Chronic Disease Epidemic

Chronic diseases—also known as non-communicable diseases (NCDs)—have become the defining global health crisis of our time. They include conditions like heart disease, cancer, chronic respiratory illnesses, diabetes, and stroke. Today, these diseases account for the majority of deaths worldwide, having replaced infectious diseases as the leading cause of mortality. The impact of chronic illness extends beyond death to include long-term incapacity and suffering, yet it remains under-appreciated as a true epidemic.

The Global Burden of Chronic Diseases

Currently, chronic diseases are responsible for over 70% of global deaths each year—about 41 million people. Cardiovascular diseases, cancers, chronic respiratory conditions, and diabetes are the primary culprits. What’s even more alarming is that nearly 85% of premature deaths (under age 70) occur in low- and middle-income countries. In developed nations, such as the US, UK, and Australia, chronic diseases are the leading cause of death and disability, with approximately 90% of deaths attributed to these conditions.

The situation is particularly bleak as aging populations—people living longer but often sicker—experience rising multi-morbidity, where individuals suffer from multiple chronic conditions simultaneously. The toll on global health systems is staggering, and the costs continue to climb.

Are Chronic Diseases an Epidemic?

Though the word "epidemic" is traditionally associated with infectious diseases, chronic diseases are increasingly referred to as a global epidemic due to their overwhelming and steadily rising burden.

Contributing factors to this epidemic include:

- Environmental and Lifestyle Changes: It’s often said that chronic diseases are caused by ‘poor lifestyle choices.’ But these choices don’t happen in isolation—they are a product of the environments we live in. Our lives today are characterized by urbanization, technological bombardment, highly processed and nutrient-poor food, polluted air and water, and endless exposure to artificial light. Government, having approved many of these environmental changes, now places the blame on individuals for their supposed ‘poor choices’, when in fact, these are systemic issues driving chronic illness.

- Aging Populations: Aging itself is the greatest risk factor for chronic disease. As we live longer, the natural processes of aging predispose us to cardiovascular disease, cancer, dementia, and other conditions. While aging is inevitable, it can be treated and managed. Our biological age—how old our cells and tissues are—is modifiable and presents a critical target for preventing chronic diseases.

Is the Chronic Disease Crisis Getting Worse?

Unfortunately, the global burden of chronic diseases is worsening. Several key factors are driving this trend:

- Failure to Prioritize Prevention: Instead of investing in research and prevention strategies, health systems focus on managing chronic diseases with expensive but often less effective treatments.

- Aging Populations: The proportion of older adults is growing rapidly, particularly in developed nations, and increasingly in developing regions. This demographic shift brings a surge in age-related conditions.

- Environmental and Lifestyle Factors: The modern lifestyle promotes disease: sedentary behaviour, poor diet, and exposure to toxins.

- Environmental Pollution: Light, Sound, Air and Water pollution. Thousands of chemicals introduced into our food chain disrupt metabolism and increase the risk of respiratory diseases, cancers, and other chronic conditions.

For example, the global prevalence of diabetes has quadrupled since 1980, with much of this increase occurring in low- and middle-income countries. Obesity rates continue to climb worldwide, placing additional strain on healthcare systems.

Are There Any Positive Developments?

While the overall picture remains grim, there have been some positive developments:

- Tobacco Control: Many developed nations have implemented successful tobacco control measures, leading to significant reductions in smoking rates and, subsequently, decreases in lung cancer and heart disease.

- Improved Medical Treatments: Advances in medical care, such as the use of statins for heart disease and early cancer detection, have improved survival rates in developed countries.

However, these medical advances mainly delay mortality rather than prevent chronic illness. You might live longer, but you are live with an increasing number of chronic diseases under management.

Global Efforts to Combat Chronic Disease?

Efforts to address the chronic disease epidemic are underway, led by organisations like the World Health Organization (WHO), which has launched an action plan to reduce premature mortality from NCDs by 25% by 2025. Policies include raising taxes on sugary drinks and tobacco, promoting physical activity, and advocating for healthier diets.

But are these initiatives a sign of action or complacency? We have seen how public health authorities react to an emergency. The Chronic Disease Epidemic is much more deadly and much longer lasting than viral pandemia. Are industries interests Truely aligned with defeating the Chronic Disease Epidemic, or is it more profitable for them to promote Chronic Disease Management - expensive treatment of a sick population? Why are the most common interventions always profitable for industry while dissenting views on the true causes of chronic disease are often suppressed? Without a broader reassessment of our current approach, I see little hope for meaningful change, particularly in low- and middle-income countries where health systems are least equipped to manage chronic conditions.

 Conclusion: A Call for a New Approach

Chronic disease is indeed a global epidemic, but the current strategies are failing to stem the tide. Our modern environment—laden with poor diet, inactivity, and pollution—is driving this epidemic, while aging populations exacerbate the problem. It’s time to rethink how we approach chronic disease. The acute care model, influenced heavily by industry, is not equipped to handle the complexities of chronic illness. We need a new model, one that focuses on prevention, addresses the root causes, and promotes healthier lives across populations. Only through honest dialogue, humility in the medical profession, and a commitment to true health promotion can we begin to turn the tide on this epidemic.

 Copyright Dr Christopher Maclay 2024. All rights reserved.

Disclaimer: This information is for educational purposes only, it does not constitute medical advice. Please consult with your health care practitioner for personalised medical advice.