By Jodi Cohn

Chronic illnesses have emerged as major health concern of Americans in recent decades. People are increasingly focused not simply on living longer, but on maintaining or even improving their capacity to live well over their entire lives.

In general, chronic illnesses are slow in progression and long in duration, and require ongoing medical treatment. All chronic illnesses have the potential to limit the function, productivity and quality of life for the people who live with them. In addition, chronic illnesses are a major contributor to healthcare costs; the medical care costs of people with chronic illnesses represent 75 percent of the $2 trillion spent annually in the United States on healthcare.

To heighten awareness of this growing trend, the Centers for Disease Control and Prevention (CDC) and the nonprofit Arthritis Foundation sought assistance from the Institute of Medicine (IOM) to help identify public health actions that could reduce disability and improve function and quality of life for people living with chronic illness. The IOM is an independent, nonprofit organization that provides unbiased and authoritative advice on health and science to decision-makers and the public. 

In the ensuing report, the committee identified key chronic conditions, defined the concept of Living Well, and made recommendations for public action.

A number of “exemplar” conditions, many of which affect older people, were highlighted: arthritis, cancer, cancer survivorship, chronic pain, dementia, depression, type 2 diabetes, posttraumatic disabling conditions, schizophrenia and vision and hearing loss.

They also defined the concept of “Living Well,” which reflects the best achievable state of health that encompasses all dimensions of physical, mental and social well-being. Living well is shaped by the physical, social and cultural surroundings and by the effects of chronic illness—not only on the affected individual, but also on family members, friends and caregivers.

Recommended actions

The committee made a number of recommendations that can be found in the Executive Summary and Full Report. To summarize, they recommended that the CDC select a variety of illnesses that merit public health action and urges the Department of Health and Human Services (HHS) to support state actions to develop population-based strategic plans, and expand capabilities to more accurately identify chronic illnesses.

Implications for Aging Service Providers

For aging service providers, the fact that a prestigious organization like the IOM focused on the issue of “living well with chronic illness” means policymakers will be more attuned to the topic, which could mean more funding and evidence-based interventions. The full report is available at www.iom.edu/livingwell.

Jodi Cohn is Research Director, Geriatric Practice Innovation with SCAN Health Plan. 

This article was brought to you by the editorial board of ASA’s Healthcare and Aging Network (HAN).