2.6 Risk Reduction
Nurses recognize risk factors that increase a client’s risk for injury or disease and then teach methods to reduce risk by behavioral changes. Risk factors for developing disease are classified as modifiable or nonmodifiable. Modifiable risk factors include factors like obesity and smoking and can be reduced by a change in behavior such as healthy diet choices, increased physical activity, and smoking cessation. Nonmodifiable risk factors cannot be changed by the client and include factors such as age, gender, and family history/genetic predisposition. Nurses empower clients to reduce their modifiable risk factors through behavioral change. The following subsections outline modifiable and nonmodifiable risk factors for several common chronic diseases.
Risk Factors for Developing Cardiovascular Disease
Risk factors for developing cardiovascular disease include the following[1]:
- Modifiable Risk Factors
- Smoking
- High blood pressure
- High cholesterol
- Diabetes
- Being overweight or obese
- Nonmodifiable Risk Factors
- Family history of early atherosclerotic cardiovascular disease (men less than age 55, women less than age 65)
- Ethnicity
- History of early menopause or preeclampsia
Risk Factors for Type 2 Diabetes
Risk factors for developing type 2 diabetes include the following[2]:
- Modifiable Risk Factors
- Having prediabetes
- Being overweight or obese
- Sedentary lifestyle
- Nonmodifiable Risk Factors
- Age 45 or older
- Family history of type 2 diabetes
- History of gestational diabetes or baby weighing over nine pounds
- Ethnicity (African American, Hispanic or Latino, American Indian, Alaska Native, some Pacific Islanders, and Asian Americans)
Risk Factors for Developing Metabolic Syndrome
Risk factors for developing metabolic syndrome include the following[3]:
- Modifiable Risk Factors
- Inactivity
- Unhealthy diet and large portion sizes
- Poor quality sleep
- Cigarette smoking
- Excess alcohol intake
- Shift work
- Nonmodifiable Risk Factors
- Increased age
- Low socioeconomic status, which affects diet, exercise, and sleep
- Genes and family history
- Medical conditions such as obesity, polycystic ovarian syndrome, or sleep apnea
- Female sex
Risk Factors for Developing Overweight and Obesity
Risk factors for developing overweight and obesity include the following[4]:
- Modifiable Risk Factors
- Inadequate physical activity
- Dietary intake of excessive calories, saturated fat, and added sugar
- Poor sleep
- High stress
- Health conditions like metabolic syndrome or polycystic ovarian syndrome
- Nonmodifiable Risk Factors
- Genetic predisposition
- Some medications like antidepressants
- Environmental factors like green space, safe places to walk, and types of restaurants
Risk Factors for Chronic Obstructive Pulmonary Disease
Risk factors for chronic obstructive pulmonary disease (COPD) include the following[5]:
- Modifiable Risk Factors
- Smoking
- Occupational exposure
- Smoke exposure from coal or wood burning stove
- Exposure to secondhand smoke
- Nonmodifiable Risk Factors
- History of childhood respiratory infections
- History of asthma
- Underdeveloped lungs
- Age over 40
- Alpha-1 antitrypsin deficiency
Risk Factors for Chronic Kidney Disease
Risk factors for developing chronic kidney disease (CKD) include the following[6]:
- Modifiable Risk Factors
- Diabetes
- High blood pressure
- Heart disease
- Obesity
- Smoking or tobacco use
- Nonmodifiable Risk Factors
- Ethnicity (African American, Hispanic or Latino, Native American, Asian American)
- Family history
- Age over 40
- Abnormal kidney structure
Risk Factors for Developing Osteoporosis
Risk factors for developing osteoporosis include the following[7]:
- Modifiable Risk Factors
- Low estrogen in women due to excess exercising
- Diet low in calcium, vitamin D, protein, and calories
- Low physical activity
- Chronic excess alcohol intake
- Smoking
- Nonmodifiable Risk Factors
- Female sex
- Increased age
- Slender, thin-boned body size
- Caucasian and Asian race
- Parental osteoporosis
- Low estrogen in women due to menopause
- Low testosterone in men
- Medical conditions such as rheumatoid arthritis
- Medications such as proton pump inhibitors
Risk Factors for Developing Cancer
Risk factors for developing cancer include the following[8],[9]:
- Modifiable Risk Factors
- Exposure to cigarette smoke
- Ultraviolet (UV) radiation exposure from tanning beds or the sun
- Overweight or obesity
- Drinking too much alcohol
- Infectious disease exposure like human papillomavirus or hepatitis B or C
- Nonmodifiable Risk Factors
- Genetic predisposition
Risk Factors for Developing Mental Health Conditions
Risk factors for developing mental health conditions include the following[10]:
- Modifiable Risk Factors
- Negative life events
- Parents who use drugs, alcohol, or have a mental health condition
- Child abuse or neglect
- Family dysfunction
- Neighborhood poverty or violence
- Nonmodifiable Individual Risk Factors
- Genetic predisposition
- Laws favorable to substance use
- American Heart Association. (2022, December 6). Understand your risks to prevent a heart attack. https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack ↵
- Centers for Disease Control and Prevention. (2022, April 5). Diabetes risk factors. https://www.cdc.gov/diabetes/basics/risk-factors.html ↵
- National Heart, Lung, and Blood Institute. (2022, May 18). Metabolic syndrome - causes and risk factors. https://www.nhlbi.nih.gov/health/metabolic-syndrome/causes ↵
- National Heart, Lung, and Blood Institute. (2022, March 24). Overweight and obesity - causes and risk factors. https://www.nhlbi.nih.gov/health/overweight-and-obesity/causes ↵
- American Lung Association. (2024, January 24). COPD causes and risk factors. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/what-causes-copd ↵
- American Kidney Fund. (n.d.). Risk factors for kidney disease. https://www.kidneyfund.org/all-about-kidneys/risk-factors?gad=1&gclid=Cj0KCQjwjt-oBhDKARIsABVRB0wbjZi8voGxnRVycfGpc4MF80sTQGZZV51jcXWaWDZhlIrm2_jr80MaAl7hEALw_wcB ↵
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2022, December). Osteoporosis. https://www.niams.nih.gov/health-topics/osteoporosis ↵
- CDC - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). (2022, June 7). Cancer. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/cancer.htm ↵
- CDC. (2022, June 30). Cancer - Why do some people get cancer? [Video]. YouTube. https://www.youtube.com/watch?v=fikxfuPvi48 ↵
- Substance Abuse and Mental Health Services Administration. (n.d.) Risk and protective factors. https://www.samhsa.gov/sites/default/files/20190718-samhsa-risk-protective-factors.pdf ↵
Include factors like obesity and smoking and can be reduced by a change in behavior such as healthy diet choices, increased physical activity, and smoking cessation.
Risk factors that cannot be changed by the client and include factors such as age, gender, and family history/genetic predisposition.