There are many causes, but patient behaviors can play a large role in many chronic
diseases. The 3-4-50 Framework, developed by the UK-based Oxford Health Alliance,
states that tobacco use, poor diet and a sedentary lifestyle contribute to cancer,
cardiovascular disease, chronic lower-respiratory disease and diabetes. Those four
conditions cause 50 percent of deaths, many of them premature.
Chronic disease is a major expense for America’s healthcare system. According to the Centers for
Disease Control, 90 percent of the $3.3 trillion in U.S. healthcare spend is for chronic diseases.
If appropriate steps aren’t taken to improve both prevention and treatment of such diseases,
the Partnership to Fight Chronic Disease predicts that the projected total cost of chronic disease in
America could tip the scales at $42 trillion by 2030. The most expensive conditions in terms of direct
healthcare costs are diabetes, Alzheimer’s and osteoarthritis, and the three most common chronic
conditions are hypertension, dyslipidemia and osteoarthritis.
In September 2012, the New York City Board of Health approved
a measure to ban the sale of large sodas and other sugary drinks in
restaurants, movie theaters, sports arenas and street carts in a first
of its kind restriction in the US. At the forefront of this measure
was Mayor Michael Bloomberg. The mayor noted that 6,000
New Yorkers die every year from obesity-related illness. Some
ethnic groups in the city have rates of overweight and obesity
approaching 70 percent of adults. African-American New Yorkers
are three times as likely, and Hispanic New Yorkers twice as likely,
as white New Yorkers to die from diabetes.1
Is this social policy
run amuck? Is it, as some have suggested, an infringement on
individual rights? Or is it simply recognition that health issues
cannot be treated in isolation from the many other factors that
affect an individual’s or a community’s health?
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