Chronic diseases are one of the most common health problems in today’s United States, especially as we move towards the older people through demographic cohorts. The sad truth is that chronic diseases are not only extremely common and very costly (both for the affected person and for the country’s medical system), but they are also hugely preventable, if actions were taken at the right time. The official government statistics* point out that since 2012 to this day, about half of all adults (117 million people) in the U.S. are suffering from at least one form of chronic disease.
The human and financial costs which this places on people’s quality of life and overall well-being, as well as the financial costs and required effort which add up and end up suffocating the medical system are huge. The worst part of it is that people tend to ignore the symptoms until they become too difficult to bear and get the required check-up too late, or they ignore the medical advice they receive altogether, practically renouncing preventative interventions (especially if it requires some life-style changes). Since this is a growing problem that doesn’t seem to be getting any better of late, let us take an in-depth look at the matter, see what the overall picture is and what steps could be taken to alleviate it.
Figures and Facts Round-up on Chronic Diseases
Some of these figures may take you by surprise, if you didn’t suspect the problem was so generalized and costly, but one thing is certain: they all paint a sad picture of the American population’s health*.
- 7 of the top 10 causes of death in 2010 were chronic diseases;
- 2 of these (chronic heart disease and cancer) were the cause of almost half of all U.S. deaths in 2010 (nearly 48%);
- 117 million people (almost half of all adults) have at least one chronic health condition as of 2012;
- In 2009-2010, more than one third of adults (78 million) and one fifth of children and teenagers were already suffering from obesity (one of the leading causes of various chronic diseases);
- Arthritis is the most common cause of disability, a severely life altering condition, which can turn life threatening as well, in time. In 2012, more than 53 million adults were diagnosed with arthritis, and 22 million of them said the condition causes them trouble with daily activities and tasks;
- Diabetes is the most important cause of lower limb amputations, kidney failure, and new cases of adult blindness;
- In 2010, cancer care costs rose to $157 billion and heart disease and stroke costs rose to $315.4 billion;
- More than a half of all U.S adults have one or more risk factors for life threating chronic disease: they smoke, they eat too much sodium (over 90% of adults) which leads to hypertension, or they don’t follow diet and exercise guidelines from nutritionists and so on.
The facts and figures presented above only refer to the American population, a landscape where things aren’t overall as bad as they can get in the underdeveloped regions of the world. At least our health care system, despite its policy-related and financial shortcomings, is overall a functional and decent one. But if we take a look at what is going on in countries like India or China in matters of chronic untreated diseases and debilitating illnesses, things are really far worse at the global scale than what we’d like to imagine.
Top 10 Most Common Chronic Diseases
Of all the chronic diseases that affect today’s American population, these 10 are the most common and most costly, both to the individual and the medical system. This is what you need to know about each of them, in just a few phrases (including symptoms, prevention, and disease management and so on.)
1. Chronic Heart Disease
One of the deadliest conditions and a silent killer, chronic heart disease is easy to miss in its initial stages. Although the condition encompasses several separate heart conditions (like mild ischemic heart disease or maxillary ischemic heart disease), it can be treated as a single condition for almost all purposes. Also called congestive heart failure, the condition affects people by slowly diminishing the strength of their heart, making it pump less blood and at a weaker pace, or causing them to become hypertensive. The affected person may notice that they suffer from fatigue and occasional bouts of arrhythmia, and if left untreated, the symptoms will begin to include a decreased kidney function, water retention and the congestion of the ankles, limbs and other body parts (hence the name of congestive heart failure). This inflammation becomes painful and cumbersome, and the disease is the leading cause of hospitalization for people aged 65+. Other underlying conditions (such as diabetes), microvascular disease or a sudden stroke may cause the affected person to develop this disease as well. The prevention of chronic heart disease must include a heart-friendly, low-sodium diet and a moderate amount of exercise as a mandatory life-style.
Although cancer is arguably not a chronic condition per se, but could also be considered an acute disease (depending on how fast and how aggressively it is spreading), most medical statistics include it on the list of chronic conditions, because its symptoms and manifestations require the same kind of care as the final stages of classic chronic diseases. The official definition of cancer states that it is a malignant tumour or neoplasm which leads to abnormal cell growth. This uncontrolled cell growth eventually invades the other regions and parts of the body, compromising its normal functions. The World Health Organisation report for 2014 states that cancer accounted for 8.2 million deaths (14.6% of all human deaths) at global level that year. While cancer can be treated successfully if detected in its initial stages, prevention should be everyone’s priority. Any medical specialist can testify that including fruit and vegetables into your diet, exercising, as well as diminishing the use of tobacco and alcohol can reduce the risk of cancer to a minimum. Vaccinating against a few infectious diseases (such as HPV – the Human Papiloma Virus) has also been proven to significantly reduce the risk of cancer.
3. Chronic Kidney Disease
Also called chronic renal disease, this illness affects people by diminishing their kidney function permanently, either as the result of other complications (such as diabetes or high blood pressure), one’s genetic background, or poor lifestyle choices (improper dieting or substance abuse). If the strained kidney function is temporary, the case can be safely labelled as acute kidney disease (usually treatable with common medications), but if the problems persist for longer than three months, the disease is chronic. It has 5 stages: in stage I the symptoms are uncomfortable, but they allow the person to go about their daily activities, in stages II and III things gradually become worse (with potential complications such as severe chronic anemia or cancer), in stage IV the doctors already recommend preparing for kidney transplant, and in stage V (also called the end stage) the kidneys effectively shut down, urging for dialysis and an immediate transplant. Stage 5 brings with it a pretty pessimistic prognosis, with low life expectancy, and requires permanent hospital care. If you know you are at increased risk of chronic kidney disease, following an appropriate diet (ask your doctor for kidney friendly recipes) and testing yourself by getting regular kidney screenings is recommended.
4. Chronic Lyme Disease
This chronic disease is still somewhat controversial in the medical world, but its symptoms encompass the aftermath of Lyme disease, namely a broad array of illnesses connected to the main disease itself long after the infection with B. burgdorferi has passed. The bottom line is that there are more and more reputable studies which state that these symptoms which exist undisputedly can be rounded up into the chronic Lyme disease syndrome, and people who are affected by it receive the medical care they need in hospitals nation-wide. One of the traditional ways to treat Lyme’s disease is by prescribing long-term antibiotics, but most doctors now advise against this course of treatment, since more than one study has revealed this can lead to chronic symptoms thereafter.
5. Chronic Obstructive Pulmonary Disease (COPD)
This chronic diseases, also called chronic obstructive lung disease, starts with a few signs that may resemble the cough which remains after a common cold, but that doesn’t quite pass. The list of typical symptoms includes shortness of breath, a permanent mild cough and generalized respiratory difficulty. The symptoms worsen with time, leading to the person’s incapacity to breathe properly on their own, or to related complications. This disease killed 2.9 million people in 2013 and currently affects 329 million people, the equivalent of 5% of the global population. As for the causes of these diseases, the main culprit is smoking, followed by pollution and genetics – in a smaller proportion. If you get a diagnosis of chronic obstructive pulmonary disease and you are a smoker, wasting more time before deciding to quit can shorten your life expectancy dramatically.
This chronic disease is defined as high blood sugar values in the affected person’s bloodstream, over long periods of time. The person is unable to effectively metabolize the sugar from the carbs they ingest, leading to dangerous blood sugar spikes. Treating this disease usually involves taking in some extra insulin, either in the form of pills or shots, a substance which the pancreas is no longer able to produce on its own. Even so, diabetes symptoms worsen with time, leading to a permanent deficiency of iron (chronic anemia) and a whole array of complications, including the loss of lower limbs and the risk of hemorrhage. Though diabetes cannot be cured, there are two pieces of good news: first of all, you can prevent the disease even if you are genetically predisposed to develop it, by being careful with the kinds of food you eat and steering clear of sugar. Second of all, the advances made by medicine in the past few years really allow diabetics to lead an almost normal life (with a less restrictive menu plan, but just some few foods which are best left avoided).
7. Alzheimer’s Disease, Dementia and other degenerative diseases
Dementia is defined as a whole array of brain diseases, which slowly progress and affect the patient’s memory, ability to think, speak and other basic neurological functions, although the person’s consciousness has been proven to remain intact. Alzheimer’s disease is responsible for about 60-70% of the total cases of dementia. Other chronic diseases which cause the same symptoms are vascular dementia (where any blood vessel can start having a low performance, leading to decreased neurological functions), Parkinson’s disease etc. Having other underlying conditions (such as obesity, diabetes or high blood pressure), smoking or being genetically predisposed are all risk factors. The prevention of the disease includes maintaining cognitive activity (like trying to learn a new foreign language even in your old age), not smoking, leading a healthy life and possibly staying away from products which contain aluminium.
Obesity is defined as a medical condition where the percentage of body fat has become so great that it poses a risk to the patient’s health. Obesity is easy to determine through the calculation of the person’s BMI (Body Mass Index), but it should be noted that the standards by which a person is considered overweight (half-way obese) and obese are much less strict in the U.S and Western countries in general than they are in some Asian countries. The way in which obesity affects your health is by making all physical activity harder, giving you shortness of breath and putting more pressure on your heart’s activity and making your blood flow less efficient. Furthermore, obesity doesn’t cause only these discomforting symptoms, but is also a risk factor for a lot of other life-threatening chronic diseases: heart disease, type 2 diabetes, various types of cancer, osteoarthritis, obstructive sleep apnea and so on. The only effective way to prevent obesity is to have a better nutrition plan: try not to exceed the recommended food intake, choose low calorie, healthier foods and exercise moderately.
9. Osteoporosis and Arthritis
These two chronic diseases will be paired together for the purpose of this article because you can define both of them as a progressive inflammatory or degenerative disease of bones and joints, respectively. Both diseases are debilitating and affect seniors in a greater proportion than youths. There is no way to cure them, just small ways to provide a bit more comfort to the patient, but the exacerbation of symptoms is expected in time. The pathophysiology of osteoporosis affects women more than men, and makes the mineral richness of the bone structure become more and more frail, leading to brittle bones, frequent fractures which may never heal, as well as humps and other deformations in due time. The deformation can occur in the related disease of arthritis, which develops as a rheumatic syndrome at first, making each affected joint painful to use and with a gnarled appearance. If you take a look at any chart of examples of how these chronic diseases, you’ll realize how difficult to manage the lives of the affected elderly can become. Prevention should be anyone’s priority, and although the diseases can’t be completely averted, exercising, staying away from the cold and supplementing your calcium intake are highly recommended paths.
10. Chronic Liver Disease
Chronic liver disease can consist of chronic hepatitis, hepatocellular carcinoma, fibrosis or cirrhosis, but all of these affections involve the progressive destruction of the liver’s parenchyma and a decreasing liver function. Some of these are caused by catching a pathogen from the environment, but others (mainly cirrhosis) are a direct consequence of the lifestyle and the over-consumption of alcohol. The symptoms include the body slowly filling with toxins as the liver becomes progressively unable to filter them from the affected person’s system. By stage 3 and 3b, the patient needs to be put on the liver transplant list as soon as possible, and if they go into liver failure, they can only survive for a few days, even with medical assistance, making the finding of a viable liver even more urgent. The best way to prevent chronic liver disease is, yet again, to attempt a healthier lifestyle, with healthier food options and non-alcoholic drinks.
All of the above** are not only costly and difficult to manage, but if they are given a chance to progress beyond an initial point of no return, they will all become harder and harder to handle, until the discomfort becomes too great to allow a normal life rhythm and the affected person has to be committed to professional disease managing centres (nursing homes). Medical treatment can only do so much, and all it can do in cases where the disease has already installed is to make its progression slower. If people would focus more on preventing or even on applying a cure in the initial stages, the disease would be in many cases reversible.
The research of further treatments and management ideas for chronic diseases should be a priority, but not at any cost. We should remember the horrors of the past programs (see the 1963 Jewish Hospital for chronic diseases controversy), but furthermore, more attention should be directed towards providing everyone with an easy to follow healthy lifestyle model. The promotion of real, complex but easy to apply guidelines for a better diet and life program could mean a huge difference in the lives of so many, and also contribute to cutting down the costs brought on by chronic diseases. Such an initiative would help everyone realise that a good example and the spreading of an authentic health culture not only saves lives, but makes all lives better and freer from illness, disability and pain.
Further Considerations and Resources
A special case to consider is the situation of premature babies: when the pregnancy is cut short for various reasons and the child is delivered before full term, the risk for chronic diseases to be developed by the infant dealing with prematurity is greatly increased. Preemies require special intensive care and, unfortunately, even so, they tend to be affected by chronic diseases, making up for most of the national numbers of cases of chronic disease in children. Besides the usual early pregnancy screenings, we recommend also researching how does living with dogs and cats affect the mother’s blood and the baby’s risk for toxoplasmosis (yes, we love pets too, and wouldn’t directly advise against having them indoors).
When you apply for specialized health care (or the Chronic Disease Fund), some of the centers you are seeking help from may require you to fill out the ICD9 code for the chronic disease or health problem you need help with. These codes – International Statistical Classification of Diseases and Related Health Problems – are the international standard codes for each health problem, something like a universal medical language. You can find a complete list of ICD 9 codes here, to make your searches easier.
Another useful resource to look into is the University of Stanford’s Chronic Disease Self Management Program, which can help people dealing with chronic diseases become more independent in their daily activities. Usually, living with chronic disease means requiring more and more assistance as the disease’s staging progresses, with maybe a few good days from time to time. Therefore, any self-management program is a more than welcome tool in the lives of chronic disease patients.
*According to the U.S. Government’s CDC (Centre for Disease Control and Prevention), http://www.cdc.gov/chronicdisease/overview/
**We should further note that there are still devastating diseases which have not been including in our list above (such as the chronic granulomatous disease or the still controversial chronic wasting disease in humans, taken from the deer disease of the same name) for space considerations. The bottom line is that chronic diseases are the most preventable of all of humanity’s horrible illnesses (except the acute diseases which have become easy to manage and eradicate with vaccines), and if more focus would be directed towards prevention, the world would really become at least a bit of a better place.