Overview of Health Conditions and Health Promotion Programming in North Carolina

What is the definition of an older adult?

There are many definitions of an older adult. The data we have presented in this document is generally for individuals over the age of 65. This is when older adults become eligible for Medicare. However, the administration on aging defines an older adult as someone over the age of 60, and many senior centers serve those 50 and over.

What are the current health conditions of older adults in North Carolina?

Current aging statistics in North Carolina

There are many ways to define health.You may want to know how many people have been diagnosed with a certain disease, or you may want to know the death rate due to a specific health condition. For the Roadmap, we were interested in county demographics and current health conditions. We chose this focus because health promotion programming generally targets individuals who live independently in the community. With this knowledge, we wanted to know what health conditions resulted in hospital admissions and discharges, and why people were visiting healthcare providers. We anticipate this information may be more valuable to health promotion programming than mortality rates.

We utilized the county profiles from 2002 to generate the pie charts for the county pages and 2006 data for the aging snapshots. We chose to use the Carolinas Center for Medical Excellence Database to access this information. This database is specifically for Medicare and Medicaid enrollees, which is the majority of the population 65 years and over in North Carolina. We felt this database would be a good starting point to ask these types of questions. What is included are the top five health conditions resulting in a hospital discharge, and the top five health conditions that result in an outpatient visit to a physician. This information is all based on Medicare data from 2006.

One problem with the data, especially for the outpatient data, is that it is based on diagnostic codes identified by the healthcare provider. Often these codes are incorrect, and do not represent all the health conditions; however this data does provide a starting point to begin to ask questions about the health of the older adults in your community.

We have additional information on falls. This is important because the rate of falls for community dwelling older adults in North Carolina is increasing each year. Currently it is estimated that 35% of adults over 65 will fall this year. Many falls can be prevented with the right intervention, and it is important to address this issue with seniors.

What type of health promotion programs are currently offered throughout the state?

The following information is based on the responses of 133 facilities or organizations that completed the North Carolina Survey of Health Promotion Programming for Older Adults between June 2007 and October 2007. Surveys were sent out to 134 senior centers, 125 YMCAs, and 80 county health departments. Respondents included 94 senior centers, 23 YMCAs, and 20 health departments.

The most common programs are general health education and health promotion programming (109 facilities), with blood pressure checks (96) and physical activity programming being second (95), and mental health programming last (34).

How are these programs offered and to whom?

Over 97% of respondents indicated that they collaborate with other local agencies or organizations to provide health promotion programming. In most cases, the programming is offered to almost anyone, with only 10% of organizations requiring membership, and 47% of respondents indicating that fees are charged for programming.

What other types of health promotion programs are offered

*Physical Activity and Exercise*

Older adults who remain physically active and/or exercise on a regular basis experience fewer falls, have a better ability to maintain thinking skills, and tend to remain independent in the community longer than their sedentary peers. Physical activity and exercise also help individuals to better manage chronic conditions such as arthritis, hypertension, and diabetes.

There are four categories of exercise classes:

1. Aerobic exercise involves increasing the heart rate and breathing while doing a dynamic exercise that uses large muscle groups. Walking, swimming and dancing are examples of aerobic exercise. Aerobic exercise can help to manage hypertension, diabetes, and heart disease.
2. Strength training specifically focuses on increasing muscle strength, and does not involve large increases in heart rate or breathing. Strength training can help people to improve their mobility, and better manage arthritis and diabetes.
3. Flexibility training classes focus on improving the flexibility of specific muscles. Improved flexibility results in improved mobility which can decrease falls, decrease pain and better manage chronic disease such as arthritis.
4. Classes specific for a condition such as balance classes or chronic disease: Several classes have been developed to address specific symptoms associated with poor balance or arthritis, osteoporosis, chronic pain, etc. These classes have their own category in this study.

*Types of exercise classes offered:*

Approximately 75% of organizations surveyed offered some type of physical activity or aerobic exercise.

Approximately 63% offered some type of strength training class.

Approximately 85% offered some type of flexibility classes.

Eight sites offered a balance specific exercise program. Approximately 48% offered classes for specific health impairments or chronic conditions.

In addition, several facilities organize senior games activities, league sports teams, and other activities to promote physical activity and exercise.

Health Education and Health Promotion Programming

Health education and health promotion programs are a very important part of improving the overall health and wellness of seniors in North Carolina. These programs can focus on providing information, support, or structured classes to help individuals better manage chronic conditions and disease.

Almost every facility surveyed offered some type of health promotion programming.

Over 97% of those surveyed indicated they partnered with other organizations to offer these programs.

18B Stress Management and Mental Health

Stress management and mental health programs can provide information and support to those coping with mental illness, dementia, and caregiver stress.

The following stress management and mental health programs are offered.