Health Conditions & Chronic Disease

An Introduction to Chronic Diseases in the US for Health and Wellness Professionals

Six in ten people in the United States have a chronic disease. 

Four in ten people have two or more chronic diseases. 

Chronic diseases have the potential to affect all dimensions of a person’s health and wellness. 

While access to high-quality primary healthcare is essential for effective chronic disease management, health and wellness coaches can have an important role in improving their client’s wellbeing. 

In this article, we give you an overview of chronic diseases in the US and provide information on the role of health and wellness professionals in supporting clients who are living with chronic diseases. 

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What Is Chronic Disease?

The Centers for Disease Control and Prevention (CDC) defines chronic diseases as “conditions that last one year or more and require ongoing medical attention or limit activity of daily living or both.” The World Health Organization also refers to chronic diseases as noncommunicable diseases, referring to the noninfectious nature of the conditions that fall into this category. 

The chronic diseases that most commonly affect people in the US and around the world include heart disease, diabetes, stroke, cancer, depression, and arthritis. 

Many chronic diseases that people face currently do not have cures. When a person is diagnosed with a chronic disease, their goal is to manage the symptoms and disease progression. 

Types of Chronic Disease

There are several types of chronic disease, and institutions may categorize them differently. Some of the types of chronic diseases include:

  • Addiction
  • ALS (Lou Gehrig’s Disease)
  • Alzheimer’s disease and other types of dementia
  • Parkinson’s disease
  • Arthritis
  • Asthma
  • Atrial fibrillation
  • Cancer
  • Celiac disease
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Cancer
  • Chronic hepatitis
  • Chronic kidney disease
  • Cystic fibrosis
  • Depression and anxiety
  • Diabetes (type 1 and type 2)
  • Eating disorders
  • Heart disease
  • Hyperlipidemia
  • Hypertension
  • Multiple sclerosis
  • Oral health diseases
  • Osteoporosis
  • Polycystic Ovarian Syndrome (PCOS)
  • Reflex sympathetic dystrophy (RSD) syndrome
  • Schizophrenia and other psychotic disorders

There are dozens of other chronic diseases that are not on this list, but it sheds light on the diversity of the chronic diseases that exist. 

The Impact of Chronic Disease on People’s Health and Wellness

Often, chronic diseases are seen as conditions that only affect the physical aspects of the body, like how we breathe, use energy, and move. However, chronic diseases can also have a significant impact on a person’s mental, emotional, and social wellbeing. 

However, wellness has many dimensions, and any health experience, including a chronic disease diagnosis, can affect all dimensions of wellness. 

Here are some ways a chronic disease diagnosis may impact the seven dimensions of wellness

  • Emotional wellness: People living with chronic disease are more likely to have anxiety and depression, even more so if they are experiencing pain
  • Intellectual wellness: People living with chronic disease may feel more pressure to be learning and studying their condition constantly. Their chronic condition may also negatively impact their cognitive health
  • Physical wellness: Physical wellness in chronic disease is often the most visible and where focus is placed in public health approaches. Most chronic diseases have a direct negative impact on the functioning of one or more bodily systems, such as the nervous system, the endocrine system, and the digestive system.
  • Social wellness: A chronic disease diagnosis can negatively impact relationships as pressure is put on an individual to make lifestyle changes or if it impacts their ability to engage in different social activities and responsibilities in the home and with friends. Chronic diseases that have an outwardly visible effect on an individual may also result in discrimination from others. 
  • Occupational wellness: When emotional, intellectual, and physical wellness decline, occupational health may also decline. A person with chronic disease may be or feel unable to carry out tasks at work, or they may face discrimination if their workplace is unwilling to adapt to their changing needs. People with chronic disease are more likely to be at risk of unemployment, especially if they are undergoing treatment. It is also important to note that occupational stress and burnout can contribute to chronic disease risk.  
  • Spiritual wellness: A person living with a chronic disease may question their religion or spirituality. They may also be unwilling, unable, or not permitted to participate in activities that are important to their spirituality. 
  • Cultural wellness: Healthcare professionals may blame the development of a person’s chronic disease on cultural practices and values, potentially causing individuals to reject their culture or to be distrustful of the health system

In many ways that are not touched upon in this article, a chronic disease, both diagnosed and undiagnosed, has the potential to impact all dimensions of a person’s wellness. 

Key Figures on Chronic Disease in America

The CDC reports the following facts and figures about chronic disease in the United States. 

  • 60% of adults have a chronic disease
  • 40% of adults have two or more chronic diseases
  • The seven leading causes of death and disability are chronic diseases:
    • Heart disease
    • Stroke
    • Cancer
    • Chronic lung disease
    • Alzheimer’s disease
    • Diabetes
    • Chronic kidney disease
  • The key lifestyle risks for chronic disease development include:
    • Tobacco use
    • Poor nutrition
    • Lack of physical activity (sedentarism)
    • Excessive alcohol use
    • Chronic diseases are a leading driver of healthcare costs.

Chronic Disease Can Be Prevented Through Lifestyle, But Lifestyle Changes Are Not Simple

When healthcare professionals and institutions like the CDC say that chronic diseases are preventable, they are saying that there are several nonhereditary factors that can significantly lower the risk of developing a disease. 

Health behaviors, or actions we take that influence our health, are determined by social factors, environmental factors, and psychological factors, among others. However, there is a common misconception that health behaviors are entirely within an individual’s control. This is untrue and detrimental to both the individuals affected by chronic disease and the systems designed to improve public health outcomes. 

If you are Black, Brown, Indigenous or a Person of Color, for example, you are significantly less likely to have equal access to healthcare, safe public spaces to carry out physical activity, and reasonably priced fresh foods. The same is true for LGBTQIA+ communities, women, and rural communities. 

After decades of BIPOC health professionals, grassroots organizations, and community health researchers repeatedly highlighting that minority communities have devastating disadvantages regarding the risk of chronic disease due primarily to systemic and historic racism and sexism, the CDC recognized that promoting health equity is essential to fighting chronic disease. In late 2020, the CDC announced that they awarded $7 million for pilot projects to reduce chronic disease by advancing health equity. 

In short, fighting chronic disease is complex. There is no one-size-fits-all solution. By understanding the data, as well as the gaps in data, creating culturally and economically adequate public health solutions for the entire life/course, and providing high-quality, individualized healthcare to those that need it, chronic disease statistics will begin to fall. 

What Is the Role of Health and Wellness Coaches in Supporting Clients Living With Chronic Disease?

Health and wellness coaches are experts in working with small groups or one-on-one with their clients. 

They understand the big picture, but they create individual plans and goals based on each person’s needs and desires. 

Health coaches know that, whether your client is living with a chronic disease or not, everyone’s conception of health, experience in their bodies, and experience with health systems is different. We also know that many factors influence health behaviors, most of which have some component over which they have no control. 

With that in mind, you might be asking yourself, what do I do with the knowledge I now have about chronic disease in America? How can I be of support to my clients who are living with a chronic disease?

Here are some suggestions:

  • Do a mindset check. Having a growth mindset will allow your mind to change with new information, critical thinking, and a commitment to your clients. By having a growth mindset, you are allowing your clients to be the experts on their personal health and chronic disease experiences. 
  • Treat them as the individuals that they are. Try to avoid making assumptions about their lifestyle or background based on a diagnosis. 
  • Ask them what their personal goals are in terms of chronic disease management and otherwise. It may be that they have sought out your help for something not directly related to their chronic disease, and be prepared to support them in that goal. 
  • If your clients feel comfortable disclosing the information, ask them about their doctor’s suggestions. You may want to discuss with your client whether their doctor’s lifestyle-related expectations seem realistic or not and if and how they would adjust them. 
  • When appropriate, and only with your client’s approval, reach out to your client’s primary care physician. You may engage in a discussion with their primary care team to make sure you are on the same page and to potentially advocate for your client. 
  • Build a plan together with your client. When clients take on an active role in building their plans and defining flexible health goals, they are more likely to feel satisfied with their progress, and they are more likely to see improvements in their disease and health management

Main Takeaways

Chronic disease may have significant detrimental effects on a person’s health and wellness. As a health coach, it is important to understand the complexities of the development of chronic diseases, as well as for all of the ways living with chronic disease can affect an individual’s wellness. 

As a coach, take actions to value your client’s individual experience with chronic disease and be instrumental in helping to build a realistic health plan to help them effectively manage their health and illness. 

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