Hi, I’m Deboki Chakravarti, I’m a science educator, and today we’re going to talk
about how chronic illness impacts public health.
If someone from two thousand years ago could see a 21st-century hospital, they’d be completely
baffled.
Even someone from two hundred years ago might wonder why there are so few people with smallpox
scars, or why the Bubonic plague isn’t still raging across Europe and Asia.
Historically, infectious diseases that spread through person-to-person contact – like
smallpox and the Bubonic plague – have been the biggest threat to human health, killing
millions of people around the world.
But thanks to advances in science and medicine, most infectious diseases are less deadly today
than they’ve ever been.
The World Health Organization reported that in 2019, only 3 of the top 10 causes of death
worldwide were infectious diseases.
Instead, chronic illnesses have become more common.
These are illnesses that last for an extended time, and usually don't get passed through
person-to-person contact.
When infectious diseases decline and populations start living longer, people typically die
from chronic illnesses that are more common in older populations – like cancer, heart
disease and stroke.
This shift from more people dying of infectious disease to more people dying of chronic disease
is called the epidemiological transition.
And although it is a victory for public health that massive numbers of people aren’t still
dying of smallpox, it means there’s a new challenge at hand: addressing the impact of
chronic illnesses, and why they happen.
Now, people often develop a chronic disease because of their genetics, but lifestyle also
plays a role.
Take tobacco use, which the Centers for Disease Control and Prevention considers to be the
number one preventable cause of death worldwide.
We’re talking about 7 million deaths each year.
And then there’s nutrition.
A diet that’s high in cholesterol, saturated fats and added sugars can seriously damage
our organs, and may lead to chronic conditions like hypertension or diabetes.
Aspects of our lifestyle that we can change – like tobacco use and poor diet – are
called modifiable risk factors.
And although modifying them doesn’t rule out the possibility of chronic disease entirely,
it can make a difference.
The CDC reports that making changes such as quitting smoking or eating more nutritious
foods can lower the likelihood of experiencing a chronic illness by as much as 80 percent.
But our lifestyles don’t exist in a vacuum, so making the best choices for our health
isn’t always easy.
Research shows that changing the social norms around smoking is the most effective way to
reduce tobacco use and improve people’s health.
So instead of simply telling everyone to quit smoking, public health efforts try to encourage
behavior changes, by including taxes on tobacco products and warning labels on cigarette packaging.
Meanwhile, external influences like food ads and portion sizes at restaurants have strong
subliminal effects on how we eat.
Food ads, for instance, may use persuasive techniques to make highly-processed, low-nutrition
foods look irresistible.
But regulations on food and drink advertising might help shape people’s dietary preferences
for the better.
But even with such measures, not everyone can simply make the choice to eat nutritious
foods if there aren’t a lot of options nearby.
The U.S. Department of Agriculture estimates that 40 million Americans live in areas without
any nearby supermarkets, or without the transportation they need to get to supermarkets.
Most of these communities are rural, low-income or home to racial and ethnic minorities.
So public health experts are working to increase access to healthy foods in areas where they’re
hard to find – by expanding public transportation in rural areas where many people live 20 miles
away from the nearest supermarket.
Or by supporting local communities in their initiatives to grow their own food.
Back in 2016, for instance, one-third of the Indigenous Ho-Chunk reservation in Nebraska
lacked access to healthy food.
So in 2020, the Centers for Disease Control and Prevention's Healthy Tribes program helped
them establish 80 family gardens and a farmers market, which made weekly deliveries of fresh
produce across the reservation.
So to sum up: yes, our lifestyle choices can have a negative impact on our health – and
may even be killing us!
But improving public health is much more than telling people to make better choices.
It’s making those choices possible by removing barriers to well-being, and nudging people
towards a healthier day to day.
Thanks for watching!
This video is part of a series created by Complexly and the American Public Health Association
to shed a little light on the important work that public health does.
To learn more, visit apha.org.