A report from the National Academy of Medicine in the Oct. 25, 2016 JAMA discusses the chronic diseases which account for seven out of every 10 deaths annually in the U.S. and more than 85 percent of health-care costs. Further, about one-half of health-care costs are caused by only 5 percent of patients.
This report suggests that chronic disease prevention should be No. 1 on our health-care list, and the report finds that tobacco use, poor nutrition and physical inactivity all contribute heavily to the high rate of chronic disease in the U.S.
Smoking is a major cause of lung cancer, C.O.P.D. (Chronic Obstructive Pulmonary Disease) and cardiovascular disease, which cause an estimated 480,000 deaths and costs $290 billion per year.
Poor nutrition and physical inactivity are major causes of obesity, which is a leading cause of Type 2 diabetes, cancer and cardiovascular disease.
The article also states that the reduction of these three major causes of chronic disease in the U.S., i.e. smoking, poor nutrition and physical inactivity, should become public health issues and not dependent on the medical profession, since doctors are not trained in behavioral change and also the demands of practice leave little time for effective counseling.
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For example, with tobacco, raising the minimum age for legal access to tobacco products from 18 to 21 years of age would result in a 25 percent decrease in youth smoking startups and a 12 percent decline in all smokers, resulting in 249,000 fewer premature deaths per year (and 45,000 fewer deaths from lung cancer alone).
Recommendation summary: Increase the legal age for buying tobacco products from 18 to 21 years and increase the excise tax on tobacco sales. Provide incentive for school physical activity programs and increase tax revenue for school lunches.