Toward reducing the prevalence of chronic disease: a life course perspective on health preservation

Chronic disease is now hyper-endemic in the United States and is the central problem to be addressed in efforts to enhance the health of the American population. Efforts to reduce the prevalence of chronic disease through diminished exposure to risk factors have achieved significant success in recent decades, but most have been expressions of secondary or tertiary prevention. Current knowledge suggests it would be more effective to extend efforts directed at reduction of risk to earlier phases in the biology of chronic diseases, and to maintain them over the life course. This approach lends itself to a health preservation perspective-in other words, to an orientation around protection of the future health of the individual across the lifespan, from preconception to old age. This will require linked efforts of the clinical, public health, and policy communities, together with private-sector collaborators in information management, marketing, and other areas of expertise.