Chronic Disease

Original Editor - Lucinda hampton Top Contributors - Lucinda hampton and Kim Jackson

Introduction

Smoking-1026556 960 720-2.jpg

A chronic disease/ non communicable disease (disease that persists for a long time) 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).[1]
  • Globally, of the 58 million deaths in 2005, approximately 35 million will be as a result of chronic diseases. They are currently the major cause of death among adults in almost all countries and the toll is projected to increase by a further 17% in the next 10 years.[2]
  • Globally, approximately one in three of all adults suffer from multiple chronic conditions.[3]
  • Health damaging behaviors - particularly tobacco use, lack of physical activity, and poor eating habits - are major contributors to the leading chronic diseases. Obesity incidences are increasing worldwide, and incidence of type 2 diabetes is growing
  • Chronic diseases tend to become more common with age.

The leading chronic diseases in developed countries include (in alphabetical order) arthritis, cardiovascular disease eg.heart attacks and stroke, cancer eg breast and colon cancer, diabetes, epilepsy and seizures, obesity, and oral health problems. Each of these conditions plague older adults.

This rise in CDs is a very serious situation, both for public health and for the societies and economies affected. Until recently, the impact and profile of chronic disease has generally been insufficiently appreciated.[2]

This video (less than 3 minutes) is good viewing.

[4]

Characteristics of a Chronic Diseases

Overweight biker.jpg

Chronic illnesses are mostly characterised by:

  • complex causes
  • many risk factors
  • long latency periods (time between onset of the illness and feeling its effects)
  • a long illness
  • functional impairment or disability.

Most chronic illnesses do not fix themselves and are generally not cured completely.

  • Some can be immediately life-threatening, such as heart disease and stroke.
  • Others linger over time and need intensive management, such as diabetes.
  • Most chronic illnesses persist throughout a person’s life, but are not always the cause of death, such as arthritis.[5]

Common Chronic Diseases

Depression opioid.JPG

While many illnesses can be considered chronic, 13 major chronic conditions that are a significant burden in terms of morbidity, mortality and healthcare are[5]:

Common stresses of Chronic Diseases

Chronic or long-term illness and its treatment pose special problems. People living with CD need to

  • deal with the treatments
  • make sure understand the condition and management strategies
  • maintain emotional balance to cope with negative feelings
  • maintain confidence and a positive self-image.[5]

Comorbidity of CDs

Comorbidity refers to the occurrence of two or more conditions or diseases in a person at one time. Chronic conditions often occur together.

In Australia, like many nations, the rate is higher for:

  • people aged 65 and over (60%) compared with people aged 0–44 (9.7%)
  • females (25%) compared with males (21%)
  • people in the lowest socioeconomic areas (30%) compared with those in the highest socioeconomic areas (19%)
  • people living in Regional and Remote areas (28%) compared with those in Major cities (21%).

The most common combination—or comorbidity—is arthritis with cardiovascular disease (7.4%), followed by arthritis with back pain and problems (5.1%), and back pain and problems with cardiovascular disease (5.0%).

Some chronic diseases may act as a precursor or as a risk factor for other chronic diseases. eg diabetes is known to be a risk factor for developing cardiovascular disease; asthmatics are at greater risk of developing chronic obstructive pulmonary disease later in life.[6]

Management / Interventions

Chronic Diseases – including cardiovascular diseases, cancer, chronic respiratory diseases and diabetes – kill 41 million people every year. Prevention and investment in CDs is important.

  • Investing in better management of CDs is critical.
  • Management of CDs includes detecting, screening and treating these diseases, and providing access to palliative care for people in need.
  • High impact essential CD interventions can be delivered through a primary health care approach to strengthen early detection and timely treatment.
  • Evidence shows such interventions are excellent economic investments because, if provided early to patients, they can reduce the need for more expensive treatment.
  • Countries with inadequate health insurance coverage are unlikely to provide universal access to essential CD interventions.
  • CD management interventions are essential for achieving the global target of a 25% relative reduction in the risk of premature mortality from CDs by 2025, and the SDG target of a one-third reduction in premature deaths from CDs by 2030.[2]

Conclusion

Chronic diseases are already the major cause of death in almost all countries, and the threat to people’s lives, their health and the economic development of their countries is growing fast.

  • Chronic diseases are the leading cause of death and disease burden worldwide, in all WHO regions except Africa.
  • Chronic diseases are the leading cause of death in all World Bank income groups (four income groups — high, upper-middle, lower-middle, and low).
  • The death and burden of disease rates are similar in men and women and increase with age.
  • Chronic disease death rates are higher in low and middle income countries than in high income countries.
  • Some 45% of chronic disease deaths and 86% of the burden of chronic diseases occur in people under 70 years of age
  • The knowledge exists to deal with this threat and to save millions of lives.
  • Effective and cost-effective interventions, and the knowledge to implement them, have been shown to work in many countries.
  • If existing interventions are used together as part of a comprehensive, integrated approach, the global goal for preventing chronic diseases can be achieved. The question is how governments, the private sector and civil society can work together to put such approaches into practice.[2]

References

  1. Medicinenet Definition chronic disease Available from:https://www.medicinenet.com/script/main/art.asp?articlekey=33490 (last accessed 19.2.2020)
  2. 2.0 2.1 2.2 2.3 WHO international Preventing 2005 CHRONIC DISEASES a vital investment Available from:https://www.who.int/chp/chronic_disease_report/full_report.pdf (last accessed 19.2.2020)
  3. Hajat C, Stein E. The global burden of multiple chronic conditions: A narrative review. Preventive medicine reports. 2018 Dec 1;12:284-93. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214883/ (last accessed 19.2.2020)
  4. EU CHRODISplus Chronic Diseases: Everyone’s Business Available from:https://www.youtube.com/watch?v=da8iw9hvQX4 (last accessed 19.2.2020)
  5. 5.0 5.1 5.2 Vichealth Better Health Channel Chronic Illness Nov. 2016 Available from:https://www.betterhealth.vic.gov.au/health/healthyliving/chronic-illness (last accessed 19.2.2020)
  6. Austgovt. The impact of chronic disease. Available from: https://www.aihw.gov.au/getmedia/65964785-e0df-4305-ae03-a9c4d1bbe2e4/ah16-factsheet-chronicdisease.pdf.aspx (last accessed 19.2.2020)