Chronic disease: A disease that persists for a long time. A chronic disease is one lasting 3 months or more, by the definition of the U.S. National Center for Health Statistics. Chronic diseases generally cannot be prevented by vaccines or cured by medication, nor do they just disappear. Eighty-eight percent of Americans over 65 years of age have at least one chronic health condition (as of 1998). Health damaging behaviors – particularly tobacco use, lack of physical activity, and poor eating habits – are major contributors to the leading chronic diseases.
Chronic diseases tend to become more common with age. The leading chronic diseases in developed countries include (in alphabetical order) arthritis, cardiovascular disease such as heart attacks and stroke, cancer such as breast and colon cancer, diabetes, epilepsy and seizures, obesity, and oral health problems. Each of these conditions plague older adults in the US (and other developed nations).
Arthritis and related conditions are the leading cause of disability in the US affecting nearly 43 million Americans. Although cost-effective interventions are available to reduce the burden of arthritis, they are underused. Regular, moderate exercise offers a host of benefits to people with arthritis by reducing joint pain and stiffness, building strong muscle around the joints, and increasing flexibility and endurance.
Cardiovascular disease is a growing concern in the US. Heart disease is the nation’s leading cause of death. Three health-related behaviors tobacco use, lack of physical activity, and poor nutrition–contribute markedly to heart disease. Modifying these behaviors is critical for both preventing and controlling heart disease. Modest changes in one or more of these risk factors among the population could have a profound public health impact.
Cancer is the second most common cause of death in the US. Cancer is largely controllable through prevention, early detection, and treatment. Reducing the nation’s cancer burden requires reducing the prevalence of the behavioral and environmental factors that increase cancer risk. It also requires ensuring that cancer screening services and high-quality treatment are available and accessible, particularly to medically underserved populations.
Colorectal canceris the second leading cause of cancer-related deaths in the US, accounting for 10% of all cancer deaths. The risk of developing colorectal cancer increases with advancing age. Lack of physical activity, low fruit and vegetable intake, a low-fiber diet, obesity, alcohol consumption, and tobacco use may contribute to the risk for colorectal cancer.
Three screening tools flexible sigmoidoscopy, colonoscopy, and the fecal occult blood test (FOBT) are widely accepted and used to detect colorectal cancer in its earliest stages, when treatment is most effective. In 1999, 66% of Americans aged 50 years or older reported not having had a sigmoidoscopy or colonoscopy within the last five years, and 79% reported not having had a fecal occult blood test within the last year.
Breast canceris best detected in its earliest, most treatable stage by mammography. Seventy-six percent of all diagnosed cases of breast cancer are among women aged 50 years or older.
What can I do to help?
If you care about someone in chronic pain, you probably want to help. But many people aren’t quite sure how to go about it, and sometimes a general offer of “Let me know what I can do” isn’t enough.So we asked four people affected by rheumatoid arthritis (RA) about the nicest things that friends and family have done for them. If you have a loved one with RA or any other chronic disease, read on. You’ll be sure to find a few new ways to show you care.
Chronic Diseases: The Leading Causes of Death and Disability in the United States
Chronic diseases and conditions such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis are among the most common, costly, and preventable of all health problems.
- As of 2012, about half of all adults 117 million people had one or more chronic health conditions. One in four adults had two or more chronic health
- Seven of the top 10 causes of death in 2014 were chronic diseases. Two of these chronic diseases heart disease and cancer together accounted for nearly 46% of all deaths.
- Obesity is a serious health concern. During 2011–2014, more than one-third of adults (36%), or about 84 million people, were obese (defined as body mass index [BMI] ≥30 kg/m2). About one in six youths (17%) aged 2 to 19 years was obese (BMI ≥95th percentile).
- Arthritis is the most common cause of disability. Of the 54 million adults with doctor-diagnosed arthritis, more than 23 million say they have trouble with their usual activities because of arthritis.
- Diabetes is the leading cause of kidney failure, lower-limb amputations other than those caused by injury, and new cases of blindness among adults.
Health Risk Behaviors that Cause Chronic Diseases
Health risk behaviors are unhealthy behaviors you can change. Four of these health risk behaviors lack of exercise or physical activity, poor nutrition, tobacco use, and drinking too much alcohol cause much of the illness, suffering, and early death related to chronic diseases and conditions.
- In 2015, 50% of adults aged 18 years or older did not meet recommendations for aerobic physical activity. In addition, 79% did not meet recommendations for both aerobic and muscle-strengthening physical activity.
- More than 1 in 3 adults (about 92.1 million) have at least one type of cardiovascular disease.8About 90% of Americans aged 2 years or older consume too much sodium, which can increase their risk of high blood pressure.
- In 2015, more than 37% of adolescents and 40% of adults said they ate fruit less than once a day, while 39% of adolescents and 22% of adults said they ate vegetables less than once a day.
- An estimated 36.5 million adults in the United States (15.1%) said they currently smoked cigarettes in 2015.Cigarette smoking accounts for more than 480,000 deaths each year. Each day, more than 3,200 youth younger than 18 years smoke their first cigarette, and another 2,100 youth and young adults who smoke every now and then become daily smokers.
- Drinking too much alcohol is responsible for 88,000 deaths each year, more than half of which are due to binge drinking.US adults report binge drinking an average of 4 times a month, and have an average of 8 drinks per binge, yet most binge drinkers are not alcohol dependent.
The Cost of Chronic Diseases and Health Risk Behaviors
In the United States, chronic diseases and conditions and the health risk behaviors that cause them account for most health care costs.
- Eighty-six percent of the nation’s $2.7 trillion annual health care expenditures are for people with chronic and mental health conditions. These costs can be reduced.
- Total annual cardiovascular disease costs to the nation averaged $316.1 billion in 2012–2013. Of this amount, $189.7 billion was for direct medical expenses and $126.4 billion was for lost productivity costs (from premature death).
- Cancer care cost $157 billion in 2010 dollars.
- The total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity. Decreased productivity includes costs associated with people being absent from work, being less productive while at work, or not being able to work at all because of diabetes.
- The total cost of arthritis and related conditions was about $128 billion in 2003. Of this amount, nearly $81 billion was for direct medical costs and $47 billion was for indirect costs associated with lost earnings.
- Medical costs linked to obesity were estimated to be $147 billion in 2008. Annual medical costs for people who were obese were $1,429 higher than those for people of normal weight in 2006.
- For the years 2009–2012, economic cost due to smoking is estimated to be at least $300 billion a year. This cost includes nearly $170 billion in direct medical care for adults and more than $156 billion for lost productivity from premature death estimated from 2005 through 2009.
- The economic costs of drinking too much alcohol were estimated to be $249 billion, or $2.05 a drink, in 2010. Most of these costs were due to binge drinking and resulted from losses in workplace productivity, health care expenses, and crimes related to excessive drinking.
More Nice Things You Can Do for Someone in Pain
Make shots less painful
When Elizabeth Gallo, 41, a yoga teacher and mother of two, was preparing to take an injectable medication, her future husband went along with her to the injection training.
Even though he never wound up giving her the shots, Gallo says, just having him there made a big difference. “For some reason, it really took the pressure off,” she says. “It wasn’t as scary.”
Support their dietary choices
As part of dealing with RA, Gallo avoids any type of food that seems to make inflammation worse, such as dairy or tomatoes. Her husband stands by her on the food front, too.”He not only was willing to eat with me, but he also learned about those things too, so he wouldn’t bring home frozen yogurt,” she says.
Alison Whitehead, 48, a marketing specialist and mother in Sydney, Australia, says one of the nicest things someone did for her was walking at her pace. She took some group walks when her knees were just too sore to keep a faster pace, and people would give her a shoulder to lean on when she couldn’t walk on her own. She’s also appreciated people “not laughing when I’m taking stairs on my bottom,” not to mention “waiting patiently when buttons and hooks are just too fiddle-y.”
Make a bed or two
Changing the sheets is one of those essential household tasks that can be daunting when you’re in the throes of an RA flare-up.”When I was in heaps of pain, the thought of changing fitted sheets and sorting out the buttons or snaps on a duvet cover made me turn cold,” says Nina McLean, a 31-year-old midwife in Melbourne, Australia.
Don’t ask, just do it
Actions do speak louder than words. So don’t ask what you can do; just go for it.
“Don’t just offer help,” says Jean P., 52, a church secretary from Illinois. “We will probably refuse. Come over with a vacuum and mop in hand and ask where to start.”
Learn and believe
If someone you love has RA, he or she will appreciate your efforts to understand the illness. It’s important to know that a person with RA may not look sick but still be in pain.
“It wasn’t until I was practically lame from hip pain that people saw I had an issue,” says Jean, who fondly remembers when a friend researched RA on her own until she “truly understood” what Jean was going through.
Make a meal
Dropping off dinner for a friend with RA is a great way to make sure she has a relaxing, enjoyable evening with her family, eating healthy food instead of ordering takeout or struggling over jars, pots, and pans.
When you’re making a run to the grocery store or farmers’ market, ask if your neighbor with RA needs anything. Or if you see something you know she’d like, just pick it up for her.
Help with the kids
Caring for children can be exhausting if you’re in perfect health, and it’s especially challenging for people with RA.”Take our kids at times and allow us to truly rest,” says Jean. When she volunteered at her children’s school, Whitehead appreciated it when people chose jobs for her that weren’t physical, so she wouldn’t feel left out; she also welcomed friends who would help her by lifting her children in and out of the car on the way to and from nursery school.
Give a lift
Offering someone with RA a ride can be a great help, says Gallo. “For a lot of people, one of the first things that hurts is their big toe joint or their ankle joint, so walking is really painful, so a ride is really appreciated.”
Lend a hand
When Deniya Davis’s hands stopped working, her mom was thinking ahead. “She would break the seal on all my bottles then put them back in the fridge,” says Davis. When someone is having trouble with their hands and fingers, Gallo adds, “any sort of help with writing or typing could be huge.”You could even offer to dry someone’s hair for them if they have to struggle just to lift their arms.
Heating pads and hot water bottles are lifesavers for people with joint pain and stiffness. They make a great gift for someone with RA, especially when they have a personalized twist, says Gallo. Jane Snyder, 47, a stay-at-home mom from Kansas, sewed heating-pad holders for her 17-year-old daughter to wear around her wrists. She made them in two sizes to match the heating packs she found, and they would stay warm for 20 hours or more at a time.
“They were made with love because I really don’t sew, but they worked,” she says. “I even used Care Bear material to make it better!”
Ease into exercise
If a loved one with RA is up for it, accompany him to a gentle yoga class or give him a gift certificate for a similarly easy workout, Gallo says.”It really can change a person’s whole mind-set about the disease and provide some serenity,” she adds.
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