The Future of Chronic Disease and the Role of Governmental Public Health

ABSTRACT: Chronic diseases have accounted for the leading causes of morbidity and mortality in the United States for decades. Today, the shape and context of chronic disease is changing. Therapeutic advances have transformed fatal conditions like HIV/AIDS and cancer into chronic conditions. Depression and Alzheimer disease are emerging as leading chronic conditions. Biomarkers are helping individuals determine their risk of certain cancers long before they appear, and technological devices like wearables, mobile applications, and self-administered tools are placing prevention in the hands of individuals. It is imperative that governmental public health redefine its role and look at new opportunities in primary prevention and early intervention of chronic disease. To assist the field, the authors offer recommendations and examples of health department-led initiatives that are meeting the moment in data and surveillance, education and communication, relationships with the health care and policy, environment, and systems efforts.