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.
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.
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