Our Volunteers

Chronic Disease: Information & Political Activism

As it should, medical school education focuses on disease processes. Unfortunately, it can sometimes lack a rigorous emphasis of the actual modifiable behaviors that cause many of these common chronic diseases. By the time providers see most patients in a clinical setting, many patients have reinforced these negative behaviors to the point that it is extremely hard to intervene and suggest behavioral change alone.

This is compounded by the fact that many of us do not feel equipped and comfortable addressing some lifestyle factors, such as diet and exercise, as aggressively as smoking or alcohol cessation for which we have validated questionnaires (i.e. CAGE). In addition we providers recommend pharmaceuticals, which definitely help when actually filled and re-filled, but work best when complemented with lifestyle modifications.

Although behaviors ultimately come down to individual choice, American policies and unethical marketing heavily influence chronic disease from childhood onwards. This is especially true when lack of financial resources limit individual choice by not allowing healthy foods and exercise options to be affordable.

Sometimes providers do not feel comfortable applying collective political and ethical pressure to help reform these industries and their practices that facilitate our patients' illnesses. This is in part because these "larger battles" are not ones that we, caretakers of the individual, feel empowered to tackle. The poor health of others negatively affects our country's ability to have a productive workforce. In addition, although certain industries benefit at the expense of others, increased chronic disease yields significant societal burden on those involved (patient, caretaker, etc) and tax payers. Furthermore, the amplified demand for medical care increases the need to recruit skilled nurses and physicians from countries whose basic requirements are much greater. Thus it is in our collective economic and ethical interest to keep people healthy physically and mentally. In some aspects, a harsh reality is that living in rich countries, such as America, cause chronic disease. This may make one think that chronic diseases are diseases of the rich yet the data show that the poor are disproportionately affected by most chronic disease. The optimal actions we can take are to promote healthy behaviors, policies, and lead by example for our patients.

Some interesting angles/facts determinants of chronic disease:

  • Medicine in the U.S. is largely funded on treatment not prevention. In other words an emphasis is placed on health care not health itself
  • Cancer has been shown in multiple studies to be more prevalent in heavy meat diets, and specifically red meat11
  • Foods we purchase account for over 80% of our daily salt intake
  • The U.S. Farm Bill grants subsidies of corn to farmers which allow for the heavy use of corn based foods, products (like high fructose corn syrup) in foods, and meat raised on a corn based diet to be significantly cheaper than fruits, vegetables, and other healthy alternatives
  • Its hard to be active in an unsafe neighborhood
  • Building and community design can largely impact activity levels
  • Global warming can exacerbate many chronic diseases in the U.S., especially respiratory related diseases12
  • The American Lung Association says that more than 1,000 kids will start smoking TODAY because of smoking's favorable portrayal in Hollywood13
  • 1 of every $10 health care dollars is attributed to Diabetes14