The federal government has updated its preventative health guidance, which may support patients and providers alike.

Healthy People issues preventive-health objectives every 10 years, and Healthy People 2030 is the newest iteration. The most recent version pares down objectives to avoid overlap and stress the most important public-health issues. 

Arthritis pain

Moderate/severe joint pain can make daily activities difficult to perform and impair quality of life. Some of those with arthritis experience extreme pain, and this condition is more common in certain racial groups. One strategy to combat pain is increasing levels of physical activity.

In most recent data, 56.8% of adults aged 18 years or more who are diagnosed with arthritis have severe/moderate joint pain. Healthy People 2030 aims to reduce this figure to 53.1%.

UTI burden

In the elderly, UTIs are the second most common infection type, with diagnosis often prompting hospitalization. UTIs can lead to kidney failure and death. Instruct patients to drink enough fluids and manage bladder issues to prevent UTIs. Early treatment can reduce the need for hospitalization.

Current data indicate that there are 551.3 hospitalizations secondary to UTI for every 100,000 adults. Healthy People 2030 aims to lower this to 492.2 hospitalizations per 100,000. 

Hearing loss

A concerning environmental hazard is excessive noise, which can cause noise-induced hearing loss. People who are surrounded by loud noises are at risk. Although permanent, this condition is preventable. Wearing hearing protection—such as earplugs, earmuffs, or helmets—helps.

The most recent data indicate that 66.7% of adults aged between 20 and 69 years use hearing protection. The goal for Healthy People 2030 is 71.4%.

Depression screening

Millions of Americans struggle with depression. Although screening during primary care visits, as well as follow-up treatment, can improve depression symptoms in adults and teens, this rarely happens.

According to recent data, only 8.5% of patients aged 12 years or older receive depression screenings during primary care visits. Healthy People 2030 is shooting for 13.5%.

Sufficient sleep

Many Americans don’t get enough sleep, and lack of sleep is linked to obesity, diabetes, heart disease, cancer, and death. Patients should be instructed on the importance of sleep and proper sleep hygiene.

According to the most recent data, 67.5% of adults aged 18 years or older get enough sleep, with a desired goal of 68.6%, according to Healthy People 2030.

Eye screenings

Diabetic retinopathy is the leading cause of blindness in adults of working age. Many adults with diabetes, however, don’t receive necessary yearly eye exams. Minorities are hardest hit. If caught early, diabetic retinopathy is more easily treated, highlighting the importance of eye exams.

According to the most recent data, 62.3% of adults with diabetes aged 18 years or older received eye exams within the past year. Healthy People 2030 is aiming to increase this figure to 67.7%.

Dementia insight

It’s often difficult for people with dementia—and their caregivers—to spot the disease. Such insight could help with possible treatment and future planning. Physicians should endeavor to identify more cases of Alzheimer disease and other types of dementia.

Only 59.7% of adults aged 65 years or older knew that they had Alzheimer disease or other types of dementia, according to the most recent data. Healthy People 2030 aims to increase this figure to 65.1%.

Sickle cell treatment

Sickle cell disease is systemic and can result in acute and chronic pain. Although hydroxyurea can treat the disease, not everyone receives it.

Healthy People 2030 recommends that based on most recent data, the 12.4% of Medicare beneficiaries aged 18 to 75 years receiving disease-modifying therapy be increased to 15.9%.

The preventive care challenge

With so much on a provider’s plate, it can be difficult to find time to discuss preventive guidance with patients. Possible insights can be gleaned from a survey of 137 primary care physicians published in JAMA concerning how they prioritize preventive-health services. 

Especially during short visits, physicians responded that they prioritized preventive services by potential to improve quality/length of life. If short on time, physicians presented less guidance, with an average of one to three preventive interventions presented. This guidance was focused on what was most likely to improve life expectancy.

While primary care physicians are typically the patient’s main source for health promotion and disease prevention, specialists can play an important role.

Another factor that physicians considered when providing preventive guidance was whether the patient would adhere. Because lifestyle interventions, such as diet and exercise, are rarely successful, they were prioritized low. Moreover, to be even moderately successful, lifestyle interventions must last between 9 and 12 months.

Overall, the chances of a patient with obesity maintaining weight loss is less than 1%. In addition to time constraints, lack of lifestyle counselors may be a barrier. Guidance on smoking cessation is highly prioritized, possibly due to higher success rates of 3%-17% per quit attempt. 

 

Preventive care guidance

 

In its Code of Ethics, the AMA also supports the importance of health promotion and preventive care regarding healthy lifestyle. These strategies could include patient education and motivations, and consideration of needs, preferences, and readiness. Although much preventive care may be within the domain of the primary care physician, specialists can play a role, too.

“While primary care physicians are typically the patient’s main source for health promotion and disease prevention, specialists can play an important role, particularly when the specialist has a close or long-standing relationship with the patient or when recommended action is particularly relevant for the condition that the specialist is treating,” according to the AMA.

Though challenging, the AMA underscores the necessity of taking a patient-centered approach to preventive care. Specifically, they recommend:

• Staying current on the latest preventive care guidelines.

• Encouraging patients to stay up-to-date on their vaccinations and screenings.

• Having open conversations about circumstances that make chronic disease management challenging, such as transportation access or lack of social support.

• Collaborating with the patient to determine which preventive care recommendations will be most effective.

• Calling in the assistance of other providers to implement preventive care measures.

• Modeling the behaviors you’re seeking to instill in patients.

Sources

1. Building a healthier future for all. Healthy People 2030.

2. Health Promotion and Preventive Care. AMA.

3. Zhang JA. Assessment of Physician Priorities in Delivery of Preventive Care. JAMA.