Uncertain Health in an Insecure World - 10

“Bored to Death”

Circa 2000, a groggy post-Millennium world awoke to a chronic disease pandemic.

Unless you’re a global public health maven, there hasn’t been a lot of excitement about this rapidly expanding threat.



The World Health Organization (WHO) calls chronic diseases ‘non-communicable diseases’ (NCD). Dr. Douglas Bettcher, WHO Director of NCD Prevention & Control, recently warned us that, “In this globalized world, we cannot isolate ourselves… from either Ebola or NCD’s”.

Unlike Ebola, you can’t “catch” a chronic disease.

Chronic diseases are defined as incurable illnesses present for >1 year that require ongoing medical care and that may affect a person’s daily life. The main chronic diseases are coronary heart disease & stroke, type-2 diabetes, cancer and chronic lung disease.

Boring!!!

But in 2005, the Agency for Healthcare Research & Quality (AHRQ) reported that 80% of American >50 years old had one chronic disease – that adds up to >60 million Americans. In 2005, the World Health Organization (WHO) estimated that 35 million people would die of chronic diseases, and projected that figure would increase to 41 million by 2015!

Once a chronic disease causes organ damage, it’s almost impossible to reverse.

The longer people around the world live, the greater their proclivity towards one or more vital organs – heart, lungs, pancreas, liver and bone marrow – failing them. We have discussed “brain failure”. More than 83% of dementia patients also suffer the profound effects of co-existing chronic medical conditions during the average 7-10 years before death.

Associated health care costs adversely affect undeveloped country economic growth & development, thwarting aspirations of developed nation status.

Once largely the selective burden of developed nations, chronic diseases are now negatively transforming the less developed world. This growing scourge visits 80% of global chronic disease deaths on low and middle income countries. In poor countries, maternal-fetal malnutrition and low birth weight predict future chronic diseases.

Of Americans aged >70 years, 90% have at least one chronic disease.

Developed nation health care systems burdened with the rising cost of caring for patients living with chronic diseases are actively exploring the potential benefits of chronic disease prevention. Singapore spends only 5% of GDP on health care by focusing on social interventions in their 70 year old “Auntie Jane” population.

Nepalese public health educator/advocate, Lonim Prasai Dixit, espouses the WHO ‘ABCDE’ life plan for reducing the burden of chronic disease – Avoid alcohol, Be physically active, Consume limited salt & sugar, Don’t use tobacco, and Eat plenty of fruits & vegetables.

Sounds quite simple…

But it’s incredibly difficult (and often financially unfeasible) to motivate seemingly un-sick, asymptomatic people to adopt these lifestyle changes.

Other experts call chronic diseases “lifestyle diseases”.

Wherever you live on Earth, the wear & tear of life (high blood pressure, type-2 diabetes, environmental & ingested toxins, and obesity) is taking its toll.

The chronic disease behemoth is steadily advancing on The Square.

High time to wake up!