THE FUTURE OF CHRONIC DISEASES
Department of Epidemiology, Institute of Social Medicine, Warsaw Medical University, Warsaw
Vyšlo v časopise:
Prakt. Lék. 2004; (11): 3-13
Major chronic diseases continue to be the main health scourge of the most developed countries, have only recently been retreating in frequencyin the fledgling market economies, and are becoming dominant in many populous areas of the developing world. The descriptive evidence from thedevelopments of the near past strongly suggests that much of the control outcomes have already been achieved with the existent imperfect causativeknowledge. The continuation of desirable trends in major chronic diseases in some places like Central & Eastern Europe, is uncertain within theintermediate time range without gaining more etiological clues, among which the role of medi cal care is worthy of reconsideration. Other factorscan grow in importance, like obesity, which may be freed from the suppressive influence of cigarette smoking to trigger major mass pathologies,like type 2 diabetes mellitus, arterial hypertension, some cancers etc. The role of social underpriviledge seems recalcitrant, although the part playedby social share of biological risk agents may diminish in response to educational persuasion. The remotest destinies of some chronic diseases maydepend on the mixture of external and genetic influences ending as predispositions towa rds some ailments, antecedents of which might haveprotected their carriers from dangers of the past unfriendly environment, like obesity (or diabetes) against famine, or hypertension against inefficientdefense reaction. The resulting medium-range prediction of well-being for inhabitants of more developed world may not be forbidding, sinceincreasing life expectancy needs not be synonymous with disability, and attaining old age does not require excessive sacrifice, beyond reducingnumber smoked, or preserving decent respiratory volumes.
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