Disease Prevention (Definition)


As a health insurer or employer who offers healthcare to your employees, you probably know how healthcare works in this country. Many people avoid the doctor until they get sick. When they do go, they may use emergency room services or need costly prescription medications or treatments. In short, the sickest patients use the most healthcare resources, such as providers’ time, facilities, and dollars.

This pattern may seem unavoidable since it is so ingrained in our culture, but there are other ways to approach healthcare. One approach is a preventative approach that can help more people maintain better health. Improving quality of life by preventing disease is not just ethically the right thing to do. It makes economic sense, too.

Disease prevention is not yet the prevailing culture, but it is increasingly being recognized as being cost-effective and worthwhile. In addition, health technology, such as digital coaching, is available that can increase access to preventive care.

 

Importance of Disease Prevention


Why is chronic disease prevention important? There are two main reasons.

  1. Treatment is expensive.

  2. These diseases are largely preventable.

  3. Prevention is feasible and simple.


Treatment is expensive. The overwhelming medical and indirect costs of chronic diseases should provide ample motivation to prevent them. Medical expenditures for chronic and mental health account for 90% of healthcare spending in the United States.[1] The annual medical costs and costs of lost productivity associated with diabetes and obesity are $245 billion and $147 billion, respectively. The medical costs of hypertension add another $109.1 billion[2,3 ], before considering indirect costs such as lost productivity.

On their own, the outlandish costs of these conditions are not enough to spur action if there is no way to prevent them, but thankfully, they are preventable. 


These diseases are largely preventable. A harmful misconception about diseases is that they are inevitable, and the belief that the only thing that can be done with diseases is treat them has led to harmful and unnecessary consequences, including poor health outcomes and skyrocketing costs from medical expenses and lost productivity.

Dig a bit, though, and it becomes apparent that most prevalent diseases and their consequences are preventable. Losing excess weight, achieving physical activity goals and choosing a more nutrient-dense diet can dramatically lower risk of chronic diseases including type 2 diabetes, certain cancers, and cardiovascular disease. In fact, “90 percent of type 2 diabetes, 80 percent of coronary artery disease, and 70 percent of stroke” are considered attributable to poor lifestyle choices[4]. Regardless of genetic risk factors, addressing modifiable risk factors can improve outcomes.


Prevention is feasible and simple. Most chronic diseases could be prevented or delayed with simple and inexpensive solutions. These strategies do not involve high-tech, experimental genetic modification, expensive or risky surgery, or costly medications with short-term side effects and long-term risks. They do not even require extensive physician involvement – and that’s important, given that nearly 2 out of every 5 visits to the doctor are for chronic conditions[5]. 

Instead, the proven effective strategy to prevent the most common and costly chronic diseases is far simpler, less expensive, and without side effects. It involves individuals making healthy lifestyle choices on a daily basis to maintain health and reduce health risks. These behaviors require healthy choices and are largely considered the responsibility of the individual, although support has been found to be instrumental in promoting healthy choices. While in-person clinical support systems can increase the likelihood of patients achieving their goals, digital alternatives, such as Lark health coaches, can be more accessible and less expensive.

Preventing and mitigating the impact of chronic diseases can happen at any time in any population, from apparently healthy to long-ago diagnosed. The principles of primary, secondary, and tertiary prevention can help illustrate this.

 

Primary Prevention


Primary prevention refers to preventing diseases before they occur. Targeted individuals might have only few or minor risk factors. These are some examples of primary prevention. 

  • Healthy individuals using Lark Wellness to establish healthy, disease-preventing habits such as getting regular physical activity, eating more vegetables, and getting adequate sleep.

  • Educational campaigns or materials targeted to the general healthy population, such as anti-tobacco ads targeted to young people who do not smoke, or nutrition labels with calorie content available to people regardless of weight status.

  • Establishing a culture of health in the workplace, such as distributing health newsletters and encouraging group walks during lunch hours. 

 

Secondary Prevention


Secondary prevention aims to minimize the effects of diseases in their earliest stages and to prevent their progression. It can include screening in order to enable early referrals and treatment. These are some examples of secondary prevention.

  • Checking height and weight to calculate body mass index (BMI) to determine if someone is overweight or obese, and if so, referring him to a weight management program.

  • Measuring blood pressure at each doctor’s visit to detect and then treat high blood pressure as soon as possible.

  • People with prediabetes or other risk factors for diabetes using Lark Diabetes Prevention Program (DPP) to lower diabetes risk through weight loss, physical activity, healthy eating, and stress management.

  • Diabetes patients attending recommended specialist appointments to check for changes in vision, reduced kidney function, and foot wounds before they become untreatable.

 

Tertiary Prevention


Tertiary prevention refers to managing established diseases to slow progression and reduce complications. These are some examples of tertiary prevention.

  • Patients with diabetes using Lark Diabetes Pro to control blood sugar and lower risk of complications through weight management, physical activity, blood glucose monitoring, and medication adherence.

  • Patients with hypertension lowering stroke and cardiovascular by adhering to the Dietary Approaches to Stop Hypertension (DASH) diet with the help of Lark Hypertension Pro.

  • Obese individuals following a weight loss program.

 

Chronic Disease Prevention and Management Strategies


Chronic disease prevention and management strategies can be multi-faceted and targeted towards all three levels of prevention. Realistic strategies must consider cost and cost-effectiveness, reach, and effectiveness. These are some approaches to chronic disease prevention that can have widespread impact.

  • Ad campaigns, such as “Five a Day” to promote fruit and vegetable consumption or “Got Milk?”

  • Wellness fairs with information and free screenings, such as blood pressure measurement and diabetes risk questionnaires.

  • Policies that promote healthy choices, such as prohibiting smoking in and near buildings, or subsidizing fruits and vegetables to make them more affordable.

  • Cultures of wellness in workplaces to make healthy choices easier, such as having vending machines with fresh fruit and encouraging walk breaks for employees.

  • Providing reimbursement for prevention programs, such as Medicare coverage for CDC-recognized Diabetes Prevention Programs.

  • Promotion of healthy behaviors by individuals and families, such as using food logging apps for weight loss.

Primary care and specialty doctors, nurses, and other healthcare providers are indispensable for chronic disease management, but patients shoulder the brunt of the responsibility for their own wellness. Their decisions about food choices, physical activity, and, if warranted, medication adherence and self-monitoring of blood glucose or blood pressure, have a great influence on chronic disease development and risk. 

These behaviors are tough to implement, and many people can do better with support from nurses, nutritionists, and other healthcare professionals. Live support from these types of professionals is in short supply. Many people have minimal access, and even those with excellent support systems are likely to be limited in the amount of contact they get and the hours the support is available.

Digital apps, such as Lark health coach, can address these shortcomings with unlimited, anytime access for users. The coaching programs are powered by artificial intelligence and backed by nutrition, exercise, sleep, and other specialists to allow delivery of personalized, evidence-backed behavior change programs to all users. The system allows for instant and infinite scalability at cost.

Benefits of fully automated health coaches can include the following.

  • High engagement rates and health outcomes comparable or superior to in-person interventions.

  • Reduced shortfalls in healthcare since each patient can have a 24/7 personal coach.

  • Fewer disparities, due to distance, socioeconomic status, or race/ethnicity, in healthcare access due to off-site, digital access.

  • More economical use of doctors and nurses, with not contacting them if unnecessary but contacting them if needed, which can reduce the time they spend and reduce emergency room visits. 

This is an exciting time in healthcare. Chronic diseases are dominating medical care, healthcare costs, and productivity in the workplace, but the opportunity is there to make a difference. Primary, secondary, and tertiary prevention allow for health and economic improvements at any point on the wellness-disease spectrum, and a single intervention, Lark, offers coaching for healthy behavior changes for weight loss, wellness, diabetes prevention management, and hypertension. Employers and healthcare providers can get full support when implementing their chronic disease prevention programs.s

 
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Preventing Diabetes is an important long-term goal of my organization
Preventing Diabetes is an important long-term goal of my organization
Answer
Do you currently offer a Diabetes Prevention Program to members?
 
 


Reference

  1.  National Center for Chronic Disease Prevention and Health Promotion. Health and Economic Costs of Chronic Diseases. https://www.cdc.gov/chronicdisease/about/costs/index.htm. Reviewed February 2, 2017. Accessed February 4, 2019.

  2.  Zhang D, Wang G, Zhang P, Fang J, Ayala C. Medical Expenditures Associated With Hypertension in the U.S., 2000-2013. Am J Prev Med. 2017;53(6S2):S164-S171. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5823517/

  3.  Centers for Disease Control and Prevention. High Blood Pressure Costs. https://www.cdc.gov/bloodpressure/facts.htm Reviewed November 30, 2016.

  4. Walter C. Willett, Jeffrey P. Koplan, Rachel Nugent, Courtenay Dusenbury, Pekka Puska, and Thomas A. Gaziano. Chapter 44: Prevention of Chronic Disease by Means of Diet and Lifestyle Changes. Disease Control Priorities in Developing Countries. 2nd edition. Jamison DT, Breman JG, Measham AR, et al., editors. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; New York: Oxford University Press; 2006.

  5.  Ashman JJ, Rui P, Okeyode T. Characteristics of office-based physician visits, 2015. NCHS Data Brief, no 310. Hyattsville, MD: National Center for Health Statistics. 2018.

Preventing Chronic Disease


Since chronic diseases are the greatest driver of healthcare costs and lost productivity[1], you cannot afford to ignore their impact. As an employer or insurer, you need to know that 9 in 10 healthcare dollars in the United States are spent on chronic diseases and mental health conditions for a total annual cost of about $3 trillion[2]. You may be shouldering a large portion of the economic burden, but with the responsibility comes opportunity.

 

The Case for Chronic Disease Prevention


Chronic diseases and their risk factors are nearly certain to be prevalent in your covered population of employees or beneficiaries. About 2 in 3 adults are overweight or obese and at risk for multiple chronic conditions, and obesity costs about $147 billion each year. The majority of American adults have at least one chronic condition, and half are managing at least two[3].

  • Heart disease and stroke, with hypertension as a major risk factor, costs $316 billion annually in healthcare costs and lost productivity.

  • Diabetes costs $245 billion annually in healthcare costs and lost productivity.

  • Prediabetes affects 1 in 3 adults, and only 10% of people with prediabetes know that they have it[4].

Chronic disease is clearly a major problem, and there is another compelling reason to address it: Many of the top chronic diseases are preventable. From a public health perspective, they are preventable at the primary, secondary, and tertiary levels, as defined below and shown in the following examples.

  • Primary Prevention – prevention of a disease before it happens, often through education and promotion of healthy behaviors. Lark Wellness promotes weight loss among overweight users, along with better diet quality, increased physical activity, and other healthy behaviors, to reduce obesity and lower risk for diseases such as diabetes and cardiovascular disease.

  • Secondary Prevention – reduction of the effects of a disease. Lark Diabetes Prevention Program (DPP) lowers risk for type 2 diabetes among individuals with prediabetes through lifestyle changes that are known to reduce insulin resistance. Lark Hypertension Pro lowers risk for diseases such as cardiovascular disease, stroke, and kidney disease, through lifestyle changes and other behaviors that can lower blood pressure.

  • Tertiary Prevention – minimization of the impact of a disease. Lark Diabetes Care assists users with lifestyle behaviors and self-care habits that can manage blood sugar and reduce the chances of comorbidities, such as heart disease and hypertension, and complications, such as blindness and kidney disease.

An abundance of research supports the potential for lifestyle changes to lower the risk for many of the most common and expensive chronic diseases[5]. Losing weight, increasing physical activity, and getting adequate sleep are examples of strategies that are not only effective, but also relatively safe and inexpensive compared to treatments such as prescription medications, frequent medical appointments, or invasive medical procedures. 

 

Multifaceted Model for Population Health


With a busy schedule and a focus on your own products and services, your organization can benefit from contracting with disease prevention programs that offer comprehensive packages. One approach to finding a provider that can help is to find a provider that helps in multiple domains. The Workplace Health Model[6], developed by the Centers for Disease Control and Prevention (CDC), is one tool that can guide employers and insurers when searching for a chronic disease management program that can act at multiple levels for greater reach, impact, and efficiency.

Lark helps in each domain to provide easy-to-implement, cost-effective programs.

  1. Assessment. Lark checks for participant eligibility based on health risks and health conditions so you can target the right patients without doing the leg work.

  2. Planning and management. Lark allows you to provide programs without having dedicated staff from your organization, and it assists with marketing and other communication.

  3. Implementation. Lark has ready-to-use programs for wellness and weight loss, prediabetes, diabetes, and hypertension. The programs include education and counseling, as well as support for participants to improve success.

  4. Evaluation. Lark makes available key statistics on program effectiveness in your organization so you can be satisfied with the cost savings potential.

 

Evidence-Based Programs


To be effective, programs need to focus on evidence-based strategies[7]. In the area of chronic disease prevention and management, lifestyle changes are clearly effective. A team of health experts, with specializations in nutrition, physical activity, sleep, and other domains related to wellness, have applied their knowledge and the most recent and accepted research when developing Lark’s programs. 

Each program offers coaching on areas known to reduce risk and manage chronic conditions. Examples include the following.

  • Weight management. Each kilogram (2.2 lb.) of weight loss in obese individuals with prediabetes lowers diabetes risk by 16%.

  • Exercise. Physical activity lowers blood sugar and blood pressure and increases focus and ability to make healthy choices.

  • Healthy eating. Eating more vegetables and less fried food and processed meat can lower blood sugar and blood pressure.

  • Sleep. Inadequate sleep increases hunger, sugar cravings, and insulin resistance.

  • Stress. Stress management can lower blood pressure and make weight loss easier.

  • Medication adherence. Non-compliance is costly, widespread, and harmful for conditions such as high blood pressure and blood sugar.

  • Self-monitoring of blood glucose. This is linked to improved control in diabetes.

Lark’s programs are also designed for some of the most costly and prevalent conditions, based on the latest and most widely accepted research on effective lifestyle changes. For example, use of Lark DPP is associated with weight loss, which is one of the most effective ways to prevent type 2 diabetes, and Lark Hypertension Care includes coaching around Dietary Approaches to Stop Hypertension (DASH), which has been clinically shown to lower blood pressure within weeks. 

 

High-Impact Strategies


Disease prevention strategies, such as healthy eating, physical activity, and loss of excess weight, may be widely recognized, but they are hard for individuals to implement themselves without a carefully-designed program and plenty of support. 

Lark’s chronic disease prevention programs promote long-term healthy habits based on established theories of behavior change, such as cognitive behavioral theory and stages of change. Programs are delivered in a compassionate and empathetic manner to allow users to develop trust for their Lark coach. Strategies like these can have a higher impact as they continually inspire and enable healthy choices.

Lark health coach provides education, assists with goal-setting and tracking, and offers empathetic encouragement. Users can feel confident depending on Lark to be there as often as needed and without fear of running out of a limited number of sessions.

 

Instant Scalability at Cost


The most effective program is useless if it is unable to reach all who need it. Both small and large organizations need to be able to offer chronic disease prevention and management programs to all of their employees, employees’ families, and members who can benefit, but they may not have the necessary resources to develop, implement, manage, and evaluate the programs. For that reason, it can make far more sense to contract with a provider that has already developed proven programs and that will lead the way in making them work for your company.

Another major concern is scalability. It is only fair that all members be granted the opportunity to participate in a relevant program with the same high quality. Furthermore, you want to be sure that the program is equipped to grow with you, no matter how big and how fast, but without excessive costs or decreases in quality. Lark is a fully scalable chronic disease management solution that is ready to grow with your business without exponentially increasing costs.

 

Digital Solutions for Preventing Chronic Disease


The digital age is upon us, and healthcare needs to be cognizant of that. A digital program can address many of the problems in chronic disease management that may help contribute to poor outcomes.

Provider shortages. Doctors and other healthcare professionals are in short supply, with gaps between supply and demand projected to increase in coming years[8]. Patients may have trouble getting the care they need. An article published in the Journal of the American Medical Association (JAMA) estimates that a measly 1.1% of eligible individuals participate in a DPP[9]. Fully automated programs can help bridge the gap, allowing patients to receive more basic medical services than they might otherwise get if they were dependent solely on live consults with doctors. 

Out-of-reach costs. One look at the national costs of chronic diseases will raise suspicions that they are hurting your bottom line. Do the math, and you are sure to discover that these costs are dominating your healthcare budget. The cost of medical care is also out of reach for many patients, who are forced to limit their primary care and specialty visits at the cost of their health. Lark offers customized programs with unlimited accessibility for each patient at no additional cost and with no decrease in quality despite infinite expansion potential.

Patient responsibility. The nature of chronic disease management is that patient behaviors have the most impact on their health. Even if they have adequate doctor’s appointments and in-person provider support, patients affect their own health with the decisions they make, many times a day, about what they eat, whether they exercise and take their medications as prescribed, and how careful they are to take their health measurements as recommended. The CDC suggests “activating patient involvement through self-management.”[10] A health coach powered by artificial intelligence is in position to assist with the daily decisions due to its ability to customize programs and be available 24/7.

A digital program can be just as effective as in-person programs. For example, Lark has led to weight loss of 2.4%, on par with in-person programs[11]. Other Lark users have experienced a remarkable decrease of 11 mm Hg in systolic blood pressure[13]. As the CDC says, “a 1% annual reduction in the level of four health risks—weight, blood pressure, glucose, and cholesterol—has been shown to save $83 to $103 annually in medical costs per person.” 

A digital program can not only be effective, but more cost-effective than in-person programs. There is no need to set aside or rent facility space for coaching sessions. Patients may depend less on healthcare providers if they can get simple questions answered in the app. Furthermore, since it does not depend on live coaches or providers to coach patients each day, a fully automated program can be scaled indefinitely without requiring excess costs due to extra support staff.

 

Easy Startup without Risk


Taking the first step does not require a big investment of time, energy, and cost on your part. You can get ready to fight chronic disease and avoid the exorbitant costs of healthcare and lost productivity by contacting Lark. You will receive the support you need to get set up, and seamless device delivery and patient enrollment are a given. You can rest easy because of performance-based billing without the need to pay for patients who may never use the program.

 

Learn More

Name *
Name
Preventing Diabetes is an important long-term goal of my organization
Preventing Diabetes is an important long-term goal of my organization
Answer
Do you currently offer a Diabetes Prevention Program to members?
 
 


Reference

  1.  National Center for Chronic Disease Prevention and Health Promotion. Health and Economic Costs of Chronic Diseases. https://www.cdc.gov/chronicdisease/about/costs/index.htm. Reviewed February 2, 2017. Accessed February 4, 2019.

  2.  National Center for Chronic Disease Prevention and Health Promotion. Workplace Health Promotion. https://www.cdc.gov/chronicdisease/resources/publications/aag/workplace-health.htm. Reviewed February 2, 2017. Accessed February 4, 2019.

  3.  Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Santa Monica, CA: Rand Corp.; 2017. https://www.rand.org/content/dam/rand/pubs/tools/TL200/TL221/RAND_TL221.pdf.

  4.  National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation. National Diabetes Statistics Report, 2017: Estimates of Diabetes and Its Burden in the United States. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf 

  5.  Walter C. Willett, Jeffrey P. Koplan, Rachel Nugent, Courtenay Dusenbury, Pekka Puska, and Thomas A. Gaziano. Chapter 44: Prevention of Chronic Disease by Means of Diet and Lifestyle Changes. Disease Control Priorities in Developing Countries. 2nd edition. Jamison DT, Breman JG, Measham AR, et al., editors. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; New York: Oxford University Press; 2006.

  6.  National Center for Chronic Disease Prevention and Health Promotion. Workplace Health Promotion. https://www.cdc.gov/chronicdisease/resources/publications/aag/workplace-health.htm. Reviewed February 2, 2017. Accessed February 4, 2019.

  7.  Centers for Disease Control and Prevention. Best practices for cardiovascular disease prevention programs: A guide to effective health care system interventions and community programs linked to clinical services. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2017. https://www.cdc.gov/dhdsp/pubs/docs/Best-Practices-Guide-508.pdf

  8.  IHS Markit Ltd. The Complexities of Physician Supply and Demand: Projections from 2016 to 2030. Association of American Medical Colleges. March 2018. https://aamc-black.global.ssl.fastly.net/production/media/filer_public/85/d7/85d7b689-f417-4ef0-97fb-ecc129836829/aamc_2018_workforce_projections_update_april_11_2018.pdf

  9.  Prevalence and Correlates of Diabetes Prevention Program Referral and Participation. Venkataramani, Maya et al. American Journal of Preventive Medicine, Volume 0, Issue 0. https://www.ajpmonline.org/article/S0749-3797(18)32334-1/fulltext

  10.  Centers for Disease Control and Prevention. Best practices for cardiovascular disease prevention programs: A guide to effective health care system interventions and community programs linked to clinical services. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2017. https://www.cdc.gov/dhdsp/pubs/docs/Best-Practices-Guide-508.pdf

  11.  Stein N, Brooks K. A Fully Automated Conversational Artificial Intelligence for Weight Loss: Longitudinal Observational Study Among Overweight and Obese Adults. JMIR Diabetes 2017;2(2):e28. DOI: 10.2196/diabetes.8590

  12.  Lark. Measurable outcomes. https://www.lark.com/outcomes/ Accessed February 4, 2019.

  13.  National Center for Chronic Disease Prevention and Health Promotion. Workplace Health Promotion. https://www.cdc.gov/chronicdisease/resources/publications/aag/workplace-health.htm. Reviewed February 2, 2017. Accessed February 4, 2019.