Chronic Diseases and Health Promotion

Chronic diseases – such as heart disease, stroke, cancer, diabetes, and arthritis – are among the most common, costly, and preventable of all health problems in the U.S.

Chronic Diseases are the Leading Causes of Death and Disability in the U.S.

• 7 out of 10 deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50% of all deaths each year.¹
• In 2005, 133 million Americans – almost 1 out of every 2 adults – had at least one chronic illness.²
• Obesity has become a major health concern. 1 in every 3 adults is obese³ and almost 1 in 5 youth between the ages of 6 and 19 is obese (BMI ≥ 95th percentile of the CDC growth chart).⁴
• About one-fourth of people with chronic conditions have one or more daily activity limitations.⁵
• Arthritis is the most common cause of disability, with nearly 19 million Americans reporting activity limitations.⁶
• Diabetes continues to be the leading cause of kidney failure, nontraumatic lower-extremity amputations, and blindness among adults, aged 20-74.⁷
• Excessive alcohol consumption is the third leading preventable cause of death in the U.S., behind diet and physical activity and tobacco. ⁸

Four Common Causes of Chronic Disease

Four modifiable health risk behaviors—lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption—are responsible for much of the illness, suffering, and early death related to chronic diseases.

• More than one-third of all adults do not meet recommendations for aerobic physical activity based on the 2008 Physical Activity Guidelines for Americans, and 23% report no leisure-time physical activity at all in the preceding month.⁹
• In 2007, less than 22% of high school students¹⁰ and only 24% of adults¹¹ reported eating 5 or more servings of fruits and vegetables per day.
• More than 43 million American adults (approximately 1 in 5) smoke.¹²
• In 2007, 20% of high school students in the United States were current cigarette smokers.¹³
• Lung cancer is the leading cause of cancer death, and cigarette smoking causes almost all cases. Compared to nonsmokers, men who smoke are about 23 times more likely to develop lung cancer and women who smoke are about 13 times more likely. Smoking causes about 90% of lung cancer deaths in men and almost 80% in women. Smoking also causes cancer of the voicebox (larynx), mouth and throat, esophagus, bladder, kidney, pancreas, cervix, and stomach, and causes acute myeloid leukemia.¹⁴
• Excessive alcohol consumption contributes to over 54 different diseases and injuries, including cancer of the mouth, throat, esophagus, liver, colon, and breast, liver diseases, and other cardiovascular, neurological, psychiatric, and gastrointestinal health problems.¹⁵
• Binge drinking, the most dangerous pattern of drinking (defined as consuming more than 4 drinks on an occasion for women or 5 drinks for men) is reported by 17% of U.S. adults, averaging 8 drinks per binge.¹⁶

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1. Kung HC, Hoyert DL, Xu JQ, Murphy SL. Deaths: final data for 2005. National Vital Statistics Reports 2008;56(10). Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf [PDF-2.3MB]
2. Wu SY, Green A. Projection of chronic illness prevalence and cost inflation. Santa Monica, CA: RAND Health; 2000.
3. Ogden CL, Carroll MD, McDowell MA, Flegal KM. Obesity among adults in the United States—no change since 2003–2004. NCHS data brief no 1. Hyattsville, MD: National Center for Health Statistics; 2007. Available from: http://www.cdc.gov/nchs/data/databriefs/db01.pdf [PDF-366KB]
4. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003–2006. JAMA 2008;299:2401–2405.
5. Anderson G. Chronic conditions: making the case for ongoing care. Baltimore, MD: John Hopkins University; 2004.
6. Centers for Disease Control and Prevention. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2003–2005. MMWR 2006;55:1089–1092. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5540a2.htm
7. Centers for Disease Control and Prevention. National diabetes fact sheet, 2007. Atlanta, GA: U.S. Department of Health and Human Services; 2008. Available from: http://www.cdc.gov/Diabetes/pubs/factsheet07.htm
8. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA 2004;291(10):1238–1245.)
9. Centers for Disease Control and Prevention. Prevalence of self-reported physically active adults—United States, 2007. MMWR 2008;57:1297–1300. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5748a1.htm
10. Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2007. MMWR 2008;57(SS-04):1–131. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5704a1.htm
11. BRFSS prevalence and trends data [Internet]. Atlanta, GA: Centers for Disease Control and Prevention; 2008. Available from: http://apps.nccd.cdc.gov/brfss/page.asp?cat=AC&yr=2007&state=US#AC
12. National Center for Health Statistics. Health, United States, 2007. With chartbook on trends in the health of Americans. Hyattsville, MD: National Center for Health Statistics; 2007. Available from: http://www.cdc.gov/nchs/data/hus/hus07.pdf [PDF-6MB]
13. Centers for Disease Control and Prevention. Cigarette Use Among High School Students—United States, 1991–2007. Morbidity and Mortality Weekly Report [serial online]. 2008: 57(25):686–688 [accessed 2009 Jan 10].
14. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General—Smoking Among Adults in the United States: Cancer. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004.
15. Centers for Disease Control and Prevention (CDC). Alcohol Use and Health. Atlanta, GA: CDC. Available at http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm.
16. Source: Kanny D, Liu Y, Brewer RD, Garvin WS, Balluz L. Vital signs: Binge drinking prevalence, frequency, and intensity among adults – United States, 2010. MMWR 2012;61:14–19.

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