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<\/p>\n Email Link<\/p>\n \n Among all high-income Western countries, the United States has shown the worst performance in reducing the probability of dying from chronic diseases, a new study finds.\n <\/p>\n \n From 2010 to 2019, deaths due to chronic diseases declined in most age groups in the US but increased among adults 20 to 45, \u201ca rare phenomenon in high-income western countries,\u201d according to the study, published Wednesday in the journal The Lancet<\/a>.\n <\/p>\n \n The study, led by researchers at Imperial College London, analyzed data on 185 countries and territories and found that, from 2010 to 2019, the probability of dying by age 80 from a noncommunicable disease \u2014 such as cancer, heart disease and stroke \u2014 declined in most of those countries, but the decline <\/strong>had slowed compared with <\/strong>the previous decade. <\/strong>\n <\/p>\n \n \u201cThe risk of dying \u2013 or what we call probability in the paper \u2013 from chronic diseases in most countries in the world is coming down,\u201d said Majid Ezzati, the study\u2019s senior author and a professor in the School of Public Health at Imperial College London and Imperial Global Ghana.\n <\/p>\n \n \u201cBut we were doing better before,\u201d he said.\n <\/p>\n \n Among the 25 high-income Western countries in the study, Denmark had the largest decline in chronic disease deaths, while the United States had the smallest, and Germany did only slightly better than the United States.\n <\/p>\n \n \u201cThe US is the slowest, but it\u2019s by no means the exception,\u201d Ezzati said. \u201cGermany is doing nearly as badly.\u201d\n <\/p>\n \n Among the high-income Western countries, there were small to moderate declines in the probability of dying from a chronic disease by age 80 from 2010 to 2019 <\/strong>overall. But the researchers noted that a possible reason why the declines were not larger as a group is that in many countries, neuropsychiatric conditions such as dementia increased and contributed unfavorably to the trends.\n <\/p>\n \n The new study included data from the World Health Organization\u2019s Global Health Estimates<\/a>, and the team of researchers analyzed deaths between time periods, countries and by age groups: young adults 20 to 45, working-age adults 45 to 65, and older adults 65 to 80.\n <\/p>\n \n The data showed that from 2010 to 2019, chronic disease deaths declined in about 80% of the world\u2019s countries, home to more than 70% of the global population.\n <\/p>\n \n The reasons for widespread decline in chronic disease mortality could be tied to improvements in diagnosing and treating chronic diseases, according to the study. For instance, there have been changes in clinical guidelines as well as increases in the use of certain medications and the early detection of certain cancers.\n <\/p>\n \n But in about 60% of countries, either the decline in chronic disease deaths from 2010 to 2019 was smaller than it had been in the preceding decade or there was a reversal of an earlier decline, the data showed.\n <\/p>\n \n \u201cThe countries that did really well did well both in older and working ages. Countries that did really badly did badly in both older and working ages,\u201d Ezzati said. \u201cAnd then there was some tradeoff between these. Some places never slowed down in older ages, but they have in working ages, and vice versa.\u201d\n <\/p>\n \n From 2010 to 2019, Finland, Norway and Denmark all had a slower decline in chronic disease deaths among older ages than they had in the previous decade. But they still maintained significant progress in reducing the risk of chronic disease deaths overall because that slower decline among older adults was countered by faster declines among working-age adults.\n <\/p>\n \n In the United States, small reductions in mortality among older adults were combined with a stagnation among working-age adults and increases in mortality among young adults, leading to the nation\u2019s poor performance compared with other high-income Western countries.\n <\/p>\n \n The study did not analyze why some countries had greater improvements than others in reducing the probability of chronic disease deaths, but Ezzati had some ideas.\n <\/p>\n \n In both high-income Western countries that performed poorly compared with their peers \u2013 the United States and Germany \u2013 there are segments of the population in which there has been less investment in public health, he noted, and these disparities in investment can lead to broad barriers to accessing care.\n <\/p>\n \n For instance, a barrier can be not having a primary care physician in your local area, which can lead to the delayed screening for and diagnosis of chronic conditions, Ezzati said.\n <\/p>\n \n Many Americans live in areas where critical-care services are lacking. It\u2019s estimated that nearly 30 million Americans don\u2019t live within an hour of trauma care<\/a>. And a CNN analysis has found that people living in 16% of the mainland United States are 30 miles or more from the nearest hospital.\n <\/p>\n \n The United States also has had a rise in the probability of dying from neuropsychiatric conditions, such as dementia and alcohol use disorders, which did not appear to offset continued declines in deaths from cancers and cardiovascular diseases \u2013 and these trends could have contributed to the nation\u2019s poor performance in reducing chronic disease mortality, according to the researchers.\n <\/p>\n \n The new study was published a day after the Trump administration released the Make America Healthy Again Commission<\/a>\u2019s action plan on reducing childhood chronic diseases<\/a> in the United States.\n <\/p>\n \n US Health and Human Services Secretary Robert F. Kennedy Jr. has made tackling chronic diseases a primary focus. In an interview Tuesday on Fox News<\/a>, Kennedy noted that the share of US adults with at least one chronic condition is 76.4%<\/a>, according to data from the US Centers for Disease Control and Prevention.\n <\/p>\n \n Elena Ladas, a professor of global integrative medicine at Columbia University and an expert on noncommunicable diseases in young people, said she is optimistic the United States is heading toward embracing wellness as a prevention tool to reduce chronic disease deaths, but she wants to see a clear implementation plan.\n <\/p>\n \n \u201cThey\u2019re talking about the right things: Ultraprocessed foods need to really be minimized, and exposures to pesticides and environmental contaminants,\u201d Ladas said of the MAHA report. \u201cThey\u2019re talking about what I think a lot of epidemiologists and clinicians have been saying for a very long time. But how they\u2019re going to implement that remains to be seen.\u201d\n <\/p>\n \n Ladas, who was not involved in the new study but has done public health work in nearly two dozen countries, said the United States should \u201cthink about wellness comprehensively\u201d to reduce the burden of chronic disease.\n <\/p>\n \n \u201cWellness approaches include good nutrition. We need to make healthy food reasonably priced. A lot of times, farmer\u2019s markets are more expensive than the grocery store. You don\u2019t see that in Europe. In Europe, farmer\u2019s markets are far less expensive than grocery stores,\u201d Ladas said.\n <\/p>\n \n \u201cAnd mental health can include meditation and deep-breathing,\u201d she added. \u201cThere are more holistic wellness approaches to include for a lot of these chronic conditions versus being only medication-based resolutions. You need both.\u201d\n <\/p>\n
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