Part Three
Resources for Promoting Health in Refugee Communities
Table of Contents
3.1 Introduction
3.2 Navigating the U.S. Health Care System
3.3 Information on Community Programs You Can Start
3.4 Information on Health Screening
Health Screening 1: Anxiety
Health Screening 2: Breast Cancer
Health Screening 3: Cervical Cancer
Health Screening 4: Cholesterol
Health Screening 5: Colorectal Cancer
Health Screening 6: Depression
Health Screening 7: Diabetes
Health Screening 8: High Blood Pressure (Hypertension)
Health Screening 9: Skin Cancer
3.5 Information on Specific Health Concerns for Refugee
Communities
3.5.1 Chronic Illness
Fact Sheet 1: Breast Cancer
Fact Sheet 2: Colorectal Cancer
Fact Sheet 3: Depression
Fact Sheet 4: Diabetes
Fact Sheet 5: Healthy Body Weight
Fact Sheet 6: Heart Disease (Coronary Heart Disease or
Coronary Artery Disease)
Fact Sheet 7: High Blood Pressure (Hypertension)
Fact Sheet 8: Lung Cancer
Fact Sheet 9: Prostate Cancer
Fact Sheet 10: Skin Cancer
3.5.2 Communicable Diseases
Fact Sheet 1: Hepatitis B
Fact Sheet 2: HIV/AIDS
Fact Sheet 3: Sexually Transmitted Diseases
Fact Sheet 1: Alcoholic Beverages
Fact Sheet 4: Tuberculosis (TB)
3.5.3 Behavioral Health Concerns
Fact Sheet 2: Nutrition
Fact Sheet 3: Oral Health
Fact Sheet 4: Physical Activity
Fact Sheet 5: Post-Traumatic Stress Disorder
Fact Sheet 6: Spirituality and Health
Fact Sheet 7: Stress and Coping
Fact Sheet 8: Substance Abuse
Fact Sheet 9: Suicide Prevention
Fact Sheet 10: Tobacco Use
3.5.4 Maternal and Child Health
Fact Sheet 1: What You Should Know Before You Become
Pregnant
Fact Sheet 2: Prenatal Care
Fact Sheet 3: Services Available for Women of Low Income and
Their Children
Fact Sheet 4: Helping Your Child Stay Healthy
Fact Sheet 5: Adolescent Health Issues
3.5.5 Older Adult Issues
Fact Sheet 1: Care for Older Adults
Fact Sheet 2: Depression in Older Adults
Fact Sheet 3: Mobility: Getting Around
Fact Sheet 4: Isolation
Fact Sheet 5: Alzheimer's Disease and Dementia
Fact Sheet 6: Caregiving
3.1 Introduction
In Parts One and Two, we took you through the steps to develop
health promotion and disease prevention activities that best meet the needs of
people in your community. Now, in Part Three, we will focus on
specific types of activities you can do and resources you can use to improve
the health of people in your community.
In the following sections, you will find information to help you address the
health needs of your community:
-
Ways to help people better understand the U.S. health care system and get the
health care they need (Section 3.2)
-
Types of community programs that can be used to address health issues in your
community (Section 3.3)
-
Types of health screenings that can be used to identify health concerns in your
community (Section 3.4)
- Fact sheets that provide basic information on various health concerns, designed specifically for you to use within your community (Section 3.5)
3.2 Navigating the U.S. Health Care System
|
At the end of this section, you will be able to
This section answers the following questions:
|
One of the most common barriers to people accessing health care is their unfamiliarity with the U.S. health care system. Your organization can help by providing them with information to get the care they need. People need such basic information as
-
Where to get health care
-
What different types of health care providers are available
-
How to pay for health care
- How to communicate with their health care provider
What Type of Health Care Information Is Needed?
Information you will want to cover in helping your communities navigate through the U.S. health care system includes the following key points:
Where to get health care/types of providers. Health care services are different in every community. In most cases, an appointment is required for medical, dental, or mental health care. You will need to learn about the health services available in your community, some of which are described below:
-
The public health department. Most offices provide
immunizations against infectious diseases and offer other preventive health
services, including testing and treatment for tuberculosis (TB). For refugees,
these services are free or inexpensive. Parents should be sure to check with
the public health department about immunizations for their children. All
children enrolling in public school must submit proof that they have received
the required immunizations.
-
Private doctors provide general and specialized health care.
The doctor's office usually requires proof of ability to pay for services or
insurance information at the time of the appointment. Some doctors work as part
of a private clinic or in a group with other general practitioners and
specialists.
-
What is a primary care provider? A primary care provider is
the health care provider who knows you best. This person can be a general
practice doctor, specialist doctor, physician assistant, or nurse. Typical
questions asked to find out whether a person has a primary care provider are
-
"Do you have one person you think of as your personal doctor or nurse?"
-
If "yes" to the first question, ask "Is this person a general practice doctor,
a specialist doctor, a physician assistant, or a nurse?"
-
"In the past 12 months, how many times did you go to a doctor's office or
clinic to get care for yourself or a close family member?"
-
"Do you have one person you think of as your personal doctor or nurse?"
-
What is a primary care provider? A primary care provider is
the health care provider who knows you best. This person can be a general
practice doctor, specialist doctor, physician assistant, or nurse. Typical
questions asked to find out whether a person has a primary care provider are
-
Community clinics or health centers supported by government
and private sources. They accept private insurance and Medicaid or charge fees
based on the uninsured patient's income.
-
Hospitals may be found in almost every American community.
Doctors or clinics refer patients with special problems to the hospital for
tests and surgery. Hospital care is expensive, and hospitals require proof of
insurance or ability to pay for those services.
- Emergency rooms in hospitals or other facilities are used for sudden, extreme health problems. Emergency rooms require no appointment, but they often are busy, and a long wait may be necessary. For most health problems, you should call or make an appointment with a doctor. Use the emergency room only when absolutely necessary. Emergency care usually is provided regardless of your insurance or ability to pay.
Additional types of services and care available:
-
Ambulance services provide transportation and medical help
when needed immediately, and no other way exists to take the injured or sick
person to receive emergency medical care. Ambulance services usually charge a
fee after service has been provided.
-
Dental care is provided through private dentists and through
clinics. Free or low-cost dental services are rare but may be available through
public health or community clinics. Not all health insurance plans include
coverage for dental services.
- Mental health care can be provided through private doctors and therapists and through clinics. Some mental health services may be available through mutual assistance associations and through family service agencies. Some resettlement agencies provide counseling services and can help you find other mental health services.
How to pay for health care. In the United States, each person, not the government, generally is responsible for paying for health services. The cost of health care is high, so most people rely on insurance programs, often through their employer:
-
Health insurance can be obtained for a monthly payment. Some
employers offer insurance and may pay all or part of the monthly payment. There
usually is a waiting period from the time you are hired until you become
eligible for health insurance. Many insurance companies offer different types
of programs. Health maintenance organizations (HMOs) increasingly are a common
form of insurance program. Through this system, care is provided by a group of
private doctors and clinics. Each member of an HMO has an assigned doctor who
provides primary care and must approve any visits to emergency rooms,
hospitals, or specialists. In some situations, the insurance company will pay
the full cost of medical care; in others, the patient will be required to pay
part of the costs.
-
To assist people of low income, government programs cover some
medical expenses. The government programs described here may be changing. Ask
staff at your local agencies to help you obtain accurate, up-to-date
information about health services available to you.
- Refugees are eligible to apply for Refugee Medical Assistance (RMA) or Medicaid at a designated local government office. Both programs pay for medical care for people of low income. Applicants must complete one or more forms that require proof of income and other personal information.
How Can Your Organization Establish a Referral Network of Health Care Providers?
Referral Networks
Your organization might want to consider developing a referral network for refugees in your community. A referral network is a group of health care providers who are all committed to the same goal and who agree to help people referred to them. Using a referral system is an organized way to get refugees in contact with health care providers in their community who can and will assist them with their needs. Without a good referral system, people often don't get the treatment they need, and if they do, it takes a lot longer and costs more money than necessary.
Steps to create your referral network:
-
You should develop a list or database of health care providers in your
community. This list should include their names, addresses, telephone numbers,
type of practice, and schedules of operation. The list should also include the
languages they speak and the types of insurance they take.
-
Next, you will want to identify those providers on the list who already are
involved with or interested in working with refugee patients. It will be
important that you establish a working relationship with these providers by
putting a formal plan in place. This plan might include talking with the
providers in their practices or clinics and letting them know about your
organization and its referral list. They can let you know how they can best
help refugees in their practice.
- With the help of the provider network, you should work toward improving the quality of refugee health care, such as providing training or other services that help them understand refugee health issues.
How Can You Organize a Health Screening?
Using Health Screenings
To help get members of the refugee community the health care and services they need, your organization can promote health screenings. The goal of a health screening is to identify whether someone is at risk for or has a particular health condition or disease. The types of screenings for health conditions and diseases include blood tests, physical exams, and surveys. Typically with a health screening, a health care professional offers a screening service for a reduced fee or at no cost over the course of a short time frame and in a location accessible to many people. For example, you might set up a table at a shopping mall where a nurse practitioner provides free blood pressure screening every third Saturday of the month. Details about some common types of health screenings are discussed in Section 3.4.
In organizing a health screening, you first will want to determine what type of screening will be most useful in your community. If you conducted a needs assessment from Part One of this manual, you might already have the answers to this question. For example, after doing some research about your community, you may determine that many people in your community are at risk for high blood pressure. You also might discover that few people have ever been told they have high blood pressure and even fewer have ever been tested for it.
If not, you may want to ask some people in your community about their screening habits to find out which types of screening they need the most. Later, in Section 3.4 of this manual, you will find a list of types of screenings you could offer.
Once you know what you want to screen for, you will need to decide several key points about the screening:
Who will conduct the screening? You will need to make a list of the groups in your community trained to offer the screening, and then approach them to see whether they would be willing to conduct it. You also can call such national health organizations as the American Cancer Society or the American Heart Association to ask for help or references (we have provided their contact information in Section 3.4). You also may be able to partner with health providers, local health clinics, or your local health department to conduct screenings. You should determine ahead of time whether the health care professionals who do the screenings will be paid for their time and who will cover the screening costs.
Where and when will you conduct the screening? You should consider where the best location in your community is to hold the screening. You should think about popular locations as well as the times of the day or week when a lot of people frequent them. Ideally, the screening should be in a place where people will have the time to stop and participate. For example, many people may go to a supermarket, but they may not stop for the screening because they don't want their groceries to melt. An indoor shopping mall on a Saturday might be a better choice because people expect to spend more time browsing.
How will you promote the screening? For the screening to be successful, people need to know about it. You should consider using several different ways to promote your screening. Some ideas are posters in areas frequented by people in your community, an advertisement in the newspaper, radio announcements (many stations might air a public service announcement for you), and word of mouth (doctors or friends). You also should put up several signs a few weeks ahead of time in the location where you will be conducting the screening so that people can make plans to attend.
How many staff people do you need to send to the screening and what will you need to do to prepare them? You should consider how many people will be needed to help out at the screening. If people being screened have to wait a long time, they might choose not to participate in the screening process. You should provide a brief training session for staff so that they know what to do on the day of the screening. If staff will be screening people from different cultures, you should educate them about the health practices and beliefs of the other cultures. You also should suggest ways to ensure the screening is respectful of the practices of those cultures.
What materials will you need for the screening? Make a list of all the materials you will need on the day of the screening, and be sure to have them ready in advance.
You should discuss whether it will be necessary to have participants sign a waiver before they have the screening. You should also discuss what important follow-up information you will give the participants-and whether this information will need to be translated ahead of time.
|
Resource: U.S. Department of State, Bureau of Population, Refugees, and Migration. (1996).
Welcome to the United States: A guidebook for refugees.
For more information: National Women's Health Information Center, Office on Women's Health, U.S.
Department of Health and Human Services: call 1-800-994-WOMAN
(1-800-994-96626), or visit
For information on a State program to provide free or low-cost health insurance for eligible children 18 years or younger, contact Insure Kids Now! Program: call 1-877-KIDS-NOW (1-877-543-7669), or visit http://www.insurekidsnow.gov/ Health Resources and Services Administration (HRSA) Information Center: Resources and referrals on health care services for individuals of low income, the uninsured, and those with special health care needs: call 1-888-ASK-HRSA (1-888-275-4772), a toll-free number, or visit http://www.ask.hrsa.gov/ National Alliance for the Mentally Ill: 1-800-950-6264, http://www.nami.org Centers for Medicaid & Medicare Services: Information on
getting medical coverage for people of low income and older persons, as well as
health insurance for children: call |
3.3 Information on Community Programs You Can Start
|
At the end of this section, you will be able to
This section answers the following questions:
|
Community health promotion and disease prevention programs are groups or events that your organization can develop and maintain to help the people in your community with some concern at hand. These programs are meant to be informative and encouraging and to help people meet others who have similar needs. They also can be fun and entertaining. We discuss four types of programs in the section below:
-
Support groups
-
Chronic illness management programs
-
Health fairs
- Walking programs
What Is a Support Group and How Do You Start One?
Support groups are a place where people with similar problems or life circumstances can get together to share information, get moral and emotional support, and develop a sense of community. They usually are ongoing, where people can return on a regular basis (e.g., every Tuesday night at 8 p.m.).
Types of Support Groups
In general, support groups fall into two categories: (1) groups led by a professional who is knowledgeable about the topic of the group, such as a nurse or social worker, and (2) groups led by the members, often called self-help groups. Some groups offer educational information on a given topic. For example, a doctor may be invited to give a talk on health issues that affect refugee communities. Other groups are less structured and serve as a place for people to get together and share information about topics affecting their lives. They often are a place where people can learn where to get the services they need in their new community, as well as information about the community they live in and its culture. These groups are also a place for people to socialize and meet others who share their circumstances.
|
Groups for Youth Most communities have separate support groups for youth. These groups usually are more structured than other groups and are run by professional community organizations. They offer a place for young people, such as teenagers, to get information on school, vocational programs, and employment. They also offer recreation and social opportunities. |
Starting a Support Group in Your Area
Before you spend a lot of time planning a group, it is important that you know what your community needs. For example, you don't want to offer a support group for refugees with TB if three such groups already exist in your area. Below are some steps you might take before starting a group:
First, research the support and self-help groups currently existing in your community. You can contact other State or community organizations, churches, and health care providers that work with refugees; check the newspaper or telephone book; and talk to refugees in your community.
Once you have a comprehensive list of the support groups active in your community, look for an unmet need. For example, do enough groups exist to meet the needs of refugee youth in your community? Make a list of some possibilities.
Next, ask your community whether the need exists for the type of group you want to start. Depending on your time and budget, you may want to use some methods described in Section 1.2 of this manual, such as a needs assessment survey, public forums, or interviews with community members, to get feedback on your ideas. You also may get suggestions for other types of groups that your organization hadn't thought about. If you don't have a lot of resources, then simply talk informally with people in your community to see what they think about your ideas.
Decide the details of your group. The type of group you decide on will guide the rest of your implementation process. Do you want it to be self-help or run by a professional? When and where will it meet? Should you have refreshments at the group meetings, and if so, who will pay for them? It will be important at this stage to make two lists: the first is a list of all the good things that could happen if a person attends the group meetings (the "benefits"); the second is a list of all those things that might stop people from attending the group meetings (the "barriers"). Then, you will want to take steps to reduce the barriers and to emphasize the benefits.
For example, if people attend the meetings, they will get together with other people who share their same experiences and whom they can learn from or befriend (benefit). But they may not come because the meeting place is too far from their home or at an inconvenient time (barriers). To overcome these barriers, you will need to consider what times and places are most convenient for the people you want to attend the meetings.
Publicize your group. You'll also need to have a plan to publicize your group to maximize the number of people who attend the meetings. You may be able to enlist the help of the local media to advertise your group for free or at a reduced cost. Other methods include posting flyers in areas frequented by refugees (e.g., the community, shopping centers, bus terminals, and health centers), talking to local churches, and spreading the information through the local refugee network. When you publicize the group, think of ways to emphasize the benefits and to reduce the barriers.
Get help from others. Organizations that already have started other support groups in your community can also be an excellent resource. They may be able to support your efforts by providing information on community groups you can partner with, places where your group can meet, and guidance based on what they learned during the process.
What Is a Chronic Illness Management Program and How Do You Start One?
Chronic illness management programs are designed to address a specific illness or disease. They provide people with information about the illness and with ways to manage the symptoms so that the person can live as normal a life as possible. These programs usually target an illness that can be managed by individual behavioral changes. They can be organized for just one time or can be ongoing (e.g., you offer it only on June 15 vs. every 15th of each month). Some programs might need a few sessions to include all the information, but remember that the more sessions you have, the more difficult it will be for people to attend them.
For example, diabetes is an illness that can be kept in check through diet and exercise. A diabetes management program would provide refugees who have diabetes, or who are at risk for developing it, information on what diabetes is and what they can do to prevent it from getting worse. These programs also provide a place for refugees to get support from each other.
Starting a Chronic Illness Management Program
The steps to start a chronic illness management program are similar to the above-cited steps to start a support group. First, you should do a little research to decide which management programs are most needed in your community. Once you know this information, you should make a list of community health groups in your area who can help you. In most cases, it will be necessary for your organization to partner with another group unless you have trained experts in the health areas you will be addressing at the program.
Next, you should decide when and where the program will be held and for how many sessions. Think of how to hold the program at the most convenient times and places for the people you want to attend it. Also, take the time to publicize the program ahead of time so that people will know about it.
During the program, you should consider using preexisting materials that have already been developed and used as part of another program (if these materials have been made available to the public). However, depending on the complexity of the materials, you still may need to work with a trained health educator. It might be possible to have a professional serve as an advisor or to train your organization to run future groups.
What Is a Health Fair and How Do You Plan One?
A health fair is a large event where several organizations come together over a short time frame (such as 1 or 2 days) to offer people advice, information, or the chance to participate in fun activities. It is an excellent way for your organization to reach a lot of people at once. Health fairs can focus on a specific health-related issue, such as healthy eating and exercise, but more often they focus on a wide variety of topics. A health fair can include exhibits, workshops, demonstrations, screenings, and other displays and activities. For example, each year a city might offer a weekend "healthy weight" health fair at the city's convention center. It might have booths that teach people how to cook healthy meals, climb rock walls, provide information about losing weight, and other activities.
How to Plan a Health Fair
The number one rule is to plan early! Begin organizing at least 4 to 10 months before the fair. The more time you have to prepare the better, especially if this is the first health fair your group is planning.
The first thing you'll need to do before you start planning the fair is to decide on a date. Choose a date that doesn't conflict with other community events (think about your target audience and any cultural or religious events that may prevent them from attending). Also, consider weather, time of year, and the best time of day to make the most of attendance.
Next, put a planning committee together. A planning committee will be involved in all aspects of planning your health fair. The committee can be staff at your organization, volunteers, and members of the target audience you hope to attract to the fair.
Steps for planning a health fair:
Audience and goal. The first step to planning a successful fair is to decide who your target audience is and what the goal of your fair will be. For example, you may want to put together a women's health fair. In that case, your audience might be women living within 15 miles of the health fair location. The goal might be to educate and encourage women to improve their health.
Budget. You will need to estimate how much it will cost to have the fair. Start by making a list of the things you will need for the fair, and then make telephone calls or inquiries to find out how much things will cost. You may be able to get volunteers or sponsors to help with parts of the list, which can help lessen the total cost. For example, you may find a sponsor willing to donate space for the fair or volunteers to prepare the food. Here is a list of standard things to consider when estimating cost:
- Health fair location
- Permits
- Insurance
- Materials (A lot of places exist to get free information and materials, so look around before spending a lot of money.)
- Advertisement (printing costs, flyers, and newspaper ads)
- Equipment (tables, chairs, and tents)
- Entertainment (music, clowns, and children's games)
- Food and refreshments
- Postage
- Prizes or other giveaways
Sponsors. Sponsors can be excellent resources to help you organize and run your health fair. Contact potential sponsors to give them background information on your organization, and tell them the goal of your health fair. Ask whether they can help with some of your needs, such as printing; donating food, space, or equipment; or advertising your event. In return, you can give them recognition by publicly acknowledging their assistance at the fair or by using your promotional efforts. Here is a list of potential sponsors you can contact:
- Local businesses
- Restaurants
- Grocery stores
- Newspapers
- Community groups
- Local business leaders
- Individuals
- Churches
- Banks
Volunteers. Volunteers are essential to running a smooth event: the more people you have, the better. Ask your volunteers about their skills to determine the best way they can help. For example, someone with artistic ability can help design flyers and other advertisements. At the event, volunteers can help set up and break down booths and exhibits, staff exhibits, direct traffic, and answer questions. It is important to show appreciation to your volunteers for their hard work by providing recognition, giveaways, free refreshments, and other incentives.
Exhibits. National, State, or local health organizations and community groups can be invited to share information with attendees. Exhibits are a wonderful way to distribute educational materials.
Exhibitors. In addition to health organizations, you may consider having other exhibitors, for example, local businesses, companies, or individuals. These groups can provide food and drink, entertainment, and other items. You may consider charging exhibitors for booth space to help offset some of your other costs.
Screenings. Health screenings are an excellent addition to a health fair. Potential screenings include blood pressure, cholesterol checks, and so forth (you will need to check with your local health department to see whether there are any requirements for offering these screenings). Make sure you have individuals who are fully qualified for the work. You may need such special accommodations as a private booth or table for some screenings.
Logistics-where, when, what, and how. As part of the first step, you probably have already planned the date and time of your fair. The planning committee also will need to consider location, permits (e.g., sign, structural, sanitary, and entertainment), and any necessary equipment (e.g., tents, tables, portable bathrooms, and special equipment for health screenings).
Promotion. Last, but certainly not least, is promoting the event. You'll want to make sure people know about the fair in advance, along with all essential information (time, place, events, and costs). Make sure you include a name and telephone number with all promotional material so that people can call with questions. The following are some ways to promote your event:
- Flyers
- Posters
- Media-newspaper, radio, and television advertisements (Local media often will give free ad space for community events.)
What Is A Walking Program and How Do You Start One?
Walking programs are groups of people who schedule regular times to walk together. They are a great way to get community members together to exercise and socialize. Setting up a walking program can be as simple as setting a time and place for community members to get together to walk, or as complex as a large-scale, structured event. Take a look at the box on the next page to read about a walking program started in Texas.
Steps to Start a Walking Program
Your organization may make changes to the program based on community needs, but here are some basic steps to get started:
- Launch event. Decide how to introduce your program to community members. Start by advertising your program through flyers, advertisements, community groups, and word of mouth several weeks in advance. Then, you can schedule a kickoff event where interested people can learn more about the program and can sign up to participate. You may want to add to the event by handing out healthy snacks, by hosting healthy cooking demonstrations, or by having a speaker talk about the benefits of exercise and good nutrition.
|
Walk Across Texas Created by Texas Cooperative Extension in 1996 and still active in 2004, the
goal of Walk Across Texas was simple-to get people to exercise. It started as
an 8-week "simulated" program in which teams of eight people set out to walk
800 miles across the State of Texas. Each team member had a goal of walking 12
miles a week for 8 weeks. Teams could walk together, but it was not required.
Each member tracked his or her own progress and reported mileage to a team
captain once each week. Every week, team captains logged into the Walk Across
Texas Web site to record the team's mileage. |
-
Weekly newsletter. The Walk Across Texas program distributed a
weekly newsletter to team captains to give to team members. The newsletter gave
updates on how teams were doing by reporting total mileage and pounds lost. It
also contained information on healthy eating and exercise. Depending on your
budget, you may want to do something similar. As an alternative, you can
organize weekly or biweekly meetings for members to get together for updates
and motivation.
-
Tracking chart. To keep participants motivated, the Texas
program members put together a tracking chart to record team mileage. They had
one chart posted in a common area and another on the program Web site. Tracking
progress is a great way to keep people motivated and to inspire healthy
competition between teams. You will need to decide whether enough people in
your community have access and the skills to use a computer before spending the
time and money to produce and maintain a Web site. If you decide that having a
Web site is worthwhile, it is a good idea to provide public computers at either
a library or a community center for those who do not have their own computer. A
simpler alternative is to just use a paper-and-pen tracking chart that your
staff can update weekly. You can post this chart at several convenient places
in your community.
- Wrap-up event. A good way to end your program is to host a wrap-up event. This event can be a simple get-together to recognize the achievements of participants. You may want to hand out ribbons or certificates of completion. You also can use this event to encourage an ongoing commitment to exercise.
|
Resources: Lancaster, T. (1992). Setting up community health programs: A practical manual for use in developing countries. London: The Macmillan Press LTD. Mayo Foundation for Medical Education and Research. (1998-2004). MayoClinic.com.
University of Kansas, Work Group on Health Promotion and Community Development.
(2004). Community tool box.
|
3.4 Information on Health Screening
|
At the end of this section, you will be able to
This section answers the following questions:
|
What Is a Health Screening?
Health screening involves testing to identify people affected by, or at risk of developing, a specific medical condition. Health screening is offered to people to find out whether they may need further tests, treatment to reduce the risk of a disease developing, or treatment to reduce the risk of potential health complications.
You do not need to know that you are at risk of a disease to receive a screening test.
Benefits of Health Screenings
Health screening can potentially save lives and improve quality of life through early diagnosis of such serious conditions as diabetes, breast cancer, colon cancer, and cervical cancer.
Most health screening tests can detect disease at an early stage because they identify a change from the body's normal function or structure. Early detection of health problems is important to maintaining good health and quality of life. Most of all, health screening tests have proven to be life savers for some people because the disease was found early enough to be treated successfully.
Risks of Health Screenings
Screening has obvious benefits. However, it is not a foolproof process. Early diagnosis of disease through screening can reduce the risk of developing a condition or its complications, but it cannot offer a guarantee of protection from the disease. With any type of screening, a small chance exists that the results will wrongly indicate that a person has the condition (false-positive test result). A small chance also exists that the results will wrongly report that the person does not have the condition (false-negative test result) when, in fact, she does have the disease.
What Types of Health Screenings Are Available?
Many health screening tests have been designed to assist with identifying, reducing, and removing health risks. The following pages describe screening tests that can be important to maintaining good health and overall quality of life. We present nine types of health screenings:
-
Anxiety
-
Breast cancer
-
Cervical cancer
-
Cholesterol
-
Colorectal cancer
-
Depression
-
Diabetes
-
High blood pressure (hypertension)
- Skin cancer
|
Resources: UK National Screening Committee. What is screening?
Ying, V. P. S. (2003, May/June). Health screening and its benefits. Mount
Alvernia Hospital Newsletter.
For more information: Talk with your doctor about the benefits and risks of health screenings. |
Health Screening 1: Anxiety
At times, people can feel anxious or nervous to the point that they cannot function in everyday tasks. If you have been feeling overly afraid of things, have expressed fears about being out or around other people, or have been reliving traumatic experiences, you may be experiencing anxiety problems. You may also be experiencing physical changes, like rapid heartbeat and fatigue, that are related to your anxieties. If this is the case, you will want to talk with your primary health care provider. He can screen you for any number of anxiety-related problems by asking you questions and talking with you about your symptoms. Then, your doctor may refer you to a mental health professional who will conduct a psychological evaluation.
Screening for anxiety is done most often through a psychological evaluation. A psychiatrist, psychologist, or other mental health professional will ask you questions about yourself that will help her determine whether you have symptoms of an anxiety problem and whether those symptoms are due to another condition.
The types of questions you might be asked include the following:
-
Do you worry constantly and have problems controlling it?
-
Do you have difficulty sleeping?
-
Do you have such physical symptoms as fast heart rate; chills, sweating, or
both; nausea; headaches; shakiness; or breathing difficulties?
-
Do you have difficulty concentrating?
-
Do you have anxiety or panic attacks?
-
Do you have intense anxiety in social situations?
-
Do you have obsessive thoughts or perform repetitive rituals?
- Do you feel sad or hopeless?
Other Screening Methods
Self-Tests
One of the quickest and easiest ways to determine whether you have symptoms of an anxiety disorder is by taking a self-test. These screening tests are not meant to provide a diagnosis or to replace a proper evaluation by a physician or mental health professional. A "positive" result from any screening test only indicates that you could benefit from a comprehensive mental health exam. Regardless of the results, contact your primary health care provider, a mental health professional, or both, if you have any concerns.
A selection of self-tests is available on the Anxiety Disorders of America Web site at http://www.adaa.org.
National Anxiety Disorders Screening Day
National Anxiety Disorders Screening Day is an annual event held in May and sponsored by Freedom from Fear, a nonprofit organization that helps and counsels persons who suffer from anxiety and depressive disorders and their families.
The screening involves watching a video and filling out a questionnaire. After you fill out the questionnaire, you may talk one on one with a mental health professional. A licensed mental health professional directs each screening site. If the answers to your questionnaire indicate a need for further evaluation, you will be given a referral to a qualified health or mental health professional.
For more information and to find out about screening locations in your area, call 1-888-442-2022.
|
Resources: Anxiety Disorders Association of America. Brief overview of anxiety disorders.
Freedom from Fear. (2000). Anxiety disorders.
For more information: Anxiety Disorders Association of America National Mental Health Association National Mental Health Information Center Substance Abuse and Mental Health Services Administration National Institute of Mental Health (NIMH) Freedom from Fear |
Health Screening 2: Breast Cancer
If you can find cancer early, the chance for survival is much better. Three basic screening methods are used to look for breast cancer:
-
Breast self-exams
-
Clinical breast exams
- Mammograms
Breast Self-Exams
A breast self-exam (BSE) is an examination to check your own breasts for lumps or anything else that seems unusual. BSE is a way for all women (starting in their 20s) to find changes in their breasts.
If you do BSE on a regular basis, you get to know how your breasts normally feel. Then, you can notice changes more easily. You should see your health care provider right away if you notice any changes.
Clinical Breast Exams
A clinical breast exam (CBE) is an examination of your breasts by a health professional, such as a doctor, nurse practitioner, nurse, or physician assistant. For this exam, you undress from the waist up. The examiner will first look at your breasts for changes in size or shape. Then, using the pads of the fingers, he will gently feel your breasts for lumps. He will also examine the area under both arms. This is a good time to learn how to do a breast self-exam if you don't already know how.
Women in their 20s and 30s should have a CBE as part of a regular exam by a health care provider every 3 years. After age 40, women should have a breast exam by a health care provider every year.
Mammograms
Women aged 40 or older should have a mammogram every year and should continue to do so for as long as they are in good health.
A mammogram is an X-ray of the breast. This test is used to look for breast disease in women who appear to have no breast problems.
For the mammogram, you will undress above the waist. You will have a wrap to cover yourself. A radiography technician (most often a woman) will position your breast correctly for the test. During a mammogram, the breast is pressed between two plates to flatten and spread the tissue. The pressure lasts only for a few seconds while the picture is taken. Although applying pressure may cause some discomfort for a moment, it is needed to get a good picture. You usually will get your results within 30 days. However, if there is a problem, you generally will learn your results within a week.
How Do You Get a Free or Low-Cost Mammogram?
Medicare, Medicaid, and most private health plans cover all or part of the cost of this test. Breast cancer testing is now more available to women without health insurance for free or at low cost through a special program, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Your State department of health will have information about the program.
You also can call the National Cancer Institute's Cancer Information Service: 1-800-4-CANCER (1-800-422-6237). TTY users should call 1-800-332-9615 or visit www.cdc.gov/cancer/nbccedp.
Also, a new program exists to help pay for breast cancer treatment for women in need. To learn more about this program, you can contact the Centers for Disease Control and Prevention at 1-888-842-6355 or visit www.cdc.gov/cancer.
|
Resources: American Cancer Society, Inc. (2004). Overview: Breast cancer-How is breast cancer found? Retrieved from http://www.cancer.org/docroot/CRI/content/CRI_2_2_3X_How_is_breast_cancer_found_5.asp?sitearea National Cancer Institute. (2003). What you need to know aboutâ„¢ breast
cancer For more information: American Cancer Society National Cancer Institute Cancer Information Service Centers for Disease Control and Prevention Susan G. Komen Breast Cancer Foundation |
Health Screening 3: Cervical Cancer
The most important thing you can do to avoid getting cervical cancer is to have regular Pap tests. The Pap test can find abnormal cells in the cervix (the opening to the uterus). These cells may, over time, turn into cancer. This change could take several years to happen.
If the results of a Pap test show abnormal cells that could become cancerous, a woman can be treated. In most cases, this treatment prevents cervical cancer from developing.
Pap tests can also find cervical cancer early. When cervical cancer is found early, the chance of being cured is very high.
What Is the Pap Test?
The Pap test, also called the Pap smear, is a cervical cancer screening test. It is not used to detect other kinds of cancer. It is done in a doctor's office or a clinic. This test can find abnormal cells in the cervix that may turn into cancer if they are not treated.
During the test, the doctor or nurse uses a plastic or metal instrument, called a speculum, to widen the vagina. This instrument helps the doctor or nurse examine the vagina and the cervix and collect a few cells and mucus from the cervix and the area around it. These cells are placed on a slide and are sent to a laboratory to be checked for abnormal cells.
The doctor or nurse also performs a pelvic exam, checking the uterus, ovaries, and other organs to make sure no problems exist. Sometimes, a doctor may perform a pelvic exam without giving you a Pap test. Ask your doctor or nurse which tests you're having, if you are unsure.
Who Should Have a Pap Test?
Doctors recommend that women begin having regular Pap tests and pelvic exams at age 21, or within 3 years of the first time they have sexual intercourse-whichever happens first. After a woman has a Pap test each year for 3 years in a row and test results show no problems, national guidelines recommend that she get the Pap test once every 2 to 3 years.
Who Does Not Need to Be Tested?
The only women who do not need regular Pap tests are the following:
-
Those women over age 65 who have had several regular Pap tests with normal
results and have been told by their doctors that they no longer need to be
tested.
- Women who do not have a cervix. This group includes women whose cervix was removed as part of an operation to remove the uterus. (The surgery is called a hysterectomy.) However, a small number of women who have had this operation still have a cervix and should continue having regular Pap tests. If you're not sure whether you have a cervix, ask your doctor.
How Do I Prepare for the Pap Test?
Doctors recommend that you try to schedule your Pap test for a time when you are not having your menstrual period. To prepare for the Pap test, doctors recommend that for 2 days before the test you avoid the following:
-
Douching
-
Using tampons
-
Having sexual intercourse
- Using birth control foams, creams, or jellies or vaginal medications or creams
When Will I Get the Results?
It can take up to 3 weeks to receive Pap test results. Most results are normal. But if your test shows that something may be abnormal, the doctor or nurse will contact you and probably want to do more tests. Pap test results can be abnormal for many reasons, and usually it does not mean you have cancer.
How Do I Get a Free or Low-Cost Pap Test?
Free or low-cost Pap tests and mammograms are available to eligible women through programs funded by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). These programs and others that offer free or low-cost Pap tests and mammograms are available throughout the country.
To find out whether you are eligible and to find locations that offer free or low-cost Pap tests and mammograms, call your State or local health department.
You can also call the National Cancer Institute's Cancer Information Service: 1-800-4-CANCER (1-800-422-6237). TTY users should call 1-800-332-9615 or visit www.cdc.gov/cancer/nbccedp.
|
Resource: Centers for Disease Control and Prevention. (2003). Cervical cancer screening fact sheet: Basic facts on screening and the Pap test (CDC Publication No. 99-6949). Retrieved from http://www.cdc.gov/cancer/nbccedp/cc_basic.htm#cc For more information: American Cancer Society National Cancer Institute Cancer Information Service Centers for Disease Control and Prevention |
Health Screening 4: Cholesterol
High levels of the wrong kind of cholesterol in your blood can increase your risk of heart disease, stroke, heart attack, and other health problems. A good way to detect high blood cholesterol early, so that you can take steps to reduce your risk of health problems, is to have a regular blood test to measure your cholesterol level.
What Does a Cholesterol Screening Involve?
It is best to have a blood test called a lipoprotein profile to find out your cholesterol numbers. A doctor, nurse, or other health care professional will take a sample of blood from a vein in your arm. This blood test is done after you have not eaten anything for 9 to 12 hours. This test provides the following information about you:
-
LDL (bad) cholesterol is the main source of cholesterol buildup and blockage in
arteries.
-
HDL (good) cholesterol helps keep LDL cholesterol from building up in the
arteries.
-
Total cholesterol level is LDL and HDL combined.
- Triglycerides are another form of fat in your blood.
If you have results from a lipoprotein profile, see how your cholesterol numbers compare to the values below.
|
Total Cholesterol Level1
Less than 200 mg/dL 200 to 239 mg/dL 240 mg/dL and above |
Explanation
Desirable Borderline high High |
|
LDL (bad) Cholesterol Level
Less than 100 mg/dL 100 to 129 mg/dL 130 to 159 mg/dL 160 to 189 mg/dL 190 mg/dL and above |
Explanation
Optimal Near optimal/above optimal Borderline high High Very high |
HDL (good) cholesterol protects against heart disease; so for HDL, higher numbers are better and lower numbers are not desirable. An HDL level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk of developing heart disease. HDL levels of 60 mg/dL or more lower your risk of heart disease.
If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done.
High triglycerides also can increase your risk of heart disease. Levels that are borderline high (150 to 199 mg/dL) or high (200 mg/dL or more) may need to be treated.
Who Should Have Cholesterol Screening?
All people age 20 or older should have their cholesterol measured at least once
every 5 years. Your health care provider may suggest that you have it checked
more often, especially if your cholesterol is too high.
It is especially important to start having your cholesterol checked if you fall into the following categories:
-
You are a man 35 years of age or older.
-
You are a woman 45 years of age or older.
- You are a man between the ages of 20 and 35 or a woman between the ages of 20 and 45, and you have other risk factors for heart disease. Other risk factors are tobacco use, diabetes, high blood pressure, or a family history of heart disease.
|
Resources: Agency for Healthcare Research and Quality. (2003). Pocket guide to good health
for adults (Publication APPIP03-0001).
National Heart, Lung, and Blood Institute. (2001). High blood cholesterol: What
you need For more information: American Heart Association National Heart, Lung, and Blood Institute |
1 Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.
Health Screening 5: Colorectal Cancer
If you are 50 years old or older, getting a screening test for colorectal cancer could save your life. Here's how:
Colorectal
cancer usually starts from polyps in the colon or rectum. A polyp is a growth
that shouldn't be there.
Over time, some polyps can turn into cancer.
Screening tests can find polyps, so they can be removed before they turn into
cancer.
Screening tests can also find colorectal cancer early. When it is found early,
the chance of being cured is good.
Several different screening tests can be used to find polyps or colorectal cancer. Each one can be used alone. Sometimes, they are used in combination with each other. Talk with your doctor about which test or tests are right for you and about how often you should be tested.
Fecal occult blood test or stool test. For this test, you receive a test kit from your doctor or health care provider. At home, you put a small piece of stool on a test card. You do this for three bowel movements in a row. Then, you return the test cards to the doctor or a lab. The stool samples are checked for blood. This test should be done every year.
Flexible sigmoidoscopy. For this test, the doctor puts a short, thin, flexible, lighted tube into your rectum. The doctor checks for polyps or cancer inside the rectum and lower third of the colon. This test usually is done every 5 years.
Fecal occult blood test plus flexible sigmoidoscopy. Your doctor may ask you to have both tests. Some experts believe that by using both tests, there is a better chance of finding polyps or colorectal cancer.
Colonoscopy. This test is similar to flexible sigmoidoscopy, except the doctor uses a longer, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the entire colon. During the test, the doctor can find and remove most polyps and some cancers. Testing often starts around 50 years of age and is repeated every 3 to 5 years, pending test results.
Colonoscopy also may be used as a follow-up test if anything unusual is found during one of the other screening tests.
Double contrast barium enema. This test is an X-ray of your colon. You are given an enema that contains barium before the doctor takes an X-ray. The barium makes it easy for the doctor to see the outline of your colon on the X-ray to check for polyps or other abnormalities. This test usually is done every 5 to 10 years.
Where Can Individuals Usually Obtain These Tests?
Tests for colorectal cancer are given at most hospitals and through your health care provider, who may refer you to a gastroenterologist-a specialist in the digestive system. You can talk with your doctor for advice about your risk of colorectal cancer and about your need to be screened for it.
|
Resources: National Cancer Institute. (2004). Colorectal cancer (PDQ®): Screening.
Screen for Life: National Colorectal Cancer Action Campaign. (2002). Basic facts
on screening
For more information: Screen for Life: National Colorectal Cancer Action Campaign American Cancer Society National Cancer Institute Cancer Information Service Centers for Disease Control and Prevention Colon Cancer Alliance |
Health Screening 6: Depression
If you have been feeling "down" for more than a few weeks or are having difficulty functioning in daily life, you may be experiencing symptoms of depression. Talk with your primary health care provider. She can screen you for depression by asking you questions and talking with you about your symptoms. Then, your doctor may refer you to a mental health professional who will conduct a psychological evaluation.
Screening for depression is done most often through a psychological evaluation. A psychiatrist, psychologist, or other mental health professional will ask you questions about yourself that will help him determine whether you have symptoms of depression and whether those symptoms are from depression or another condition.
The types of questions you might be asked include the following:
-
Do you feel sad or hopeless?
-
Do you have difficulty sleeping?
-
Do you have difficulty concentrating?
-
Do you have less interest or pleasure in hobbies and activities that you
usually enjoy?
-
Have you experienced a loss of appetite, weight loss, overeating, or weight
gain?
-
Do you have thoughts of death or suicide?
-
Do you feel restless or irritable?
- Do you have ongoing physical symptoms, such as headaches, digestive disorders, and chronic pain, which do not respond to treatment?
Other Screening Methods
Self-Tests
One of the quickest and easiest ways to determine whether you have symptoms of depression is by taking a self-test. This screening test is not meant to provide a diagnosis or to replace a proper evaluation by a physician or mental health professional. A "positive" result from any screening tools only indicates that you could benefit from a comprehensive mental health exam. Regardless of the results, contact your primary health care provider, a mental health professional, or both, if you have any concerns.
A confidential depression screening test can be found on the Web site sponsored by the National Mental Health Association (http://www.depressionscreening.org).
National Depression Screening Day
National Depression Screening Day is an annual event held at various sites around the country. The event is organized by Screening for Mental Health, Inc., a nonprofit organization developed to coordinate nationwide mental health screening programs.
The screening involves watching a video and filling out a screening questionnaire. After you fill out the questionnaire, you may talk one on one with a mental health professional. A licensed mental health professional directs each screening site. If the answers to your questionnaire indicate a need for further evaluation, you will be given a referral to a qualified health or mental health professional.
|
Resource: National Institute of Mental Health. (2000). What is a depressive disorder?
(NIH Publication No. 00-3561).
For more information: Depression-Screening.org Screening for Mental Health, Inc. National Mental Health Information Center Substance Abuse and Mental Health Services Administration National Alliance for the Mentally Ill
National Depressive and Manic-Depressive Association National Institute of Mental Health (NIMH) National Mental Health Association
|
Health Screening 7: Diabetes
Diabetes is a condition in which the level of sugar in your blood is higher than normal. If diabetes is not treated, potentially life-threatening health problems can develop.
What Does Diabetes Screening Involve?
Diabetes screening involves measuring the level of sugar in your blood. A normal blood sugar range for a person who has not eaten in 8 hours, or who has fasted overnight, is between 70 to 100 milligrams per deciliter of blood (mg/dL). That is equal to about 1 teaspoon of sugar in an entire gallon of water. If your blood sugar level is above 126 mg/dL on a consistent basis, you are likely to have diabetes.
Screening for diabetes usually is not done during routine visits with your doctor unless you show symptoms or if you are at risk of the disease.
Four screening tests can detect whether a person has diabetes:
-
Finger-prick blood sugar screening test. This simple,
inexpensive blood test requires a single drop of blood from a prick in your
finger. The drop of blood is placed on a chemically treated strip that is
inserted into a small device that reads the strip and displays your blood sugar
level. The finger-prick blood sugar screening test usually is done after you
fast overnight. If the reading is high (more than 126 mg/dL), then you should
have a more advanced blood sugar screening test.
-
Random blood sugar screening test. This test is included as
part of routine blood work during your physical exam. Your blood is drawn from
a vein in your arm and is sent to a laboratory for testing. Your results may be
high because fasting is not required and because you may have just eaten. Even
in this case, your blood sugar level should not be higher than 200 mg/dL.
-
Fasting blood glucose screening test. A more formal blood
glucose test, this method is preferred because your blood is drawn after you
have fasted overnight or for at least 8 hours. A blood sugar level measuring
126 mg/dL or higher means you need a second test. If the second test measures
126 mg/dL or higher, you probably will be diagnosed with diabetes.
- Glucose change screening test. This test is used to screen pregnant women for gestational diabetes. Some women develop this type of diabetes during the second or third trimester. The test requires that the pregnant woman drink 8 ounces of very sweet liquid after fasting for 8 hours. Blood is drawn from a vein in the arm and is sent to a laboratory. If the woman's blood sugar level measures 126 mg/dL or higher, the doctor will want to repeat the test. If the results of the second test are the same, the woman likely will be diagnosed as having gestational diabetes.
Where Can Individuals Obtain These Tests?
Tests for diabetes can be obtained at any primary health care clinic or at your local health department. Talk with your doctor for advice about your risk of diabetes and about your need to be screened for it.
|
Resources: American Diabetes Association. (2002). Screening for diabetes: Position
statement.
Mayo Foundation for Medical Education and Research. (2003). Diabetes.
For more information: American Diabetes Association National Institute of Diabetes and Digestive and Kidney Diseases
|
Health Screening 8: High Blood Pressure (Hypertension)
Only your doctor can tell you whether you have high blood pressure. Your doctor
may check your blood pressure several times on different days before deciding
that you have high blood pressure. A diagnosis of high blood pressure is given
if repeated readings are 140/90 or higher, or 130/80 or higher if you have
diabetes or chronic kidney disease.
Your blood pressure should be checked at least once every 2 years.
How Is Blood Pressure Tested?
Having your blood pressure tested is quick and easy. Your doctor or nurse will
use some type of a gauge, a stethoscope (or electronic sensor), and a blood
pressure cuff, also called a sphygmomanometer (sfig-mo-ma-NOM-e-ter).
Blood pressure readings usually are taken when you are sitting or lying down
and relaxed. Before your blood pressure is measured, it is important that you
follow these instructions:
-
Do not drink coffee or smoke cigarettes 30 minutes before having your blood
pressure taken.
-
Wear short sleeves.
-
Go to the bathroom before the reading. Having a full bladder can change your
blood pressure reading.
- Sit quietly for 5 minutes before the test.
Ask the doctor or nurse to tell you the blood pressure reading in numbers.
You also can check your blood pressure at home with a home blood pressure measurement device, or monitor. It is important that you understand how to use the monitor properly. Your doctor, nurse, or pharmacist can help you check the monitor and can teach you how to use it correctly. You also may ask for their help in choosing the right blood pressure monitor for you. You can buy blood pressure monitors at discount chain stores and pharmacies. Below are additional things to do when taking your blood pressure at home:
-
Sit with your back supported and your feet flat on the floor.
-
Rest your arm on a table at the level of your heart.
- Take two readings, at least 2 minutes apart, and average the results.
Some people's blood pressure is high only when they visit the doctor's office. This condition is called white-coat hypertension. If your doctor suspects this condition, you may be asked to check and record your blood pressure at home with a home monitor. Another way to check blood pressure away from the doctor's office is by using an ambulatory blood pressure monitor. This device is worn for 24 hours and can take blood pressure as often as every 30 minutes.
|
Resource: National Heart, Lung, and Blood Institute. High blood pressure: How do you know
if you have high blood pressure?
For more information: American Heart Association National Heart, Lung, and Blood Institute |
Health Screening 9: Skin Cancer
Screening for skin cancer can be done through a routine skin examination with your primary health care provider or a dermatologist-a specialist in skin disorders. Skin self-exams also are an important method of screening for skin cancer that you can do at home.
How to Do a Skin Self-Exam
You can improve your chances of finding skin cancer promptly by performing a
simple skin self-exam regularly. The best time to do this self-exam is after a
shower or bath.
You should check your skin in a well-lighted room using a full-length mirror
and a hand-held mirror. It is best to begin by learning where your birthmarks,
moles, and blemishes are and what they usually look like. Check for anything
new-a change in the size, texture, or color of a mole, or a sore that does not
heal.
Check all areas, including the back, the scalp, between the
buttocks, and the genital area:
-
Look at the front and back of your body in the mirror, then raise your arms and
look at the left and right sides.
-
Bend your elbows and look carefully at your palms, forearms (including the
undersides), and the upper arms.
-
Examine the back and front of your legs. Also, look between your buttocks and
around your genital area.
-
Sit and closely examine your feet, including the soles and the spaces between
the toes.
- Look at your face, neck, and scalp. You may want to use a comb or a blow dryer to move hair so that you can see these areas better.
By
checking your skin regularly, you will become familiar with what is normal. If
you find anything unusual, see your doctor right away. Remember, the earlier
skin cancer is found, the better the chance for a cure.
The ABCD Rule for Early Detection of Melanoma
Almost everyone has moles. The vast majority of moles are perfectly harmless. A change in the appearance of a mole is a sign that you should see your doctor. Here's the simple ABCD rule to help you remember the important signs of melanoma and other skin cancers:
A is for ASYMMETRY. One-half of a mole or birthmark does not match the other.
B is for BORDER. The edges are irregular, ragged, notched, or blurred.
C is for COLOR. The color is not the same all over. It may have differing shades of brown or black, sometimes with patches of red, white, or blue.
D is for DIAMETER. The area is larger than 6 millimeters (about ¼ inch-the size of a pencil eraser) or is growing larger.
Other important signs of melanoma include changes in size, shape, or color of a mole or the appearance of a new spot. Some melanomas do not fit the ABCD rule described above, so it is particularly important for you to be aware of changes in your skin.
|
Resource: National Cancer Institute. (1998). What you need to know aboutâ„¢ skin
cancer (NIH Publication No. 95-1564).
For more information: American Cancer Society National Cancer Institute Cancer Information Service Centers for Disease Control and Prevention American Academy of Dermatology
|
3.5 Information on Specific Health Concerns for Refugee Communities
|
At the end of this section, you will be able to
This section answers the following questions:
|
Many health issues can affect refugees in your community, beyond the infectious diseases that are of greatest concern when they first enter the United States. Chronic diseases that affect many Americans are also a concern for refugees. Also, many refugees may be unfamiliar with what they can do to prevent chronic diseases. However, your organization can play an important role in helping refugees in your community stay healthy.
In the following pages, we provide you with a series of fact sheets on various health concerns-chronic and infectious-for refugee communities. These fact sheets contain basic information including definitions, risk factors, suggestions for what refugees can do to lower their risk of specific diseases, and organizations where they can find more information. The fact sheets cover the following topics:
| Chronic illness (Section 3.5.1) |
| Communicable diseases (Section 3.5.2) |
| Behavioral health concerns (Section 3.5.3) |
| Maternal and child health (Section 3.5.4) |
| Older adult issues (Section 3.5.5) |
These fact sheets are designed specifically for you to use within your communities. They are written in such a way that they can be used as handouts you can give to the people in your community. We encourage you to use them as is, translate them, or adapt them as you see fit to provide your refugee communities with information to help them stay healthy.
3.5.1 Chronic Illness
Our first set of fact sheets provides information about chronic illness:
-
Breast cancer
-
Colorectal cancer
-
Depression
-
Diabetes
-
Healthy body weight
-
Heart disease
-
High blood pressure
-
Lung cancer
-
Prostate cancer
- Skin cancer
Fact Sheet 1: Breast Cancer
What Is Breast Cancer?
Breast cancer is a disease in which cells become abnormal, grow fast, and form
tumors in the breast. It is the second leading cause of death from cancer in
the United States.
Women in the United States get breast cancer more than any other type of cancer
except skin cancer. Breast cancer occurs in men also, but the number of cases
is small.
What Increases Your Risk of Breast Cancer?
-
Older age
-
Early age at first menstrual period
-
Older age when your first child is born or never having given birth
-
Personal history of breast cancer or benign (noncancer) breast disease
-
A mother or sister with breast cancer
-
Treatment with radiation therapy to the breast or chest
-
Breast tissue that is dense on a mammogram
-
Hormone use (such as estrogen and progesterone, which are found in birth
control pills)
-
Drinking alcoholic beverages
- Caucasian race
What Are Some Symptoms of Breast Cancer?
-
A change in how the breast or nipple feels:
-
A lump or thickening in or near the breast or in the underarm area
-
Nipple tenderness
-
A lump or thickening in or near the breast or in the underarm area
-
A change in how the breast or nipple looks:
-
A change in the size or shape of the breast
-
The nipple turned into the breast
-
The skin of the breast, the area around the nipple (the areola), or the nipple
is scaly red or swollen; these areas may look like the skin of an orange.
- Fluid draining from the nipple
-
A change in the size or shape of the breast
What Can You Do to Lower Your Risk of Breast Cancer and to Detect It Early?
-
Get a mammogram every 1 to 2 years if you are a woman over the age of 40.
-
Talk with your doctor about having a mammogram if you are younger than age 40
and know you have a higher risk of breast cancer.
-
Visit your doctor or other health care provider for a breast exam.
-
Perform a monthly breast self-exam. Call your doctor if you feel a lump or
notice any changes.
-
Limit alcohol.
-
Eat a healthy diet.
- Exercise.
Talk with your doctor about your risk of breast cancer, and ask what you can do to stay healthy.
|
Resource: National Cancer Institute. (2003). What you need to know aboutâ„¢ breast
cancer For more information: American Cancer Society National Cancer Institute Cancer Information Service Centers for Disease Control and Prevention Susan G. Komen Breast Cancer Foundation |
Fact Sheet 2: Colorectal Cancer
What Is Colorectal Cancer?
Colorectal cancer is a disease in which cells become abnormal, grow fast, and
form tumors in the tissues of the colon or the rectum, which are parts of the
large intestine.
Cancer that begins in the colon is called colon cancer, and
cancer that begins in the rectum is called rectal cancer. Cancer
that begins in either of these organs may also be called colorectal cancer.
Colorectal cancer is the second leading cause of death from cancer in the
United States. It is found more often in men than in women.
Screening tests, including a fecal occult blood test (FOBT), sigmoidoscopy, and
colonoscopy, are used to detect colorectal cancer.
What Increases Your Risk of Colorectal Cancer?
-
Being older than 50 years of age
-
Having a personal history of any of the following:
-
Colorectal cancer or polyps (small growths in the bowel)
-
Cancer of the ovary, endometrium, or breast
-
Ulcerative colitis or Crohn's disease
-
Colorectal cancer or polyps (small growths in the bowel)
-
Having a parent, brother, sister, or child with colorectal cancer or polyps
-
Having certain rare hereditary conditions
- Eating a low-fiber diet
What Are Some Symptoms of Colorectal Cancer?
-
A change in bowel habits
-
Diarrhea, constipation, or feeling that the bowel does not empty completely
-
Blood (either bright red or very dark) in the stool
-
Stools that are narrower than usual
-
General abdominal discomfort (frequent gas pains, bloating, fullness, and/or
cramps)
-
Constant tiredness
- Vomiting
What Can You Do to Lower Your Risk of Colorectal Cancer and to Detect It Early?
-
Visit your doctor to conduct a colorectal cancer screening test if you are over
age 50 or at increased risk of colorectal cancer.
-
Eat a healthy diet with increased fiber.
- Exercise regularly.
Talk with your doctor about your risk of colorectal cancer, and ask what you can do to stay healthy.
|
Resource: National Cancer Institute. (1999). What you need to know aboutâ„¢ cancer
of the colon and rectum (NIH Publication No. 99-1552).
For more information: American Cancer Society National Cancer Institute Cancer Information Service Centers for Disease Control and Prevention Colon Cancer Alliance |
Fact Sheet 3: Depression
What Is Depression?
Depression is an illness that involves the body, mood, and thoughts. It affects
the way you eat and sleep, the way you feel about yourself, and the way you
think about things. It is more than just being sad for a short time. Signs of
anxiety, as well as possible signs of suicide, often can be seen with
depression.
Depression is defined as losing the ability to work, study, sleep, eat, and
enjoy activities you usually enjoy that lasts for more than 2 weeks. It may
happen only once, but it usually happens several times in a lifetime.
People with a depressive illness cannot "pull themselves together" and get
better without help. Without treatment, symptoms can last for weeks, months, or
years. However, correct treatment can help most people who suffer from
depression.
What Increases Your Risk of Depression?
-
Family members with depression
-
Low self-esteem or confidence in yourself
- Being female-women experience depression about twice as often as men
What Are Some Symptoms of Depression?
-
A persistent sad, anxious, or "empty" mood
-
Feelings of hopelessness or pessimism
-
Feelings of guilt, worthlessness, or helplessness
-
Loss of interest or pleasure in hobbies and activities that were once enjoyed,
including sex
-
Decreased energy, fatigue, or feeling "slowed down"
-
Difficulty concentrating, remembering, or making decisions
-
Difficulty sleeping, early-morning awakening, or oversleeping
-
Appetite and/or weight loss or overeating and weight gain
-
Thoughts of death or killing oneself; suicide attempts
-
Restlessness or irritability
- Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Children, teens, and older adults may react differently to depression. In these groups, symptoms may take a different form or may be masked by other conditions.
What Can You Do If You Think You Are Depressed?
Healthy lifestyle habits can help prevent depression, or lessen the chances that it will happen again. These habits include
-
Eating a healthy diet
-
Getting enough sleep
-
Exercising regularly
-
Taking time to relax
-
Not drinking alcohol or using recreational drugs
-
Talking with others or getting counseling to help get you through difficult
times
- Volunteering or getting involved in group activities if you feel isolated or lonely
Talk with your doctor if you feel you have symptoms of depression or would like to learn more.
|
Resources: National Institute of Mental Health. (2000). What is a depressive disorder?
National Library of Medicine. (2003). Depression. Retrieved from MedlinePlus® Medical Encyclopedia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm National Institute of Mental Health (NIMH) |