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Chronic diseases are illnesses that characteristically have a slow, progressive onset and a long duration. Chronic diseases impact every aspect of the individual's and family's life and usually result from repeated or prolonged exposure to an environment or substance that does not support the normal structure and functioning of the body.

Chronic diseases are those illnesses that are part of a person's life, with little or no chance for full recovery. In acute disease, treatments focus on returning the individual to full health. With chronic disease, the medical focus is to limit the progression of the disease or to delay any secondary complication that might arise because of the disease.

The body's normal structure and function work like a well-coordinated machine, with each part vital to the whole. The structure and function of the human body of a person with a chronic disease, on both the cellular and systemic levels, is permanently altered. It is due to this permanent, and often progressive, cellular change that the person with the chronic disease has an altered ability to function in activities of daily living. Centers for Disease Control and Prevention (CDC) statistics reveal that 1 out of 10 Americans (25 million people) have severe limitations in their daily activities because they have a chronic disease.

According to the CDC's 2004 data on death in the United States, the current four leading causes of death are heart disease, cancer, stroke, and chronic lower respiratory disease, all chronic diseases. Of the 10 leading causes of death in the United States, only three are not due to chronic illness. More than 1.7 million American deaths, or 7 out of 10, each year are due to a chronic disease. More than 75 percent of the $1.4 trillion spent on U.S. medical care costs is to treat chronic diseases.

Although some chronic diseases transmit during gestation or at birth and others have a genetic link predisposing a person to be more likely to develop that disease, most of the existing chronic diseases are preventable or manageable through lifestyle choices and changes.

Mortality refers to the rate of deaths in a given population, and morbidity is the rate of illnesses occurring. These statistics are important when evaluating chronic diseases because we are able to identify trends and shifts in norms. For example, before the discovery of antibiotics, the leading cause of death in the United States was infection, not heart disease. As the population continues to age, the causes of death will change. In the United States, the highest mortality and morbidity rates are due to chronic diseases.

Heart disease, cancer, stroke, upper respiratory disease, diabetes, Alzheimer's disease, kidney disease, liver disease, hypertension, and Parkinson's disease are among the top 15 causes of death. Deaths attributed to accidents, suicide, and pneumonia/influenza may also reflect the impact of chronic diseases such as epilepsy, depression, and AIDS.

According to the 2002 Chartbook on Trends in the Health of Americans, life expectancy for Americans increased during the past century from 51 to 79.4 years for females and from 48 to 73.9 for males. Despite this increase, however, the United States still lags behind other developed countries in life expectancy. This gap may be due, in part, to the fact that more Americans live longer with chronic diseases but not as long as healthy people.

Bibliography:

1) Brownson, Ross C., Patrick L. Remington, and James R. Davis, eds. 1998. Chronic Disease Epidemiology and Control. 2nd ed. Washington, DC: American Public Health Association.

2) Crowley, Leonard V. 2004. An Introduction to Human Disease. 6th ed. Boston: Jones & Bartlett.

3) Hamann, Barbara. 2006. Disease Identification, Prevention, and Control. 3rd ed. New York: McGraw-Hill.

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