Cohn, D. (2007, May 17). The growing global chronic disease epidemic. Retrieved from: http://www. prb. org/Publications/Articles/2007/.asp x Georgetown University Health Policy Institute. (2004). Cultural competence in health care: Is it important for people with chronic conditions? Retrieved from https://hpi. georgetown. edu/agingsociety/pubhtml/cultural/c ultural. html Putsch, R., & Joyce, M. (n. d.). Dealing with Patients from Other Cultures: Methodology in Cross-cultural Care. 229, 1050–1065. Retrieved from https://www. ncbi. nlm. nih. gov/books/NBK340/pdf/Bookshelf_NBK3 40.pdf Roush, S. (2011). Chapter 19: Enhancing surveillance. In VPD surveillance manual (5th ed.). Retrieved from https://www. cdc. gov/vaccines/pubs/surv-manual/chpt1 9-enhancing-surv. pdf This week, we discussed the growing social diversity in the United States and the resultant barriers to care. Use the information presented in the readings and identify three of the most pressing issues, which, if addressed, might have the greatest impact upon healthcare delivery. In your approach, you can elect to identify an issue specific to a local hospital catchment area. Taking this approach, include the regional demographics, the problem, the issues of diversity differences within the healthcare workforce, and your approach to an effective solution. In your narrative, also discuss whether the efforts would be effective in addressing the problem and improving the health outcomes.

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    however, coronary heart disease , or chd, is actually a result of coronary artery disease, or cad, said edward a. fisher, m.d., ph.d., m.p.h., an american heart association volunteer who is the leon h. charney professor of cardiovascular medicine and also of the marc and ruti bell vascular biology and disease program at the nyu school of medicine.

  with coronary artery disease, plaque first grows within the walls of the coronary arteries until the blood flow to the heart’s muscle is limited. view an illustration of coronary arteries. this is also called ischemia. it may be chronic, narrowing of the coronary artery over time and limiting of the blood supply to part of the muscle. or it can be acute, resulting from a sudden rupture of a plaque and formation of a thrombus or blood clot.

    the traditional risk factors for coronary artery disease are high ldl cholesterol, low hdl cholesterol, high blood pressure, family history, diabetes, smoking, being post-menopausal for women and being older than 45 for men, according to fisher. obesity may also be a risk factor.

    “coronary artery disease begins in childhood, so that by the teenage years, there is evidence that plaques that will stay with us for life are formed in most people,” said fisher, who is former editor of the american heart association journal, atvb. “preventive measures instituted early are thought to have greater lifetime benefits. healthy lifestyles will delay the progression of cad, and there is hope that cad can be regressed before it causes chd.”

  living a healthy lifestyle that incorporates good nutrition, weight management and getting plenty of physical activity can play a big role in avoiding cad.

    “coronary artery disease is preventable,” agreed johnny lee, m.d., president of new york heart associates, and an american heart association volunteer. “typical warning signs are chest pain, shortness of breath, palpitations and even fatigue.” if you feel any of these symptoms, don’t delay — call 9-1-1.