Dean Emeritus, Johns Hopkins Bloomberg School of Public Health
One thing that we have to recall is everybody is going to get a chronic disease if they live long enough. So the issue is not about eradicating chronic diseases or noncommunicable diseases.
Everyone’s going to suffer from something. You want to suffer from it hopefully late at life just before you die. That means reducing the risk factors, a chain of effects that modify the incidence, the frequency of onset, the age of onset and the severity of these noncommunicable diseases. The primary prevention is basically real lifestyle changes.
These changes are tough. They [require] far greater people’s involvement than taking an antibiotic or even taking a vaccine. But we certainly have plenty of proof that it can be done for noninfectious diseases. Now more American women die every year from lung cancer because they smoke than die from breast cancer. American women never died from lung cancer before World War I. We know that this is totally a lifestyle disease.
Now, how, in fact, do you make people really change what they do? I like to think of the five “tions”: There’s the education, because you have to tell people what it’s all about and why you’re now really going to stick it to them. Then you have regulation, taxation, legi slation and litigation.