2. WELLCOME 926.03 Advanced Interventions Wellness & Prevention Dr. Paul F. Granello, PhD LPCC

3. Status of Healthcare in U.S. Spending 2.16 trillion a year –Less then 1% on prevention of disease 2002 our healthcare spending was 15.2% of our total GDP Medical premiums rose an average of 14% in 2002 (Hays 2002) Prescription drug expenditures increased 17% in from 1990 to 2000 and continue to rise

9. 3 Leading Causes of Death United States 1900 1.Pneumonia 2.Tuberculosis 3.Enteritis, Colitis Americans Died of Infectious Diseases

10. Leading Causes of Death United States 2004 Heart disease: 654,092 Cancer: 550,270 Stroke (cerebrovascular diseases): 150,147 Chronic lower respiratory diseases: 123,884 Accidents (unintentional injuries): 108,694 Diabetes: 72,815 Alzheimer's disease: 65,829 Influenza/Pneumonia: 61,472 Nephritis: 42,762 Septicemia: 33,464

12. Prevalence of Obesity* among U.S. Adults BRFSS, 1991 (*Approximately 30 pounds overweight) Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16. 15%

13. Prevalence of Obesity* among U.S. Adults BRFSS, 1992 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

14. Prevalence of Obesity* among U.S. Adults BRFSS, 1993 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

15. Prevalence of Obesity* among U.S. Adults BRFSS, 1994 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

16. Prevalence of Obesity* among U.S. Adults BRFSS, 1995 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

17. Prevalence of Obesity* among U.S. Adults BRFSS, 1996 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

18. Prevalence of Obesity* among U.S. Adults BRFSS, 1997 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

19. Prevalence of Obesity* among U.S. Adults BRFSS, 1998 15% Source: Mokdad AH, et al. J Am Med Assoc 1999;282:16.

24. Physical Activity

25. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS 1991-92 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

26. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS 1993-94 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

27. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS 1995-96 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

28. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS 1997-98 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

29. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS 1995 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

30. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS 1999 Source: Mokdad et al., Diabetes Care 2001;24:412.

31. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS 2000 Source: Mokdad et al., J Am Med Assoc 2001;286:10.

32. Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS 2001 Source: Mokdad et al., J Am Med Assoc 2001;286:10.

33. COSTS? Dollars and Human Suffering 129 million U.S. adults are overweight or obese which costs this Nation anywhere from $69 billion to $117 billion per year. 2000, an estimated 17 million people (6.2 percent of the population) had diabetes, costing the U.S. approximately $132 billion. Heart disease and stroke - 2003 alone, 1.1 million Americans had a heart attack. Cardiovascular diseases cost the Nation more than $300 billion each year. 23 million adults and 9 million children have been diagnosed with asthma at some point within their lifetime, with costs near $14 billion per year.

34. What are some strategies to cope with increased medical costs? Consolidate health plans Pass costs to employees Health Reimbursement Arrangements (HRA’s) Wellness and Disease Management

35. What is health and wellness? Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. (World Health Organization) Illness HealthWellness PathogenSalutogen

36. Holism, Holistic Health, Health Promotion, Wholism, Prognostic Health, Preventative Medicine Wellness counseling is the science and art of helping people change their lifestyle to move toward a state of optimal health. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual health. Wellness Counseling Definition

37. Historical Context of Wellness Paradigm Ancient Greeks - Asclepius Cartesian Dualism yields reductionism German Gestalt Psychology Alfred Adler – “striving” for superiority Abraham Maslow – Self-Actualization H. Dunn - “High Level Wellness” Stress and Immunity Research Market for Alternative Medicine Private Industry, Insurance, Government

38. Characteristics of A Wellness Model Holistic and Integrative Persons oriented Developmentally all inclusive Quality and Longevity of Life Positive Wellness Proactive Cross Cultural - Universal Eclectic Approaches and Methods

39. Lifespan Model of Wellness Witmer & Sweeney, 1991

40. LifeSpan Model of Wellness Life Tasks Spirituality Self-Regulation Work - Leisure Friendship Love