C
hronic diseases are now
the leading cause of
disability and death in
the United States, with
seven in ten deaths each
year attributed to such
illnesses as cancer, heart
disease, diabetes, and stroke. About 133
million Americans—nearly one in two
adults—live with at least one chronic
disease, and more than one in ten have
three or more.
The costs are staggering. Chronic
disease accounts for 75 percent of the
more than $2 trillion spent on health
care each year in the United States.
According to the Arthritis Foundation, arthritis alone affects 46 million
Americans and costs $128 billion
annually in medical costs and lost
productivity. Coronary heart disease,
which afflicts 16. 8 million Americans,
costs some $165 billion a year.
Until the mid-20th century, infectious diseases such as diphtheria, polio, meningitis, and chicken pox posed
the greatest health threat to society.
The advent of vaccines, antibiotics,
and more sanitary living conditions
greatly reduced mortality and increased life expectancy. But as people
began living longer, chronic diseases—
ongoing, generally incurable medical
conditions—began to replace acute
illnesses as the nation’s main health
care challenge.
Despite this shift, the U.S. health care
system is still largely designed to treat
patients with acute medical problems.
“At no point in medical school are
physicians exposed to patients with
chronic illness, except for acute episodes leading to hospitalization,” says
Michael Lockshin, M.D., a Harvard
Medical School graduate and head of
the women and rheumatic disease center at New York City’s Hospital for Special Surgery. The result: Many patients
shuffle from doctor to doctor in search
of relief from the many complications
of their chronic illnesses.
On average, people with one chronic
condition see three different physi-
HOW TO LIVE LIFE ON YOUR OWN TERMS
::::::::::::::::::::::
cise to nutrition. If you
have arthritis and
you need to strength-
en muscles around
joints, don’t just tell
yourself you need to
do it. Make a list of
specific weekly objec-
tives, from exercise
reps to the days you’ll
do them. It won’t just
help your body; it’ll put
you in charge of your
treatment.
To live well with chron-
ic illness, try learning
from others who have
a chronic condition.
Stanford University’s
self-management
workshops, for exam-
ple, are led by two
people, at least one of
whom has a chronic
disease. “The partici-
pants can identify
with us,” says Greg
Bailey, 61, a workshop
leader who also suf-
fers from a chronic
pulmonary disease.
“We know exactly
what they’re going
through.” Here are a
few key tenets of the
program that you
can adapt to manage
your own illness.
; Face your feelings
Physical symptoms
aren’t the only challenge. Anger, fear,
depression, and isolation often accompany chronic illness.
A support group can
be a therapeutic way
to help you confront
these issues.
; Set your goals
Create clear goals for
everything from exer-
; Live your life
Visualize the life you
want—and do what
it takes to achieve it,
from hobbies to an
active social life to
getting a job. Manage
the illness; don’t let
it define you. —M.A.F.
cians and fill seven prescriptions a
year, according to Partnership for
Solutions, a research group at Johns
Hopkins University in Baltimore.
People with five or more chronic conditions make 12 physician visits and fill
50 prescriptions a year.
Even with all that care, patients with
chronic illnesses are among the sick-
est members of society. A 2009 National
Council on Aging (NCOA) survey found
that 32 percent of people 44 and over
who have one or more chronic ill-
nesses are living in pain, 65 percent are
stressed, and 50 percent are depressed.
