis occurring later in the disease process. 

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  • Clinical depression (also referred to as major depression or major depressive disorder) is a serious condition that affects millions of Americans every year. It is significantly different from the periods of sadness or feelings of grief that occur as an expected part of life for most people. Although it is normal to be sad or “down” occasionally and to experience grief when a significant loss occurs, clinical depression has more severe symptoms, often lasting for a long period of time, and is more likely to have an impact on a person’s ability to function normally.

    It is estimated that during any given month almost five percent of Americans will experience an episode of major depression, and the lifetime prevalence is more than 17 percent. When other depressive conditions such as bipolar disorder and persistent depressive disorder are included, the estimate of lifetime prevalence exceeds 20 percent. In other words, one of every five Americans will experience at least one serious episode of depression at some point in his or her life. Females are generally thought to be about twice as likely as males to experience major depression, but no group is exempt from this painful illness. Depression can be found among the young and the old, the religious and nonreligious, and all ethnic and racial groups. 

     

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  • Dementia is a clinical syndrome or condition in which there is a progressive deterioration of mental faculties, usually over many years. Problems with memory are typically the first sign of dementia. Other symptoms may include difficulties with language, impaired judgment, problems in performing simple tasks such as dressing, and changes in personality and behavior. It is common for people with dementia also to develop clinical depression, agitation, or anxiety symptoms as their disease progresses. There are a number of brain disorders that can result in dementia, the most common being Alzheimer’s disease which accounts for 60 – 80 percent of dementia cases.

    It is important for people to understand that dementia is not an inevitable consequence of aging. Although the risk of developing dementia increases with age, the overwhelming majority of older adults do not have dementia. Most older adults who report problems with memory do not have and may never develop dementia.

    Dementia is often referred to as a “caregiver’s disease” because of the impact on family and friends. A person with dementia will need a loved one or loved ones to help with the many new challenges and stresses that, at times, may seem overwhelming and endless. 

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  • Childhood Obesity

    Childhood obesity has increased dramatically in recent decades. Currently, almost 20 percent of school-aged children are obese, with the highest rates found among Hispanic/Latino and African American children. This is a disturbing development because obesity places children at higher risk for a number of health conditions, including asthma and type 2 diabetes. Children with obesity also are more likely to have low self-esteem, experience depression and anxiety, and be bullied.

    Mental Health

    Autism spectrum disorder refers to a group of developmental disorders characterized by (1) difficulty communicating and interacting with others and (2) repetitive behaviors as well as limited interests and activities. The symptoms of autism spectrum disorder may appear as early as infancy. The severity of the symptoms and the degree of disability can vary widely. Diagnosis relies on a medical examination and careful review of the child’s history.

    Attention deficit hyperactivity disorder (ADHD) is a condition that affects millions of children. Symptoms include difficulty maintaining attention, hyperactivity, and impulsive behavior. Symptoms of ADHD in a child may be predominantly inattention or predominantly hyperactive-impulsive behavior or a mixture of the two. Diagnosing ADHD relies on a comprehensive examination and detailed data gathering conducted by a pediatrician, psychologist, or other health professional with expertise in ADHD.

    Depression is a serious mental health issue among adolescents. While it is not uncommon for adolescents to feel sad at times, and perhaps use “depression” to describe how they are feeling, approximately five percent of adolescents will experience a much more serious emotional disturbance, a condition that health professionals refer to as major or clinical depression. This is a medical illness that can lead to significant problems at home and school and that increases the risk of both substance abuse and suicide, the second leading cause of death among individuals ages 15 to 24. Fortunately, there are effective treatments for depression.

    Anxiety is another important mental health issue for children and adolescents. Although it is not unusual for children and adolescents to feel anxious about school or friendships or when they are facing new, unfamiliar situations, when these feelings of anxiety persist for weeks or months and interfere with their schoolwork or relationships with family and peers, this may be an indication that they have an anxiety disorder. Although there are effective treatments, anxiety disorders often go unrecognized and untreated.

    Substance Use Disorders

    Adolescence is a time with the brain is vulnerable to substance use disorders. The National Institute of Drug Abuse has a helpful analogy, stating, “The adolescent brain is often likened to a car with a full functioning gas pedal (the reward system) but weak brakes (the prefrontal cortex).” And we know that the use of alcohol, tobacco, and illegal and prescription drugs by teenagers is not uncommon. One of the most important objectives with respect to adolescent substance use is to identify and address the problem as soon as possible so that the adolescent can obtain professional help and family can get the education and support it needs.

    Injuries

    Childhood injuries are a major health concern, with millions of children treated in hospital emergency departments each year. Many of these injuries occur in the home, while others occur during sporting or recreational activities, and still others when children are in motor vehicles. Learning effective prevention strategies and using appropriate safety equipment can greatly reduce the risk of many of these injuries and in some cases can even result in saving lives. 

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  • Vaccines are part of a healthy individual’s life from birth to old age. Vaccines help infants and toddlers acquire immunity to otherwise lethal infections, such as measlestetanus, and diphtheria, and are initiated as early as two months after birth. In adults and the elderly, vaccines help boost the immune system, fighting off bacteria that cause pneumonia and viruses that cause the flu. Some vaccines may have to be given again, in order to “reboot” the immune system. An immune system’s memory may decline over time, so vaccines such as tetanus require a “booster” dose. The influenza vaccine is unique among vaccines, as it is given annually because the influenza virus mutates (or changes) constantly. So, each year’s vaccine supply is engineered to create immunity to a few types of the virus judged most likely to be circulating in the upcoming flu season.

    In spite of the demonstrated effectiveness of vaccines, an alarming development is that compliance with receiving vaccinations has decreased in the pediatric population. In the early 2000s, measles was at its lowest rate of incidence ever recorded, but avoidance of this vaccine in recent years has led to a resurgence of measles. And large numbers of adults (up to 40 percent of Medicare beneficiaries) do not take advantage of vaccines that can prevent serious illnesses, hospitalizations, and even death. 

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  • The ethical basis for preparing an advance directive regarding health care is the moral and legal right of every adult to accept or refuse recommended medical treatments. Each individual can decide what medical care to accept and what to reject. Physicians, hospitals, and nursing homes must respect the wishes of competent adults, even if they disagree with certain decisions. Some people may decide that they do not want to accept a medical treatment or be on a type of life support system if they have a terminal or progressive illness and functional or cognitive disabilities, while others in similar situations may want to be sure that such treatments are continued.

    If an injury or illness prevents a person from making a decision or communicating wishes, however, the situation may become far more complicated. Often the hardest decisions about life-sustaining or invasive treatment must be made by others, usually family members, who may not know whether their loved one would or would not want treatment. Therefore, it is advisable for adults of all ages to do some advance planning and use one or more advance directives to convey their wishes and decisions. The most common ways to provide guidance are to leave specific instructions, often called a living will, or to designate and authorize someone to make medical decisions in the event of incapacity.

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  • Good, clear communication between patients and their health care providers is absolutely essential, but many people have had the experience of coming out of an appointment feeling more confused than when they went in. It is not unusual for people to report that they do not fully understand their illness or what they should do to manage their condition effectively, even though they have had several meetings with their health care provider.

    Although there are many factors that can contribute to the problem of poor communication between patients and providers, patients can use a few key strategies to overcome these obstacles, and the benefits of adopting these strategies are well established. People who take the initiative to improve communication with their providers receive more factual information from their providers, are more likely to follow through with treatment recommendations, and report greater satisfaction with the care they are receiving. A key point for patients to always remember as they prepare for medical visits is that most important issues can be covered during a meeting with a provider if the information is well organized and presented in a direct, clear manner. 

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  • There are a number of risk factors for most chronic diseases, some of which are beyond our control (e.g., age, gender, family history). But there are other risk factors, often referred to as lifestyle factors, over which we can exert considerable influence.

    Stress

    Stress is an inevitable part of life – there is simply no way to completely avoid it. But when it is prolonged or excessive, it can have harmful consequences for our health. For example, it can impair immune system functioning or trigger the release of hormones that speed up heart rate and raise blood pressure. Stress also can increase our risk of illness or worsen existing illnesses by making it more difficult for us to maintain a healthy lifestyle (e.g., regular exercise, nutritious diet). Therefore, it is important for us to learn how to manage stress effectively.

    Physical Activity

    One of the major risk factors for several serious medical conditions, including heart diseasestroke, and diabetes, is physical inactivity. Despite this well-documented link, the National Center for Health Statistics has found that only a little over half of American adults meet the federal physical activity guidelines for aerobic activity through leisure-time activity (150 minutes a week of moderate-intensity aerobic activity), with African American and Hispanic/Latino adults having rates lower than non-Hispanic/Latino white adults. Clearly, there is a need for more programs to educate adults about the health benefits of increased physical activity and to provide ongoing encouragement and support for maintaining regular individualized programs of exercise.

    Weight

    The most common approach to weight loss has been dieting, a method in which people focus on reducing their caloric intake. Although the basic equation underlying this approach is correct – weight loss results when the calories you use exceed the calories you take in – the weight loss produced by using this approach alone is generally not maintained for long. A more effective strategy for losing weight is a multidimensional approach that can be incorporated into your overall lifestyle and sustained for the rest of your life.

    Smoking

    Smoking is the number one cause of preventable death in America. Individuals who smoke have an increased risk of cancerlung diseaseheart attackstrokevascular disease, and even blindness, and have, on average, a life expectancy that is ten years shorter than that for nonsmokers. In spite of the well-documented link between smoking and these serious medical conditions, many people find it extremely difficult to quit smoking. The primary reason underlying this difficulty is that nicotine can be as addictive as cocaine or heroin. Although stopping smoking can be difficult, the health benefits for those who succeed are significant and well worth the effort.

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  • Even individuals who have no signs of ill health can take many prescribed and over-the-counter medications to treat common conditions such as arthritis pain, high blood pressurehigh cholesterol, and acid reflux. As people age and develop chronic diseases, the list of medications frequently grows long. But regardless of the number of medications a person takes, adverse side effects are always possible, and the risks increase dramatically as the number of medications rises.

    While adverse reactions to medications occur frequently, noncompliance with prescribed medication regimens is probably even more common. Studies have shown that as many as 50 percent of patients fail to take their medications as prescribed. The problem is even greater for older adults, in large part because they are likely to have multiple chronic diseases and thus are prescribed many medications.

    The most serious danger of failing to take a medication as instructed is that the disorder or condition for which it is prescribed will not be well controlled, and thus an individual will be at risk of developing more serious medical problems. Another danger is that if people take some medications improperly, they may develop new medical problems, such as mental confusion or injuries sustained from a fall due to an imbalance related to adverse effects on brain function.

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  • Accidents and fall frequently are overlooked as major health problems associated with aging. However, both the number and severity of falls increase with age, and falls are the leading cause of fatal and nonfatal injuries for older adults. Each year almost 3 million older adults are treated in emergency departments for fall injuries, and more than 800,000 are hospitalized for these injuries.

    Many factors increase the risk of falls among older adults. Some of these are associated with the aging process, while others are associated with medical disorders (e.g., diabetes or stroke) that occur more frequently in old age. Such disorders can cause muscle weakness, sensory deficits, or balance problems that can lead to postural and gait instability. In addition, adverse reactions to many commonly prescribed medications can result in inattention, drowsiness, dizziness, or weakness and can directly cause a fall. Finally, many falls are the result of environmental factors that could be prevented if proper home inspections and modifications are made.

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  • Families are being called on to play an increasingly important role in health care today. A recent survey conducted for the National Alliance for Caregiving and the AARP Public Policy Institute found that almost one of every five adults in the United States is serving as a family caregiver, a term that is used most often to describe individuals who care for members of their family of origin but also can refer to those who care for their family of choice – often a member of their congregation, neighbor, or close friend. These informal, unpaid caregivers tend to the needs and concerns of persons with limitations caused by illness, injury, or disability.

    Most caregivers report that they have little preparation for many of the tasks they take on, and providing this care can be physically and emotionally demanding, especially for those caring for loved ones with chronic mental health issues or Alzheimer’s disease or other forms of dementia. It often means sacrificing some of their own interests and not paying enough attention to their own health. There is also often the challenge of balancing caregiving with work. It is not unusual for family caregivers to have to reduce their work hours or take a leave of absence, which then impacts their own financial situation.

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