Chronic Conditions, The Stanford Model and Outcomes

Chronic Conditions

A 2009 Public Health Report by the U.S. Surgeon General reported that in 2007, 38 million people or 13% of the American population were aged 65 and over. By the year 2030, it is estimated that 71.5 million Americans will be in that same age category. Unfortunately, chronic disease often accompanies aging and according to 2002 statistics, 60% of U.S. adults age 65 and older died from the top three chronic illnesses: heart disease, cancer and stroke. The report also states that currently at least 80% of older Americans are living with at least one chronic condition, and 50% of them have at least two conditions.

New Hampshire aging population trends are not unlike those at the national level. According to the 2009 US Census Report, it is estimated that New Hampshire’s older adults (age 65 and older) comprise 13.5% of our population and that number will double  in the next 20 years. Approximately 52% of New Hampshire’s older adults have been diagnosed with high blood pressure; 53% with arthritis; 18% with diabetes; 17% with coronary heart disease; 8% with asthma; 10% with chronic obstructive pulmonary disease and 7% with stroke.

Chronic Disease Self-Management Program: The Stanford University Model

Better Choices, Better Health  is the brand name of the evidenced-based Stanford University Chronic Disease Self-Management Program, developed at Stanford University’s Patient Education Research Center in California. This program, which helps participants learn to self-manage their chronic conditions, is built on three basic principles:

  • Regardless of the chronic condition, people have similar challenges with self-management.
  • People can learn the skills needed to better manage their diseases day to day.
  • People who understand and take control of their condition will be healthier and happier.

The researchers developed the content of the workshop by keenly listening to various focus groups of people with chronic conditions. The participants were the driving force behind determining which content areas were the most important.

An important point to note is that this self-management workshop does not conflict with any existing programs or treatments but instead is designed to enhance regular treatment plans and disease-specific education.


 Nearly two decades of peer-reviewed data reveal impressive results for the Stanford model. According to the National Council on Aging, a number of major published studies measured and reported significant improvements in health status, psychological well-being, and self-efficacy which is a person’s belief in his or her ability to succeed in a particular situation. Other notable improvements, also measured and sustained, were increased exercise, reduced fatigue, and enhanced partnership with physicians. Studies have also shown participants enjoy fewer emergency room visits, hospitalizations, inpatient days, and/or outpatient visits.