Health risk assessment frameworks and methods

Health Risk Assessment

year-old Greek male who is a retired firefighter and who is a stay-at-home father of a four-year-old son. This individual is overweight and uses the Atkins Diet irregularly to lose weight. This individual has high cholesterol and his father has suffered from strokes and heart disease. Due to asthma this individual fails to exercise regularly and has stated he desires to change his behavior since he has a small child who needs him. This work will: (1) identify health screening specific for the age of this subject; (2) identify risk factors specific to this subject; (3) identify which risk factors can be modified by interventions; (4) make recommendations for this individual; and (5) develop a plan for this individual.

Identification of Risk Factors & Health Screening

There have been several risk factors identified for this individual including the risk of stroke and heart disease, both of which are inherited risks associated with genetics. Furthermore, the individual in this case study has been identified as having high cholesterol levels, being overweight and having asthma.

II. Stroke & Heart Disease Screening, Prevention, and Interventions

Reports state that the individual who has a parent, grandparent, brother or sister who has had a stroke is at a much higher risk of stroke. (American Heart Association cited in: National Human Genome Research Institute, 2009) the American Heart association states that family history is an "important non-modifiable stroke risk factor, along with advancing age, male sex, and prior history of heart attack or stroke." (National Human Genome Research Institute, 2009)

It is important for these individuals to "make lifestyle changes that can decrease risk." (National Human Genome Research Institute, 2009) the U.S. Preventive Services Task Force (USPSTF) Guidelines for screening of patents at moderate risk for stroke due to family history is stated as follows:

"USPTF strongly recommends that clinicians routinely screen men aged 35 years and older and women aged 45 years and older for lipid disorders and treat abnormal lipids in people who are at increased risk for coronary artery disease (CHD)." (National Human Genome Research Institute, 2009)

It is stated by the National Human Genome Research Institute in its 2009 report that the USPSTF

"...has found that there is good evidence that high levels of total cholesterol and low density lipoprotein-cholesterol (LDL-C) and low levels of high density lipoprotein-cholesterol (HDL-C) are important risk factors for coronary heart disease. The risk for coronary heart disease is highest in those with a combination of risk factors. The 10-year risk for coronary heart disease is lowest in young men and in women who do not have other risk factors, even in the presence of abnormal lipids." (2009)

The USPSTF additionally reports that there is a good evidence base that supports lipid measurement as being capable of identifying

"...asymptomatic men and women who are eligible for preventive therapy...[although] the absolute benefits of lipid-lowering treatment depend on a person's underlying risk for coronary heart disease." (National Human Genome Research Institute, 2009)

It is held that men who are over the age of 35 and who are at an increased risk "...will realize a substantial benefit from treatment..." (National Human Genome Research Institute, 2009)

The National Guidelines for coronary heart disease screening states that "older age, male gender, high blood pressure, smoking, abnormal lipid levels, diabetes, obesity, and sedentary lifestyle" are all risk factors for coronary artery disease. It was reported by Journal Watch on October 2nd 2009 in an article entitled: "Guidelines: Screening for Coronary Heart Disease" that the USPSTF has updated its 1996 recommendations for coronary heart disease screening. Recommendations are stated as follows:

"Clinicians should routinely ascertain an individual's overall risk for CHD events by screening for risk factors and by using that information with a risk-assessment tool such as Framingham scoring." (Journal Watch, 2009)

II. Asthma Interventions

It is reported in the work of Bravata, et al. (2007) entitled: "Closing the Gap: A Critical Analysis of Quality Improvement Strategies, Vol. 5: Asthma" as follows:

"A wide variety of types of QI interventions have been found to improve the outcomes and processes of care for children and adults with asthma. Young children with asthma benefit most from QI strategies that also include their caregivers or parents. General populations with asthma can have clinically significant improvements in spirometric measures after participating in self-monitoring, self-management, or patient education interventions-especially interventions that are based on theoretical frameworks, are of relatively long durations, and utilize combinations of educational modalities. Being overweight is also known to contribute to asthma. (Bravata, et al., 2007)

III. Obesity and High Cholesterol

Overweight or obesity is a major risk factor for coronary heart disease leading to heart attack. Obesity is known to:

(1) raise blood cholesterol and triglyceride levels;

(2) lower 'HDL' or 'good' cholesterol;

(3) raises blood pressure levels;

(4) induce diabetes and heightens the risk of heart attack. (Mayo Clinic, 2009)

IV. Physical Activity Recommendations

The President's Council on Physical Activity and Sports states as follows:

(1) Significant health benefits can be obtained by including a moderate amount of physical activity (e.g., 30 minutes of brisk walking or raking leaves, 15 minutes of running, 45 minutes of playing volleyball). Additional health benefits can be gained through greater amounts of physical activity;

(2) Thirty to sixty minutes of activity broken into smaller segments of 10 or 15 minutes throughout the day has significant health benefits. (2008)

V. Analysis & Recommendations

The individual in this case study is on the Atkins Diet. A recently released study shows that individuals participating in the 'Eco Atkins' diet have realized benefits in terms of weight reduction and reduction of cholesterol levels. The Eco Atkins diet is a "low-calories, low-carbohydrate diet high in plant-based proteins." (Elements4Health, 2009) However, there is stated to be "a dilemma relating to the proportion and source of fat, protein and carbohydrate that constitutes the optimal weight loss and cholesterol-lowering diet." (Elements4Health, 2009)

The Atkins diet that is not the 'Eco' Atkins diet has been reported negatively with reports stating that individuals who follow this diet "may worsen risk factors for heart disease compared to other popular diets." (Boyles, 2009) There is a contradiction however, as it is has been reported that low carbohydrate diets are