aspect of chronic illness

Chronic Illness

Based on reading the two attached articles compose a reaction paper about an aspect of chronic illness you just discovered.

Support your commentary with citations from the assigned readings.

The paper shall be 1 page and should be doubled spaced.
Chronic Diseases: The Leading Causes of Death and Disability in the United States
Chronic diseases and conditions—such as heart disease, stroke, cancer, diabetes, obesity, and arthritis—are among the most common,

costly, and preventable of all health problems.
• As of 2012, about half of all adults—117 million people—had one or more chronic health conditions. One of four adults had two

or more chronic health conditions.1
• Seven of the top 10 causes of death in 2010 were chronic diseases. Two of these chronic diseases—heart disease and cancer—

together accounted for nearly 48% of all deaths.2
• Obesity is a serious health concern. During 2009–2010, more than one-third of adults, or about 78 million people, were obese

(defined as body mass index [BMI] ≥30 kg/m2). Nearly one of five youths aged 2–19 years was obese (BMI ≥95th percentile).3
• Arthritis is the most common cause of disability.4 Of the 53 million adults with a doctor diagnosis of arthritis, more than 22

million say they have trouble with their usual activities because of arthritis.5
• Diabetes is the leading cause of kidney failure, lower-limb amputations other than those caused by injury, and new cases of

blindness among adults.6
Health Risk Behaviors that Cause Chronic Diseases
Health risk behaviors are unhealthy behaviors you can change. Four of these health risk behaviors—lack of exercise or physical

activity, poor nutrition, tobacco use, and drinking too much alcohol—cause much of the illness, suffering, and early death related to

chronic diseases and conditions.
• In 2011, more than half (52%) of adults aged 18 years or older did not meet recommendations for aerobic exercise or physical

activity. In addition, 76% did not meet recommendations for muscle-strengthening physical activity.7
• About half of US adults (47%) have at least one of the following major risk factors for heart disease or stroke: uncontrolled

high blood pressure, uncontrolled high LDL cholesterol, or are current smokers.8 Ninety percent of Americans consume too much sodium,

increasing their risk of high blood pressure.9
• In 2011, more than one-third (36%) of adolescents and 38% of adults said they ate fruit less than once a day, while 38% of

adolescents and 23% of adults said they ate vegetables less than once a day.10
• More than 42 million adults—close to 1 of every 5—said they currently smoked cigarettes in 2012.11 Cigarette smoking accounts

for more than 480,000 deaths each year.11 Each day, more than 3,200 youth younger than 18 years smoke their first cigarette, and

another 2,100 youth and young adults who smoke every now and then become daily smokers.11
• Drinking too much alcohol is responsible for 88,000 deaths each year, more than half of which are due to binge drinking.12, 13

About 38 million US adults report binge drinking an average of 4 times a month, and have an average of 8 drinks per binge, yet most

binge drinkers are not alcohol dependent.14
The Cost of Chronic Diseases and Health Risk Behaviors
In the United States, chronic diseases and conditions and the health risk behaviors that cause them account for most health care costs.
• Eighty-six percent of all health care spending in 2010 was for people with one or more chronic medical conditions.15
• The total costs of heart disease and stroke in 2010 were estimated to be $315.4 billion. Of this amount, $193.4 billion was for

direct medical costs, not including costs of nursing home care.16
• Cancer care cost $157 billion in 2010 dollars.17
• The total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176 billion in direct medical costs and $69

billion in decreased productivity. Decreased productivity includes costs associated with people being absent from work, being less

productive while at work, or not being able to work at all because of diabetes.18
• The total cost of arthritis and related conditions was about $128 billion in 2003. Of this amount, nearly $81 billion was for

direct medical costs and $47 billion was for indirect costs associated with lost earnings.19
• Medical costs linked to obesity were estimated to be $147 billion in 2008. Annual medical costs for people who are obese were

$1,429 higher than those for people of normal weight in 2006.20
• For the years 2009-2012, economic cost due to smoking is estimated to be more than $289 billion a year. This cost includes at

least $133 billion in direct medical care for adults and more than $156 billion for lost productivity from premature death estimated

from 2005 through 2009.11
• The economic costs of drinking too much alcohol were estimated to be $223.5 billion, or $1.90 a drink, in 2006. Most of these

costs were due to binge drinking and resulted from losses in workplace productivity, health care expenses, and crimes related to

excessive drinking.
The state of US health, 1990-2010: burden of diseases, injuries, and risk factors.
Abstract
IMPORTANCE:
Understanding the major health problems in the United States and how they are changing over time is critical for informing national

health policy.
OBJECTIVES:
To measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these

measurements with those of the 34 countries in the Organisation for Economic Co-operation and Development (OECD) countries.
DESIGN:
We used the systematic analysis of descriptive epidemiology of 291 diseases and injuries, 1160 sequelae of these diseases and injuries,

and 67 risk factors or clusters of risk factors from 1990 to 2010 for 187 countries developed for the Global Burden of Disease 2010

Study to describe the health status of the United States and to compare US health outcomes with those of 34 OECD countries. Years of

life lost due to premature mortality (YLLs) were computed by multiplying the number of deaths at each age by a reference life

expectancy at that age. Years lived with disability (YLDs) were calculated by multiplying prevalence (based on systematic reviews) by

the disability weight (based on population-based surveys) for each sequela; disability in this study refers to any short- or long-term

loss of health. Disability-adjusted life-years (DALYs) were estimated as the sum of YLDs and YLLs. Deaths and DALYs related to risk

factors were based on systematic reviews and meta-analyses of exposure data and relative risks for risk-outcome pairs. Healthy life

expectancy (HALE) was used to summarize overall population health, accounting for both length of life and levels of ill health

experienced at different ages.
RESULTS:
US life expectancy for both sexes combined increased from 75.2 years in 1990 to 78.2 years in 2010; during the same period, HALE

increased from 65.8 years to 68.1 years. The diseases and injuries with the largest number of YLLs in 2010 were ischemic heart disease,

lung cancer, stroke, chronic obstructive pulmonary disease, and road injury. Age-standardized YLL rates increased for Alzheimer

disease, drug use disorders, chronic kidney disease, kidney cancer, and falls. The diseases with the largest number of YLDs in 2010

were low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, and anxiety disorders. As the US population

has aged, YLDs have comprised a larger share of DALYs than have YLLs. The leading risk factors related to DALYs were dietary risks,

tobacco smoking, high body mass index, high blood pressure, high fasting plasma glucose, physical inactivity, and alcohol use. Among 34

OECD countries between 1990 and 2010, the US rank for the age-standardized death rate changed from 18th to 27th, for the age-

standardized YLL rate from 23rd to 28th, for the age-standardized YLD rate from 5th to 6th, for life expectancy at birth from 20th to

27th, and for HALE from 14th to 26th.
CONCLUSIONS AND RELEVANCE:
From 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and HALE increased, all-

cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable. However, morbidity and

chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have

not kept pace with advances in population health in other wealthy nations

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