“There is simply no justification for chronic disease to continue to take millions of lives prematurely each year when the understanding of how to prevent these deaths is available now.”
-Dr. JoAnne Epping-Jordan, Senior Program Adviser, Chronic Diseases and Health Promotion, World Health Organization
The United States of America is one of the richest countries in the world. Financial prosperity should have translated to health prosperity, but it hasn’t. We are not only the richest, we are also the sickest.
Collectively, chronic disease is the leading cause of death and disability worldwide. The definition of chronic disease per the U.S. National Center for Health Statistics is a disease that persists for a long time, lasting at least three months or more. These diseases can generally not be prevented by vaccines or cured by medication, nor do they just disappear or resolve on their own. Chronic diseases include but are not limited to these top ten most prevalent conditions: cancer, heart disease, COPD (chronic obstructive pulmonary disease) and allied conditions, Alzheimer’s disease and other dementias, high blood pressure, diabetes, stroke, depression, arthritis, and osteoporosis.
Chronic diseases affect approximately 133 million Americans, more than 40% of the total population. By 2020, that number is expected to grow to an estimated 157 million, with 81 million having multiple conditions. Chronic disease was responsible for seven out of the ten top causes of death in 2009, with heart disease and cancer accounting for more than half of all deaths. In light of these statistics, it is shocking to learn that only 56% of those with chronic conditions received the recommended preventative healthcare services, according to a study in the New England Journal of Medicine.
Take note here. This is important. Inflammation underlies all chronic disease. Learn more about the causes and consequences of chronic inflammation in my article “Think Pro-Immunity, NOT Anti-Inflammation”. Now let’s continue.
Excess weight is a known risk factor for almost every chronic disease, as well as a 2-fold increase in the risk of death. It is arguably the most critical healthcare crisis we face. Today, the average American is carrying around 1/5th more body fat, equivalent to 3 gallons or so of flab, than in 1970. At least two thirds of obese people have an obesity-associated disease. Currently, 75% of Americans are overweight or obese, and that number is expected to be 100% by 2030, if current trends continue.
What’s even more shocking is the cure for obesity (and chronic disease) is known – eat the right foods, move more, and stress less. The Standard American Diet (SAD, an apt acronym) is characterized by high intake of animal protein, sugar, and processed or refined foods combined with little or zero intake of nutrient-rich foods. Despite this knowledge, many continue to eat this way while remaining inactive, a deadly – literally – combination.
The surgeon general reports that each year 300K deaths are caused by or related to obesity. Diabetes, an obesity-associated condition, has risen by a third since 1990, costing our society $100 billion a year, as well as more lost work days and healthcare costs than any other disease. Obesity wreaks havoc on the development of degenerative conditions, costing billions of dollars to symptomatically manage and reduce the risk of further complications. Instead of reactively managing the effects of obesity, we could be preventing them by treating their known causes – poor diet, inactivity, and unmanaged stress.
Are you a healthy weight? Take note again – you don’t have to be overweight or obese to be chronically inflamed and suffer the complications of the SAD and other unhealthy lifestyle choices. If you are struggling with a chronic symptom or disease, there is ongoing, chronic inflammation that needs to be addressed in order to heal. Many of my patients were not overweight before implementing the positive behavior changes discussed on DrDWellnessAddict.com. Whether to treat disease or simply to live well, adopting a healthy lifestyle has positive benefits – for everyone.
Unhealthy lifestyle habits and associated weight gain increase the risk for more than just chronic disease. They have been associated with less productivity at work and school, increased hyperactivity among children and adolescents, and mood swings, all of which heighten feelings of stress, isolation, and insecurity. Even basic quality of life concerns are affected, such as constipation, resulting in Americans spending $600 million annually on laxatives. Over time, unhealthy habits increase the rates of depression, fatigue, and hypertension (high blood pressure), to name a few, as well as the risk of death – in all age, ethnic, and gender groups.
Research suggests if Americans adopt the lifestyle habits known to prevent and treat chronic disease, they could lose an average of 20 lbs, suffer half the rate of heart disease, 1/5th the rate of diabetes and certain cancers, and add 8 more years to their lives. Articles like this one in the New York Times, titled “To Treat Chronic Ailments, Fix Diet First,” are helping to increase awareness that for most patients (and I would argue all), lifestyle choices such as nutrition should be the first medicine prescribed.
If all this is known, why is the chronic disease crisis only increasing? The answer is systemic and multifactorial. Addressing these issues requires more time to educate and a different way of educating, beginning in the medical classroom all the way to the patient visit with the doctor. There is a lack of time in an average doctor’s appointment to discuss these changes. Insurance companies rarely reimburse physicians for the time needed, or for preventative services that would make these choices affordable and easy to implement for the average person.
The problem extends as deep as medical education. Cutting edge, scientific research on the choices we make and their effects on disease, as well as practical ways to apply that data to change health, are generally not included in the educational curriculum for physicians and other healthcare providers. How, then, can this information be included in the average treatment plan for patients?
The good news is that the movement to make wellness synonymous with healthcare by addressing lifestyle choices is more powerful than ever before. Wellness websites like mindbodygreen.com have created community-based education platforms making it easier to start and maintain your wellness journey. Physician experts pioneering the medical profession, such as Drs. Steven Gundry, Dean Ornish, and Mark Hyman, to name some of my favorites, are ensuring that the latest and greatest science gets to the people. Even insurance companies have dipped their toes into the prevention pond. Some now cover treatments such as acupuncture, or offer positive incentives for getting your preventative wellness checks.
Yet the road ahead is long. We still rely heavily on pills, rotating in and out of doctors offices and hospitals in order to maintain health. The increase in addiction and suicide complicates the wellness movement further. After a consistent yearly increase over a 50 year period, mortality has not declined/increased for the third year in a row. The CDC attributes this to the all time high rate of suicide and overdose.
Whether we are addicted to drugs, sugar, or something as fundamental as negative self-thought, we are a society that has perfected living with illness, dependent on the benefits of Western Medicine. We are great at keeping people living, but at what cost? We have to find a better way to live well, and a better way to live happy. We must change our Western Medical Model (WMM), and we start by empowering the people with knowledge.
In addition, the biggest challenge to successful behavior change must be overcome – sustainability. For the WMM to move to prevention, the way we teach healthcare providers to deliver the information needs to be practical, affordable, enjoyable, and as simple as possible. The data show behavior change programs such as dietary interventions do not fail – their permanent implementation does. To be successful in changing the future of our health, we must find a way to make our system generalizable to all individuals who want to learn to live well.
This is the mission of DrDWellnessAddict.com, to bring forward cutting edge science to anyone with curiosity and internet access, while offering practical, generalizable, enjoyable and sustainable suggestions to effectively change one’s behavior – no matter where you live or how old or sick you are.
References
- https://www.who.int/chp/chronic_disease_report/en/
- https://www.cdc.gov/chronicdisease/index.htm
- https://www.cdc.gov/mentalhealth/data_publications/index.htm
- National Center for Health Statistics, Centers for Disease Control and Prevention. (2013) Summary Health Statistics for the U.S. Population: National Health Interview Survey, 2012. Accessed at http://www.cdc.gov/nchs/data/series/sr_10/sr10_259.pdf
- Centers for Disease Control and Prevention. The Power of Prevention. (2009) Accessed at http://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf
- Tackling the burden of chronic diseases in the USA. Lancet 2009;373(9659):185. Accessed at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60048-9/fulltext
- Centers for Disease Control and Prevention. Chronic Diseases and Health Promotion. Accessed at http://www.cdc.gov/chronicdisease/overview/
- Centers for Disease Control and Prevention, National Center for Health Statistics. Chartbook on trends in the health of Americans. Limitation of activity: Children. (2007) Accessed at http://www.cdc.gov/nchs/data/hus/hus07.pdf
- Agency for Healthcare Research and Quality. Multiple Chronic Conditions Chartbook: 2010 Medical Expenditure Panel Survey Data. (2014) Accessed at http://www.ahrq.gov/professionals/preventionchronic-care/decision/mcc/mccchartbook.pdf
- Centers for Disease Control and Prevention. The Power to Prevent, The Call to Control. (2009) Accessed at http://www.cdc.gov/chronicdisease/resources/publications/AAG/chronic.htm
- McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. New England Journal of Medicine, (2003) 348:2635-264. Accessed at http://www.nejm.org/doi/full/10.1056/NEJMsa022615
- Centers for Disease Control and Prevention. The Power to Prevent, The Call to Control (2009). Accessed at http://www.cdc.gov/chronicdisease/resources/publications/AAG/chronic.htm
- Stanton MW. The High Concentration of U.S. Health Care Expenditures. Research in Action, Issue 19. AHRQ Publication No. 06-0060 (2006) Accessed at http://www.ahrq.gov/research/ria19/expendria.htm
- R. DeVol and A. Bedroussian, An Unhealthy America: The Economic Burden of Chronic Disease. Milken Institute. (2007) Accessed at http://www.milkeninstitute.org/pdf/ES_ResearchFindings.pdf