Health and Chronic Conditions
- Define "chronic condition" and explain its prevalence and impact on public health in the United States.
- Name the factors contributing to chronic conditions, both within and outside an individual's control.
- Explain the ways chronic conditions can impact an individual's daily life now and as they age.
- Describe the impact of pain on individuals with chronic conditions and strategies for pain management.
- Explain the relationship between sleep and health, particularly in the context of chronic conditions.
- Become familiar with the resources, treatments, and management strategies available to individuals with chronic conditions.
Why health matters in your work
Health greatly influences our quality of life. As a community health worker, you will work with individuals who have chronic health conditions. CHWs need to know what chronic health conditions are and the effect they have on people's lives. CHWs should also understand what causes chronic conditions and how to manage them.
What is a chronic condition?
A chronic condition is an illness or health condition that lasts for at least three months and is slow to progress.
Common chronic conditions you'll encounter
Cardiovascular Disease
Coronary heart disease · Heart attack · Stroke · Pulmonary embolism
How chronic conditions affect daily life
Chronic conditions ripple into many areas of individuals' daily lives:
- Physical energy and sleep
- Chronic pain
- Nausea
- Ability to complete daily tasks
- Bowel or bladder control problems
- Stigma or negative attitudes from others
- Emotional or mental health
- Shame, isolation, and loss of career and relationships
What drives chronic conditions
A person's environment, activity level, and food choices have a large impact on their health — areas individuals can often improve. Other factors, like genetics and some social factors, are outside individual control.
Outside our control
Bacteria and viruses cause some chronic diseases (certain cancers, HIV). Genes play a role in heart disease and depression. Aging itself can lead to chronic conditions.
Environment
The places we live affect our health. Quality schools, housing, healthcare, and grocery stores with fresh produce all benefit us. Air pollution and mold can cause chronic diseases like asthma. Older people struggle in areas where walking is hard — uneven sidewalks, busy streets without crosswalks. Community violence prevents activity and increases stress.
Personal relationships
Family and friends can help us stay healthy or make us sick. They affect what we eat, whether we smoke or drink, how much we exercise, and how we deal with stress. CHWs should remember how much loved ones influence their clients.
Stress
Stress is a leading cause of chronic disease, especially in communities exposed to traumatic stress from poverty, food insecurity, inequality, and violence. Stress makes our heart beat faster, raises blood pressure, releases hormones, and pulls energy away from the immune system to fight, flee, or store fat. Over time, the stress response increases risk for a wide range of chronic conditions.
Common treatment options
Medications
Prescription, over-the-counter, or homeopathic.
How might the symptoms of a chronic condition influence your ability to engage in school, work, caregiving, volunteering, or social events?
If you were experiencing these symptoms, what kinds of services and supports might be helpful?
Prevalence in California
A California Health Care Foundation report found that chronic conditions are the leading cause of death and disability in the US. In California:
Chronic condition example: Pulmonary hypertension
Pulmonary hypertension happens when the pressure in the blood vessels leading from the heart to the lungs is too high. Chronic lung disease is a common cause — mold exposure can also play a role.
Chronic conditions like this can feel out of your control as a CHW. But because you visit patients in their homes and talk about different parts of their lives, you can spot issues doctors might miss. For example, while checking a home for safety, you might see mold making the patient's pulmonary hypertension worse.
Which statement best defines a chronic condition?
Which of the following are factors that are generally OUTSIDE an individual's control when it comes to chronic conditions?
Pain and health
An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.
Pain can be classified as either acute or chronic.
Acute vs. chronic pain
ACUTE PAIN
- Starts suddenly and is expected to last a short time
- Usually linked to a specific event — injury or illness (muscle strain, severe sunburn, kidney stone)
- Treated with over-the-counter medications or a short course of stronger pain relievers and rest
- Pain ends when the underlying cause resolves (e.g., kidney stone passes, diseased tooth removed)
- Can also be recurrent — episodes interspersed with pain-free periods (menstrual cramps, migraines)
CHRONIC PAIN
- Lasts 3–6 months or more (longer than "normal healing")
- Can be difficult to treat
- Improvement may be possible, but for many patients a cure is unlikely
- Makes it difficult to take part in the fundamental tasks and pleasures of daily living
- Can be so debilitating it affects every aspect of life — work, school, friendships, family
Culture and pain
People from different cultures feel and talk about pain differently. In some cultures, people might think they should bear pain and try to ignore it; in others, they might be more expressive about pain and the underlying health issues. CHWs should keep these cultural differences in mind.
Pain has wide-ranging effects: diminished quality of life, difficulty keeping a job, and more frequent (and expensive) healthcare utilization. Chronic pain most commonly affects middle-aged adults but can affect people of any age.
Pain management
Interventional Techniques
Nerve blocks, spinal cord stimulators, injections.
Sleep and health
Sleep is the body's rest cycle — one of the body's most critical physiological needs. It makes up a third of every person's life and shapes how we live, function, and perform during the other two-thirds. It's as vital as the air we breathe and the food we eat, especially for those with chronic diseases or compromised immune systems.
Sleep vs. lack of sleep
SLEEP...
- Consolidates memories, which facilitates learning
- Restores our ability to concentrate and pay attention
- Helps muscles repair and recover
- Regulates the metabolism
- Allows us to maintain mental and physical health
LACK OF SLEEP...
- Causes problems beyond the feeling of tiredness
- Reduces our judgment and concentration
- Triggers hunger hormones that can cause weight gain
- Weakens the immune system and increases our risk of illness
- Reduces our reaction times, leading to more accidents
- Causes irritability, anger, and anxiety
Supporting sleep health
Poor sleep can be associated with mental health struggles. Many mental disorders involve sleep disruption — either sleeping too much or not enough.
9 strategies to improve sleep
- Use a fixed bedtime and wake up time
- Keep naps to 45 minutes or less
- Don't smoke or drink alcohol before sleeping
- Exercise regularly (but not right before bed)
- Avoid caffeine before bed
- Use comfortable bedding
- Avoid spicy and sugary foods before bed
- Set your bedroom to a comfortable temperature
- Block out noise and light
Match each pain-management approach to the example that best describes it.
In Linda's case, what was the FIRST barrier the CHW addressed to help her avoid repeated ER visits?
🌟 Lesson takeaways
Chronic conditions are the leading cause of death and disability in the US, shaped by factors both within and outside individual control. They ripple into every area of daily life — energy, pain, mental health, and relationships. Pain and sleep are two of the most pervasive impacts CHWs help patients manage. As a CHW, you should be familiar with the common symptoms of your patients' chronic diseases, as well as the treatments, management techniques, and resources and supports available to them. By spending time with people in their homes and lives, CHWs can spot what doctors miss — and connect patients to the resources, specialists, and supports that make a real difference.
Great work! At the end of this module, you'll join a live discussion with your cohort and an instructor to talk through these cases and questions. We'll see you there.