The frightening reality of chronic diseases

Disease is a frightening word. It’s even more frightening that chronic disease is in danger of getting out of control in Australia.

The term “chronic disease” covers a lot of illnesses that all have one thing in common. The patient needs regular medical care and support, usually over an extended period and often a lifetime. Chronic disease includes things like asthma, diabetes, cardiovascular problems, cancer and mental health issues.

The incidence of every one of those different diseases is growing rapidly, mostly faster than population growth.

Some of this increase is caused by ageing. For example, 30 years ago if I had a heart attack I usually died at the time or within 12 months. Now, I can expect to stay alive and in comparatively better health for 20 to 30 years through a carefully monitored and managed medication regime, diet and exercise. So, we have a lot of older people living normal lives except they need to go to the doctor very regularly.

A lot more of the growth is related directly or indirectly to lifestyle choices.

Australia has 1,000 new cases of diabetes every week. The number of people with diabetes will increase by 350 per cent over the next 20 years. It is already the seventh leading cause of death and is increasing in line with rates of obesity.

Cardiovascular problems are increasing by 4 per cent per year and remain our number one cause of death. Smoking, lack of exercise and high fat diets are still major causes.

There are 1,800 extra cases of cancer every week. By the time they are 75-years-old, one in three men and one in four women will have had cancer. Again, diet, exercise and smoking play a major role.

The scariest part is these figures are just averages. The rates are much higher in some parts of the country.

Many outer metropolitan areas are relatively poor. Areas of cheap and public housing and fringe rural areas rank high on the Australian Bureau of Statistic’s table of economic disadvantage. As inner-city areas have become popular with young well off couples and families, the rate of welfare dependence and poverty in outer metropolitan areas has increased steadily.

Poor areas have poor health statistics. Diet is often inadequate, fresh vegetables and food can often be paradoxically difficult to get in rural areas, people who don’t work suffer a lack of motivation when it comes to exercise and other activities. Often low income families just don’t care about themselves or their health. And of course even better-off families can find it difficult to keep their own and their children’s fast food consumption down to a reasonable level or to get the family away from the computer and television.

There are two very frightening outcomes.

The first is the current generation of children may actually live shorter lives than their parents. The earlier chronic disease begins, the shorter life expectancy will be and we are seeing growing numbers of children with adult-onset diabetes and other chronic conditions.

The second is that the badly understaffed health workforce in all outer metropolitan areas of Australia is reeling from the massive simultaneous demands of a growing, ageing, poor and increasingly unwell population.

What do we do about it? There’s not much government can do other than encourage physical activity and improved diet. And there’s not much doctors and nurses can do to cure chronic disease once you have it. This is one area where community and individual lifestyle choices are critical.

At the same time, we do need resources and time to teach people about informed choices and how to better manage their health.

And time we just don’t have.