Chronic disease largely preventable |
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Dr. Ken Cutler

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Chronic disease largely preventable

As a county health officer, I am often asked, "What is public health?" Public health is the science of protecting and improving the health of families and communities through the promotion of healthy lifestyles, the control of communicable diseases and disease and injury prevention. We investigate and try to contain communicable and food-borne disease outbreaks, enforce local and state health and safety codes, ensure that our water supplies are safe and educate the public about health risks and prevention measures.

But public health is best explained not by a definition but by examples.

Back in the 1980s when I was a medical student, there were about 20,000 cases a year in the United States of an infection with a bacteria called Haemophilus influenza type B (better known as Hib and not related to the influenza virus). It mainly struck infants and young children and was a major cause of meningitis and pneumonia, as well as something we rarely see any more called epiglottitis. Epiglottitis was scary to everyone as the tissue covering the windpipe would swell and cause severe respiratory distress. The child would come to the emergency room, frightened and drooling with difficulty breathing. We would rush them to the operating room to have a breathing tube inserted. Fortunately, an excellent vaccine was developed, and the number of Hib infections has since gone down by 99 percent.

There have been many successes on the infectious disease front: Smallpox, a disease that killed and disfigured, was declared eradicated in 1980. Polio, a paralytic disease, was eliminated from the Americas by 1994. Because polio still exists in some countries, vaccination against it is recommended. There have been very dramatic decreases in the U.S. in whooping cough, measles and rubella (sometimes called German measles).

Since 1900, the average lifespan of persons in the United States has been lengthened by more than 30 years; 25 years of that have been attributable to advances in public health.

Since 1900, the average lifespan of persons in the United States has been lengthened by more than 30 years; 25 years of that have been attributable to advances in public health.

One hundred years ago, the leading causes of death were from infectious diseases, such as tuberculosis, pneumonia and the flu. Today, the leading causes of death look very different: heart disease, cancer, chronic lung disease and stroke.

Chronic diseases now take a great toll on Americans. About three out of every four health care dollars go into the management and treatment of chronic diseases. But chronic diseases are largely preventable. Eliminating tobacco use, having a healthy diet, being physically active and not overusing alcohol all dramatically reduce the burdens of heart disease, stroke, diabetes and many cancers.

In 1964, the first report by the Surgeon General linking smoking to lung cancer was released. Smoking is the leading cause for preventable deaths in the US. Back in the 1960s, almost half of American adults smoked. Today, about 14 percent of Californians smoke. Through education and policy changes, millions of smoking-related deaths have been prevented by decreased tobacco use. Public health saves lives and saves money.

In the United States and in California, we haven't done enough to prevent chronic diseases. Surveys show that many children are watching more than two hours of television or video games on a typical weekday. One out of three Californian teens does not get the recommended amount of physical activity and about one out of four adults report no exercise. Add that to the fact that Americans consume 300 more calories each day than they did in 1985, and you start to see why obesity has become so common.

Drinking one soda a day could add a pound of fat per month. Two sodas a day and you can gain almost 20 pounds a year!

Why so many continue to smoke, to consume unhealthy foods and to be sedentary is complex. But the most recent evidence shows that having a good education, having meaningful jobs with a living wage, living in safe and affordable housing, having access to areas for physical activity and getting a healthy start in life with good nutrition in pregnancy all make positive differences. We all have a role to play in making our communities healthier places. And it starts with each of us taking the simple preventive steps that lead to better health.

Dr. Ken Cutler is a Nevada County Public Health officer.