Case Study Coronary Heart Disease

I. Public Health Problem
Coronary heart disease is a chronic disease in which plaque, fatty deposits, builds up inside the coronary arteries which supply blood to the heart. The build up of plaque is called atherosclerosis and can develop for many years undetected. Some common symptoms of coronary heart disease are chest pain, shortness of breath, and extreme fatigue with exertion, in turn increasing the risk of other health issues such as angina pectoris and eventually heart attacks. Today, coronary heart disease is the leading cause of death for both men and women in the United States (“Who is at Risk for Coronary Heart Disease”, n.d.). The etiological risk factors for coronary heart disease include smoking, high levels of low-density proteins
(LDL) and low levels of high-density proteins (HDL), diabetes, being overweight or obese, having lack of exercise, and stress. In most cases, coronary heart disease can be prevented and controlled with a healthy lifestyle and diet. Other risk factors, however, cannot be controlled – for example, age, gender and family history (“Coronary Heart Disease Risk Factors”, n.d.).
One of the main reasons why coronary heart disease is such a big issue in today’s society is because not many people understand the severity behind the risk factors. Because the social stigma of coronary heart disease revolves around the mistaken belief that only older adults may experience the symptoms, many people underestimate the risks in young adults. This very idea overshadows the fact that plaque can develop in the coronary arteries even during childhood, regardless of age, which can lead to the advancement of atherosclerosis. The extent to which atherosclerosis develops directly correlates with the number of risk factors someone has (Arts, Fernandez, & Lofgren, 2014). Over the past 30 years, obesity has doubled in children and tripled in adolescents (Arts et al., 2014). In college, students are less likely to prioritize self-care over their academic and social obligations, therefore increasing added weight gain. In 2008 to 2009, a cross-sectional study was conducted to determine the relationship between dietary intake and physical activity to the risks of coronary heart disease in first-year college students attending University of Rhode Island. The results of this particular study showed that although amounts of physical activity may not have been a major factor in the risks for coronary heart disease, the poor dietary intake of the students represented a direct correlation with the increased risks (Fernandes, Arts, Dimond, Hirshberg, & Lofgren, 2013). College students are more likely to develop certain habits and traits that can increase the risk of coronary heart disease, ultimately posing a threat to a person’s overall health.
Poor diet and lack of exercise are more common risk factors for coronary heart disease among college students because of the increased responsibility of practicing self-care and the lack of motivation and time to do so.
An average college student’s diet can consist of little to no nutritional value (Reilly, Burke, & Morrell, 2006). The amount of sodium, cholesterol, and sugar an average college student may consume, while also under added amounts of stress and physical inactivity, could increase the risk for coronary heart disease in the long-run, eventually leading to the rupture of an artery thus causing a heart attack. However, these risks could be minimized as well as prevented if the correct measures are
taken.

II. How to Solve the Public Health Problem
While coronary heart disease has no definite cure with today’s medicine, there are various ways to control it. Coronary heart disease can be controlled and prevented with changes towards healthy living. In order to minimize the risks of coronary heart disease, one must practice a healthy diet, maintain a healthy weight, stay physically active, manage stress levels, and avoid smoking and minimize the amount of alcohol consumption (“How to Prevent and Control”, n.d.). While these measures can help with risk prevention for an individual, public policies are also important to the process of the prevention for a community.
The International Heart Health Network has played a role in public policy by providing a series of declarations regarding the public efforts to control and prevent any cardiovascular disease. These documents together serve as the Policy Framework for Heart Health and discuss how policy approaches heart disease. They also emphasize the need for the involvement of other governmental and private agency sectors that are beyond health and life sciences, which include education, trade and commerce, culture, and recreation and agriculture (Pearson, 2011). In order to reduce the problem of increased risk of coronary heart disease, certain interventions must occur. Social conditions that must take place are improving the quality of healthcare and allowing healthcare to be more accessible to everyone; this can lead to the prevention of an increase in mortality rates. A behavioral change in the public must also take effect by reinforcing awareness of coronary heart disease and fostering support for heart disease prevention (“A Comprehensive Public Health Strategy”, n.d.). Knowledge and awareness play vital roles in the prevention of coronary heart disease. Some Filipino-Americans in the U.S. are unaware of the risks that their behavioral and cultural factors, such as their high cholesterol induced diet, have on coronary heart disease (Dalusong-Angosta, 2013). For Filipino-Americans, the leading cause of death is coronary heart disease (Ryan et al., 2000). A population needs to be mindful of the health risks in order for coronary heart disease to be prevented.
The risks for coronary heart disease can be prevented also through primary prevention such as a population wide approach (Mensah et al., 2005). For example, in England, a population wide approach was taken to prevent people from becoming overweight through the nationwide campaign in 2009, Change4Life. The campaign’s policies promoted healthy eating and physical activity thus reducing the risk of coronary heart disease (“What is Change4Life”, n.d.). Similar to nationwide campaigns, most colleges promote school-wide campaigns to promote healthy lifestyles within college students. Throughout a college campus, there are many opportunities and reminders for a student to eat healthier, watch their calorie intake, and stay physically active.

III. Public Health in the Future
Coronary heart disease is a chronic disease that cannot be cured or removed from society and can last for years or even a lifetime. Coronary heart disease is regulated by a person’s choice of lifestyle. Prevention of this chronic disease should start with the ideal targets: young adults. The unhealthy dietary habits and sedentary lifestyle learned in young adulthood predetermines the long-term risk of coronary heart disease (Arts et al., 2014). College is likely to be the place where young adults are establishing their lifestyle habits that will carry on with them throughout adulthood, which is why college students should be more aware of the risks of heart disease and know how to monitor their own health. Active awareness of coronary heart disease and early detection are ways to prevent it from reoccurring. College students need to fully understand the consequences of their lifestyle habits, diet, weight, and physical activeness to prevent them from increasing their risk of developing coronary heart disease.
After reading peer reviewed journals regarding coronary heart disease, I have come to the conclusion that coronary heart disease in college students can be regulated and controlled but not entirely prevented in the future.
Most of the prevention of coronary heart disease comes from a person’s own motivation and will to develop better lifestyle habits towards a healthier life. In addition, there are still other risk factors that are uncontrollable such as age, gender, and family history. A person who has a healthy diet, exercises regularly, takes time to relax, and does not smoke or drink can still be at risk for coronary heart disease if it’s in the person’s family history. Coronary heart disease is linked to not only lifestyle but heredity, therefore expecting permanent prevention of coronary heart disease in the future is far from realistic. If public knowledge of coronary heart disease expands and people start monitoring their health better, however, the rate of coronary heart disease in the U.S. could be reduced
significantly.