Medicine & Society: Chronic Diseases

Question 1

For much of history chronic diseases are considered …. of elements of the body in relation to environment rather than discrete disease entities.

Answer 1

imbalances

Question 2

How did the meaning of chronic diseases change in the 20th century?

Answer 2

It became a social problem that demands social action

Question 3

Why is chronic disease a social problem (traditional reason)

Answer 3

“Chronics” take up beds in hospitals (where Medicine can do little to help) that are increasingly geared to treating acute and curable diseases. “Bed Blockers”; Goal to get them out.

Question 4

Why is chronic disease a social problem (standard reason)

Answer 4

Amidst falling mortality rates, mortality for certain diseases of adults apparently increased rapidly (cancers, cardiovascular diseases, diabetes).

Question 5

What explains the increased mortality for certain diseases like cancers, cardiovascular diseases and diabetes in the 20th century?

Answer 5

• Radically transformed disease categories
• specialists now look for these disease
• better diagnosis methods
• medical fashion
• lower infant and child mortality rates so that more people reached middle age

Question 6

As infectious disease comes under control and more people live longer, what happened to the proportion of non-infectious diseases (expressed as “chronic”) among adults?

Answer 6

It increased! This is called an epidemiologic transition

Question 7

3 main reasons why started finding more chronic diseases in the 20th century

Answer 7

• Changing epidemiology (decline in infectious diseases in industrialized society)
• Finding more cases of disease through better diagnosis and active searching.
• Regularly creating new disease categories (medicalization).

Question 8

2 approaches to chronic disease

Answer 8

1. Problems are linked to a specific disease
2. Chronic disease is a single comprehensive problem (as was thought in the 18th century)

Question 9

What was the justification for building the NIH (extreme expense)

Answer 9

The institute was to focus on developing cures for chronic diseases.

Question 10

2 other names for chronic diseases

Answer 10

Non-infectious
Non-communicable

Question 11

The notion os risk factors developed during the 1950s as a result of… (2)

Answer 11

1. Debates over the effect of smoking on lung cancer
2. Framingham study on cardiovascular diseases

Question 12

What happened in the last 70 years or so is a search for… (hint: think of the idea of risk factors)

Answer 12

biological irregularities that might signal disease that is asymptomatic.