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Institute of Medicine Looks at 'Living Well' with Chronic Illness

By Jane Norman, CQ HealthBeat Associate Editor

January 31, 2012 – A recent Institute of Medicine report on chronic illness warns that an epidemic of debilitating conditions is "steadily moving toward crisis proportions," but nobody's paying much attention. The rising tide of aging baby boomers will only make it worse, the report cautions.

So there's a need for action by the public health community to come up with better ways to help Americans burdened with chronic illness to "live well"—to come up with ways to have a better quality of life despite their health problems. That can help not just them but their family members, friends, caregivers and society.

An IOM committee that did the study said in a series of recommendations that federal and state policy makers must do better in tracking chronic disease, preventing it and finding ways for people to live better while coping with their conditions. Chronic illnesses generally are slow to develop, last a long time, require medical treatment and have great potential to harm people's quality of life.

Medical costs for those with chronic illness make up 75 percent of the $2 trillion in national health care spending and account for 70 percent of all deaths, says the IOM. While huge improvements in health have been made over the years, that's offset by increases in physical inactivity, unhealthy eating, obesity and tobacco use, says the report.

It picks out examples of nine conditions that carry a significant impact, including on health care spending: arthritis, cancer survivorship, chronic pain, dementia, depression, type 2 diabetes, post-traumatic conditions, schizophrenia, and vision and hearing loss.

It's up to public health agencies to come up with a comprehensive response to chronic illness, the report concludes. "Government public health agencies have the ability to take action to help people live better with chronic illness," says the report. "They have the expertise to assess a public health problem, develop an appropriate program or policy, and ensure that programs and policies are effectively delivered and implemented."

Recommendations include:

  • The Centers for Disease Control and Prevention should select a variety of chronic illnesses for special consideration in its work, avoiding those for which public health programs already have been developed, such as cardiovascular disease.
  • The Department of Health and Human Services should support states in developing plans with specific objectives that focus on managing chronic illness and reaching out to those who have problems in getting better particularly because of their income level, race or geographic location.
  • Public and private funders should focus on research on the impact of healthy lifestyles and prevention for people with chronic illnesses.

Institute of Medicine Report 

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