Editor: Welcome to our roundtable on chronic diseases, where Dr. Jahan and Dr. Lee shed light on long-term
health conditions. Chronic diseases (also called noncommunicable diseases or NCDs) are health issues that
last a year or more and require ongoing care . Globally, these ailments are the leading causes of death,
accounting for about 75% of all non-pandemic deaths (over 43 million people in 2021) . In the United
States alone, roughly three out of four adults (about 76%) now report at least one chronic condition .
These conditions — including heart disease, stroke, cancer, chronic respiratory diseases (like COPD and
asthma), and diabetes — pose a massive burden on patients and health systems. For example, five of
the top ten U.S. causes of death are linked to preventable chronic diseases , and nearly $4.1 trillion
(about 90%) of U.S. healthcare spending goes toward treating chronic illnesses and mental health
conditions .
Dr. Jahan: In practical terms, think of chronic diseases as long-term management projects rather than quick
fixes. As WHO notes, their root causes are often a mix of genetic factors and behaviors or environments –
like our diets, physical activity, tobacco and alcohol use, and even air pollution . When we talk to
patients, we emphasize these risk factors and the importance of a sustainable care plan.
Dr. Lee: Right. We see that 47.7% of U.S. adults have hypertension (high blood pressure) , 11.6% have
diabetes , and nearly 9% have asthma . These numbers can feel overwhelming. In conversation, we
stress that risk rises with age and lifestyle but also that prevention and management are possible.
Encouragingly, data show younger adults are catching on – they’re the fastest-growing group with chronic
issues , which means we have an opportunity to intervene early.
Editor: The stats are striking. What have we learned from these trends?
Dr. Jahan: We learn that chronic conditions are highly prevalent and costly, but also that early, coordinated
care can make a real difference. By recognizing these conditions early – through regular screenings and
check-ups – we can often slow their progress. In fact, detection and screening are key parts of the global
response to NCDs .
Dr. Lee: And that leads us into some common questions people have. Let’s tackle a few FAQs.
Engagement Question: Have you or a loved one faced a chronic disease? What surprised you most about
managing it? Share your experiences or questions below!
Frequently Asked Questions about Chronic Diseases
Editor: First, what exactly counts as a chronic disease?
Dr. Lee: Technically, any health condition that lasts more than a year and needs ongoing medical attention is
considered chronic . Common examples include diabetes, hypertension (high blood pressure),
asthma, chronic obstructive pulmonary disease (COPD), heart disease, stroke, cancer, and many
others. (Look at the CDC’s list of chronic illnesses for more examples.)
Editor: How do chronic diseases differ from acute illnesses?
Dr. Jahan: Acute illnesses are usually short-term and resolve on their own or with treatment (like a cold or
broken arm). Chronic diseases, on the other hand, are long-lasting and often progress slowly. They
typically require regular monitoring, medication, or lifestyle changes to control. For instance, a broken bone
heals in weeks, but someone with diabetes will manage blood sugar every day for life.
Editor: Are chronic diseases contagious?
Dr. Lee: No, chronic diseases are noncommunicable; you can’t catch them from another person. They arise
from factors like genetics, behavior, or environment. However, their effects ripple through communities, so
in that sense patients often rely on support from family and care teams.
Editor: Why are they so common and costly?
Dr. Jahan: There are a few reasons. First, our population is aging, and chronic diseases become more
common with age. Second, modern lifestyles often include risk factors like poor diet, lack of exercise, and
smoking . Finally, many people now live decades with chronic conditions thanks to better treatments,
which increases the overall prevalence.
In terms of cost, chronic diseases dominate healthcare spending. In the U.S., about 90% of the $4.1 trillion
annual healthcare costs are for chronic and mental health conditions . That’s mostly from repeated
doctor visits, hospital stays, medications, and complications over a lifetime. Managing multiple conditions
multiplies costs – in fact, roughly 42% of Americans have two or more chronic conditions and 12% have
five or more .
Editor: What can someone do to prevent or delay chronic disease?
Dr. Lee: Great question. Prevention starts with addressing well-known risk factors. WHO and CDC both
emphasize things like quitting smoking, eating a balanced diet, staying active, limiting alcohol, and
managing stress . For example, recent data show that modest weight loss (5–7% of body weight)
plus 150 minutes of moderate exercise per week can cut the risk of developing type 2 diabetes by about
58% . That’s huge, considering over 38 million Americans have diabetes today .
We also stress regular screening: getting blood pressure and cholesterol checks, cancer screenings (like
colonoscopies or mammograms), and so on. Early detection of high blood pressure or prediabetes can
allow for lifestyle fixes before full-blown disease develops.
Editor: What happens after diagnosis – how do patients manage these conditions?
Dr. Jahan: Chronic disease management often requires a team-based approach. That means doctors,
nurses, pharmacists, dietitians, and sometimes community health workers all work with the patient. Each
team member has roles: for instance, pharmacists can help patients understand their medications, nurses
can provide lifestyle counseling, and social workers can address access issues like insurance or
transportation. Research shows that effective chronic illness care generally relies on such multidisciplinary
teams .
Dr. Lee: Exactly. We encourage patients to be active members of their care team. This means keeping track
of their own symptoms or measurements (like home blood pressure logs or blood sugar diaries) and
communicating openly with providers. The patients we see who succeed often have that two-way
engagement.
Engagement Question: What questions do you have about living with chronic illnesses? Drop them below –
our experts will try to answer!


Spotlight on Diabetes, Hypertension, COPD, and Asthma
Editor: Let’s discuss some of the most common chronic diseases by name. How do they affect people?
Dr. Jahan (Diabetes): Diabetes mellitus is a prime example. In type 2 diabetes, the body doesn’t use insulin
properly, causing high blood sugar. According to the CDC, about 38.4 million Americans (11.6%) have
diabetes, and an additional 97.6 million adults (38%) have prediabetes . That’s roughly 1 in 9 Americans
with diabetes, and nearly 2 in 5 with prediabetes.
Managing diabetes means careful attention to diet, exercise, medications, and monitoring. Uncontrolled
diabetes can lead to complications like heart disease, kidney failure, blindness, and amputations. We see
many patients struggle with these lifestyle changes. As one recent review noted, giving patients the skills to
manage their own diabetes (education, family support, problem-solving strategies) is critical to better
outcomes .
(Case example: A patient “Maria,” age 55, had uncontrolled diabetes and weight issues. Her care team enrolled her
in a group program where she learned meal planning and stress management. Over a year, she lost 7% body
weight and her HbA1c (blood sugar measure) dropped by 1.5 points. This illustrates how multidisciplinary support
can change trajectories.)
Dr. Lee (Hypertension and Heart Disease): High blood pressure is often called a “silent killer” because it
usually has no symptoms but damages organs over time. It’s extremely common: nearly 48% of U.S. adults
have hypertension (blood pressure over 130/80 or on treatment) . Yet only about 22.5% of them have it
under control . High blood pressure contributes to heart attacks and strokes – WHO counts about 19
million cardiovascular deaths yearly worldwide . In 2022 alone, high blood pressure was a factor in
685,875 U.S. deaths .
As physicians, we emphasize lifestyle steps (like reducing salt and exercise) and consistent medication use.
A great illustration of teamwork here: programs where nurses or pharmacists help monitor blood pressure
at home lead to much better control. For instance, the CDC highlights a Virginia pilot program
(BuchananCares) that used pharmacists and clinical staff to follow high-risk patients; it significantly reduced
hospital readmissions and improved medication adherence .
Dr. Jahan (COPD – Chronic Lung Disease): Chronic obstructive pulmonary disease (COPD) – which includes
chronic bronchitis and emphysema – is another major chronic illness. About 4.3% of U.S. adults have been
diagnosed with COPD . Symptoms include shortness of breath and cough, which worsen over time.
Smoking is the biggest cause, though air pollution and genetics play a role. COPD is deadly: chronic lower
respiratory diseases (including COPD and asthma) are the 6th leading cause of death in the U.S., causing
roughly 147,000 deaths in 2022 .
Care for COPD involves smoking cessation, inhaler medications, pulmonary rehab, and in advanced cases,
oxygen therapy. It also involves preventive care: patients with COPD should get annual flu and pneumonia
vaccines to avoid lung infections. We work with respiratory therapists and nurse educators to teach patients
breathing exercises and inhaler techniques.
(Example: “John,” a 68-year-old retired mechanic with COPD, had frequent hospital visits. His care team gave him a
peak-flow meter and set up weekly calls with a nurse coach. Over months, he learned to recognize flare-ups early
and adjust treatment. His ER visits dropped by half, showing how patient engagement and follow-up improve
outcomes.)
Dr. Lee (Asthma): Asthma affects about 8.9% of U.S. adults and 6.7% of children . It causes wheezing,
chest tightness, and breathing trouble due to inflamed airways. Unlike COPD, asthma often starts younger
and can sometimes be outgrown. Management includes identifying triggers (allergens, exercise), daily
controller medications (like inhaled steroids), and using quick-relief inhalers when needed. Education is key
– teaching patients to use asthma action plans and inhalers correctly cuts emergency visits. For example,
asthma leads to millions of doctor visits each year (about 4.9 million office visits) , but with proper longterm control, hospitalizations drop dramatically.
Editor: To sum up these examples, each condition has its own challenges, but the solutions share common
themes: patient education, adherence to treatment, and support from a care team.
Engagement Question: Which chronic condition would you like to learn more about, or have experience
with? Tell us your story or questions below!
Behavioral and Systemic Challenges Faced by Patients
Editor: Living with a chronic disease involves more than just taking pills. What obstacles do patients often
face?
Dr. Jahan: Many. First, behavior change is hard. Someone with diabetes might know they need better diet
and exercise, but factors like time, stress, and habits make change difficult. For instance, a review on
diabetes care highlighted that health literacy, community resources, and family support greatly influence a
patient’s ability to stick to recommendations . If a patient doesn’t have easy access to healthy food or a
safe place to walk, it’s nearly impossible to change diet or activity.

Dr. Lee: That touches on social determinants of health (SDOH) – nonmedical factors like where people live,
their income, education, and support network. The CDC points out that conditions like poverty, poor
housing, food insecurity, and education gaps directly affect chronic disease risk and management . For
example, people living in unsafe neighborhoods may avoid outdoor exercise, and those with food deserts
may rely on cheap processed foods. CDC data show communities with high chronic disease rates often have
more people living in poverty, less access to care, and fewer resources .
Dr. Jahan: Language and cultural differences can also be barriers. Patients from diverse backgrounds might
not fully understand medical advice or may have beliefs about illness that differ from Western medicine. We
must listen and incorporate their perspectives.
Dr. Lee: Access to healthcare is another system challenge. Some patients lack insurance or live far from
good clinics. This leads to missed visits and unmanaged conditions. As one study noted, areas with high
chronic disease prevalence had higher uninsured rates and longer distances to care .
Dr. Jahan: On the provider side, there’s burnout and time constraints. A single doctor can’t be everything to
the patient. This is why teamwork is so important. In a team-based model, each member can handle parts
of care that a busy doctor can’t, like intensive follow-up or education. Indeed, experts say the real power of
team care is increasing the number and quality of services available . For example, in hypertension
management, having nurses or pharmacists to do medication counseling and follow-up has been shown to
improve blood pressure control .
Dr. Lee: Even so, patients often feel judged or misunderstood. Some report feeling stigma, especially with
conditions like obesity, mental health issues, or HIV. Stigma can make patients less likely to seek help or
admit difficulties. We must create a trusting environment: supportive language, empathy, and partnership.
Editor: It sounds like chronic disease management requires tackling all these layers: patient motivation,
social context, and healthcare delivery.
Dr. Jahan: Absolutely. We often remind ourselves and our patients that managing a chronic illness is a
marathon, not a sprint. It involves setbacks and tweaks along the way.
Engagement Question: What has been the biggest challenge you’ve encountered in managing a chronic
condition (yours or a loved one’s)? Share your experience or seek advice below – you’re not alone.
Prevention and Medical Advice: Staying Ahead of Chronic Diseases
Editor: Let’s talk about what can be done. How can patients and doctors work together to prevent or
manage chronic diseases effectively?
Dr. Lee: Prevention is multi-pronged. First, lifestyle medicine: eat more fruits and vegetables, whole grains,
lean proteins; cut down on salt, sugar, and unhealthy fats; exercise regularly (the CDC recommends at least
150 minutes of moderate exercise weekly for adults). Avoid tobacco entirely and limit alcohol. WHO and CDC
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highlight these behaviors as key ways to lower chronic disease risk . For example, quitting smoking
will benefit virtually every chronic condition.
Tobacco use – quitting reduces risk of heart disease, COPD, cancer, and even severe COVID-19
outcomes .
Unhealthy diets (high in salt, sugar, saturated fat) – shifting to a balanced diet can prevent obesity,
hypertension, and diabetes .
Alcohol misuse – moderation helps prevent liver disease, high blood pressure, and some cancers.
Physical inactivity – even brisk walking 30 min a day significantly cuts risk of metabolic disease .
Dr. Jahan: We also emphasize regular health screenings. For instance, checking blood pressure annually,
getting cholesterol tests, cancer screenings (mammograms, colonoscopies) at recommended ages, and
keeping up with vaccinations (flu, pneumonia, COVID when indicated) is critical. Early treatment of high
cholesterol or prediabetes can prevent heart attacks or diabetes later on.
Dr. Lee: Medication adherence is another key piece. Many patients stop taking meds when they feel fine,
but we explain that continuing a blood pressure or statin medicine might prevent a future stroke. Our care
teams try to make it easier: monthly med reminder