There is a large degree of variation when describing chronic diseases within the professional communities (medical, public health, macadamia, and policy).
The NHS and Centers for Disease Control and Prevention (CDC) define chronic conditions as illnesses that last for over a year and require ongoing medical attention with or without limit to the capacity of an individual to carry out physical activity. In other words, any long-lasting condition that significantly impairs an individual's quality of life.
The CDC only classifies cardiovascular disease, diabetes, obesity, cancer, and arthritis as chronic diseases. In contrast, the Centers for Medicare and Medicaid Services has a more extensive list of over 15 chronic conditions, including Alzheimer's disease, HIV/AIDS, and several mental health issues. This difference can create confusion and lead to misconceptions about the burden of chronic diseases on individuals and their family members.
Prevalence of chronic disease
Chronic conditions are a significant global public health concern. The World Health Organization (WHO) stated that chronic conditions contributed to 61% of all deaths in 2005. This number is projected to increase to 70% in 2030.
Approximately 1 in 3 adults around the globe is thought to suffer from multiple chronic health conditions. However, there is no agreed definition for numerous chronic diseases, resulting in a significant variation in prevalence rates from 16-58% in the UK, 26% in the US, and 9.4% in Urban Southern Asia.
Certain chronic conditions cluster together more frequently than others, increasing chronic disease prevalence globally and considerably pressurising health services. For example, treating illnesses like depression, Alzheimer's disease, or infectious diseases associated with diabetes or HIV/AIDS can increase health care expenditure yet drastically improve a patient's quality of life, emphasising the need for continuous research on chronic disease.
Characteristics of chronic conditions
Chronic diseases are thought to be influenced by a combination of modifiable and inherited risk factors.
Genetic
Multiple studies have established that genes are attributed to common chronic diseases, including heart disease, diabetes, Alzheimer's disease, and more. Research regarding genetic predisposition for chronic diseases is ongoing. It will help us understand the long-term implications of said genes and introduce more prominent testing.
Environmental
According to the WHO, environmental factors contribute to around 60% of cancers. Furthermore, various studies have confirmed the correlation between pollutants (air pollution, chemical exposure, noise) and chronic disease. Such findings suggest that exposure to these environmental factors has been attributed to chronic disease in children, adolescents, and adults.
Lifestyle
Lifestyle factors pose considerable economic and health burdens. Certain behaviours such as smoking, a bad diet, and a sedentary lifestyle result in the development of chronic health problems, specifically heart disease, diabetes, and stroke. Implementing healthy lifestyle interventions can significantly improve your quality of life and allow for better chronic disease management.
Social
Several studies have suggested that the social context of a person's life can determine their risk of exposure to chronic conditions. For example, social factors such as smoking can predispose you to more than 21 different chronic diseases. According to Public Health England and the National Research Council and Institute of Medicine, the most important social factors that influence our health outcomes are income, accumulated wealth, education, and social inequality.
The major chronic diseases
The causes of most major chronic diseases are well established and can be classified as modifiable and acquired, as described above. However, as per the WHO fact sheet, without addressing these causes, deaths caused by chronic conditions may increase by up to 17% over the next ten years.
So what can we do aside from relying on our healthcare provider?
Firstly, education. Let's take a look at the most common major chronic diseases below;
Cardiovascular disease
Cardiovascular disease (CVD) is a general term used for conditions that primarily affect the heart and blood vessels. Most major causative factors for cardiovascular disease are attributed to lifestyle.
Smoking, an unhealthy diet, and not carrying out regular activities can lead to a build-up of plaque in the arteries, leading to a risk of blood clots, heart failure, and heart attack.
The leading causes of CVD include:
- High blood pressure
- Inactivity
- Diabetes
- Obesity
- Family history
- Ethnicity
- Diet
- Alcohol
If left untreated, CVD can cause damage to other organs. For example, heart failure can lead to organ failure, particularly in the kidneys, causing chronic kidney disease. However, the good news is that most risk factors for CVD can be reversed. Cardiovascular disease management can not only reduce health care costs but significantly reduce the burden of CVD.
So what can you do?
- Develop a healthy diet full of fruit and vegetables
- Partake in regular exercise - 20 minutes of exercise every day
- Be compliant with medications, such as those used to reduce your blood pressure
- Drink alcohol in moderation
- Stop smoking
Respiratory disease
Chronic respiratory diseases are a group of conditions that affect the airways and structures of the lung. Common chronic respiratory illnesses include chronic obstructive pulmonary disease (COPD), asthma, and pulmonary hypertension.
COPD
COPD is the third leading cause of death worldwide. People with COPD will experience progressive and persistent respiratory symptoms, often including shortness of breath, coughing, and possible phlegm production.
COPD occurs when the airways start to narrow due to inflammation caused by tobacco smoke and air pollutants. As a result, people can find it more challenging to perform their regular daily activities as COPD progresses. In addition, COPD can flare up in some patients, causing their symptoms to suddenly worsen. This requires additional treatment, either at home or in hospital, depending on the severity of their condition.
Asthma
Asthma is a major non-communicable disease that is thought to affect over 250 million people worldwide. The condition most commonly affects children.
Asthma is caused by the narrowing of the airways due to inflammation and tightening of the muscles. This causes asthma symptoms, including shortness of breath, coughing, and chest tightness. Symptoms are often worsened at night and during exercise. In addition, asthma can be triggered by changes in weather, dust, fumes, and other allergens.
Asthma is managed well in the UK. Most patients receive adequate inhalers and appropriate counselling from an accredited professional. Unfortunately, asthma cannot be cured, but good management with inhalers can significantly control the disease and allow those with asthma to enjoy a normal, healthy life.
The main risk factors for developing chronic respiratory diseases include:
- Smoking
- Air pollution
- Exposure to chemicals
- Frequent airway infections during childhood
Unfortunately, chronic respiratory diseases are not curable. However, various forms of treatment are available to help control symptoms and increase the quality of life for people with these conditions.
Cancer
Cancer is a chronic disease during which the cells in your body begin to divide and grow uncontrollably. There are many types of cancer that can start to grow anywhere in your body. There is ongoing research to determine the exact cause of many cancers. However, certain lifestyle conditions, including tobacco and alcohol use, lousy diet, lack of physical activity, and hereditary genes, are known to increase your risk of developing cancer.
Cancer is the leading cause of death worldwide, accounting for approximately 10 million deaths in 2020. By implementing healthier lifestyles and complying with prevention strategies, 30-50% of cancers can be prevented. The most common forms of cancer in the UK are:
- Prostate Cancer
- Breast Cancer
- Lung Cancer
- Bowel Cancer
- Skin Cancer
Many cancers have a high chance of cure when diagnosed early and treated appropriately. However, others may be terminal, so treatment strategies aim to keep the individual comfortable.
There are many screening programs devised to help detect cancer early. Anyone who falls within the criteria to be screened should accept whatever screening options they're offered.
Diabetes
Diabetes is a chronic condition that affects how your body turns food into energy. Most food we eat gets converted into glucose and released into your bloodstream. As the blood sugar rises, it triggers the pancreas to produce insulin, which allows the glucose into your body's cells for energy.
If you have diabetes, your body either doesn't make enough insulin (type 1 diabetes) or doesn't use insulin as well as it should (type 2 diabetes). When this occurs, the blood remains in the bloodstream, spiking your blood sugar levels. Over time, this can lead to significant health problems, including heart disease, kidney disease, and loss of vision and sensation.
Type 1 diabetes affects nearly 5-10% of people with diabetes. Symptoms often develop quickly and are diagnosed at a younger age. Those with type 1 diabetes have to take insulin to survive. Unfortunately, there is still a lack of information about how type 1 diabetes can be prevented.
Type 2 diabetes mainly affects older adults. This condition affects our body's ability to utilise insulin, causing a spike in blood sugar levels. Unfortunately, symptoms may not develop until the damage has been done, so it is vital to test your blood sugar levels if you are at risk. Risk factors include being obese, low levels of physical activity, and smoking. However, implementing medications and healthy lifestyle interventions can delay or prevent the worsening of the condition.
Neurological
Chronic neurological conditions such as stroke, Parkinson's, Alzheimer's disease, epilepsy, and mental illness place a significant burden on patients, family members, society, and the NHS. They occur due to damage to the brain, either through trauma, infection, or hereditary genes.
There are over 600 known neurological conditions. To make them easier to treat, many healthcare specialists group the conditions into four main categories:
- Sudden Onset - e.g. Stroke, spinal injury, meningitis, and Guillian-Barre syndrome
- Intermittent - e.g. Migraines, epilepsy, and cavernoma
- Progressive conditions - e.g. Parkinson's disease, dementia, and motor neurone disease
- Stable with changing needs - Tourette's syndrome, fibromyalgia, and cerebral palsy
Current statistics show that 1 in 6 people in the UK has a neurological condition. Getting the proper care and support is the most crucial aspect of treatment regarding these conditions. If you're looking for help or support, then contact your local health provider.
Musculoskeletal
Most musculoskeletal conditions are not chronic. They occur due to direct injury or trauma to the affected bone or joint. However, the damage caused can sometimes remain for prolonged periods. As such, sufferers of fractures or ligament damage may notice significant mobility impairment and chronic pain for a prolonged duration.
How to cope with chronic illness
As well as affecting your health, chronic conditions can influence your ability to work and worsen your quality of life. But why should you suffer alone?
The most important step you can take if you have a chronic illness is to seek help. Taking action early can help you understand and deal with the many effects a chronic disease may have on you.
People struggling to cope with their chronic illness can contact a counsellor or support groups to help them deal with the stress, pain, and fatigue that accompany their condition. Learning to manage stress and pain can help you maintain a positive outlook on life and open up various avenues for relief.
Chronic illnesses affect millions of people in the UK. Each condition comes with its own set of symptoms that can significantly affect your quality of life. Living with a chronic condition can cause stress and trigger additional diseases. If you or a loved one has a chronic condition, contact your local healthcare provider to learn how to deal with stress and get a better understanding of your condition.
