What is a long-term physical health issue?
Long-term or chronic health conditions "are those which in most cases cannot be cured, only controlled, and are often life-long and limiting in terms of quality of life" (NHS Wales). Long-term physical health conditions differ from other types of health issues in the way that they develop. While acute physical health issues develop suddenly and last for a short time, chronic health issues tend to develop slowly and worsen over time.
Types of long-term physical health conditions include diabetes, arthritis (and other chronic pain disorders), chronic obstructive pulmonary disease (COPD), epilepsy, asthma, coronary heart disease and stroke. It is not uncommon for people to have more than one long-term health condition (called co-morbidities).
Unfortunately, the older we get, the more likely we are to suffer from a long-term physical health condition, but our risk of developing multiple long-term conditions also increases with age. These types of conditions affect 58% of people over 60 (compared with 14% of people under the age of 40).
Age is not the only factor. Social deprivation has also been shown to increase a person's risk of developing a chronic physical health condition, with those in the lowest social class being twice as likely to develop these conditions compared to people in the highest social class: https://www.kingsfund.org.uk/projects/time-think-differently/trends-disease-and-disability-long-term-conditions-multi-morbidity
Lifestyle factors, such as smoking, alcohol abuse and a poor diet, can also increase the risk of developing chronic health conditions.
About 15 million people in England have a long-term physical health condition.
Having a long-term physical health condition can be frightening and stressful, especially if you have recently received a diagnosis. Two thirds of people with long-term physical health conditions have a co-morbid mental health issue, such as anxiety and/or depression.
While the challenges of managing a chronic health issue can impact negatively on mood and wellbeing, it's also the case that people with existing long-term mental health problems can go on to develop long-term physical health issues.
If you're finding your long-term physical and mental health conditions difficult to manage, it's important that the services that are providing you with support are aware of all conditions so that your care can be managed in a holistic way and you don't risk either your physical or mental health becoming neglected.
Other things that can help:
- stay connected with family, friends and/or a support group of people who can relate to your difficulties
- don't suffer in silence and ask for help when you need it
- don't be tempted to put on a brave face when you just need to rest. It's normal to have bad days
- try to continue doing the things you enjoy to keep well
- slow down when things feel too much. Try meditation to help you feel calm and relaxed
Find more information and support on long-term physical health conditions and mental health from the Mental Heallth Foundation, here.
BMC Public Health recently published a paper on the prevalence of co-morbid long-term physical health conditions among those aged over 40.
The study surveyed 7,951 people people from the 1970 British Cohort Study to track how many developed multiple chronic health conditions.
For those aged between 46 and 48 years old, the study found:
- one-third (33.8%) reported multiple chronic health problems
- 26% engaged in high-risk drinking
- 21% reported recurrent back issues
- 16% had high blood pressure
- 8% had arthritis
- 5% had diabetes
The study concluded that early-life variables, such as social circumstances, cognitive, physical and emotional development, were potentially associated with an increased risk of multiple chronic health conditions in mid-life.
Read the full report here.
What do I do if I suspect I might have a long-term physical health condition?
If you are concerned about your health, you should speak to your GP as a first port of call and as soon as possible. Your GP will ask you questions about your symptoms and may conduct tests or refer you to specialists to determine if you have a chronic health issue.
Your GP will be involved in your care throughout, but it is likely that you will have a team of specialists working to support your physical and mental wellbeing.
Getting the right care
Some studies have found that people living with long-term health conditions can face challenges in getting the right care for them. These can relate to a lack of a joined-up approach between services that are involved in a patient's care and difficulties in accessing and sharing important patient information.
The NHS 'House of Care' Framework (see below) is changing the way that services support people with chronic health conditions, so that their care is more tailored to their individual needs and they have more choice in how their diagnoses are managed.
Self-managing a long-term health condition
It's usually the case that medication will be needed to treat chronic health conditions to manage the symptoms and slow down the rate of deterioration as much as possible. But there are things, as well as medication, that can help you to manage the symptoms of your condition(s) on your own and away from clinical environments.
These include making sure that you're eating a healthy and balanced diet and being as active as possible (within the limits of what your health condition allows you to do) to give your body the best chance to live with your condition (see our Keeping Well page for inspiration). It could also involve making sure that you know where to find information about your condition and who to ask for help when you need it.
The importance of functionality
Holistic management of a long-term condition helps individuals to maximise their level of functionality so that they are able to continue to participate in day-to-day activities and enjoy a fulfilling life. For example, a chronic health condition does not necessarily mean that an individual can no longer work. Discussing your condition(s) with your organisation's occupational health team (if there is one), or another qualified practitioner, can help you to explore what career options are available and find adaptive ways to make your current workplace suitable.
- Self-management UK has some fantastic resources available to support people to self-manage their long-term conditions, be they physical or mental in nature.
- This paper from the King's Fund explores the importance of self-management and suggests ways that health care providers can better support patients to manage their conditions.
- Imparts (Integrating Mental and Physical healthcare: Research, Training and Services) has a host of free information and self-help resources available to download to support those living with chronic health conditions.
- Patient Info: Living with a long-term condition
- Patients Association: Long-term conditions
- Asthma UK
- British Heart Foundation
- British Lung Foundation
- Diabetes UK
- Epilepsy Action
- Macmillan Cancer Support
- Stroke Association
- The ME Association
- Versus Arthritis