Chronic Disease Is Biggest Scourge In American Health

"Health and Human Services Secretary Robert F. Kennedy Jr. has made combating chronic disease a rallying cry as he looks to overhaul the health department and "Make America Healthy Again."

So how healthy is America, historically? It isn't that we used to be healthier, data show, but the biggest threats have changed.

The deadliest scourges in the U.S. were once infectious, with influenza and tuberculosis topping the list at the start of the 20th century. Better sanitation and advances in antibiotics and vaccines muzzled them, transforming Americans' well-being. Medical innovations and antismoking campaigns then spurred decades of progress against heart disease and cancer.

But chronic diseases, persistent or long-lasting health conditions, are undermining that momentum, contributing to our stalled life expectancy over the past decade that trails behind that of other wealthy nations.

Much of the gap in life expectancy is due to deaths among working-age adults, says Dr. Steven Woolf, a life-expectancy researcher at the Virginia Commonwealth University.

"Americans die earlier and are sicker than people in other high-income countries," he said. "This has been true for a long time, and the trend is getting worse."

Drug overdoses from opioids, alcohol, suicide and chronic diseases drive most of those early deaths, researchers said. The U.S. also took a bigger hit from Covid-19, even among younger adults who were at lower risk.

That was in part because Americans were already in worse health and more vulnerable to the virus's toll. The U.S. obesity rate is nearly double the average of peer nations. Around a third of U.S. adults have had multiple chronic conditions, the highest rate among our peers, according to the Commonwealth Fund.

Rates for conditions including hypertension and chronic obstructive pulmonary disease have held relatively steady in recent decades, and the rising prevalence of diabetes is in part because people are living longer with the disease.

Many preventable chronic diseases are related to four major risk factors: cigarette smoking, excessive alcohol use, physical inactivity and poor nutrition.

In the U.S., people get less exercise, moving less than some European counterparts, studies have shown. The nation's Western-style diet is heavy in sugars, processed meat and unhealthy fats. Americans also consume more ultra-processed foods, surveys suggest, and such diets have been linked to increased risks of obesity, Type 2 diabetes and some cancers.

The fractured U.S. health system also contributes to our lagging health, researchers say. Unlike other peer nations, the U.S. doesn't guarantee healthcare coverage. We spend more per person because prices are higher, and Americans are more likely to report skipping care because of cost. We also have fewer doctors per capita than many peer countries, data show.

The U.S. is arguably the best in the world at treating complex diseases, says Dr. Philip Landrigan, director of the global public health program at Boston College. 

But it is worse at providing access to care and services that help manage or prevent illness, he says." [1]

1. U.S. News: Chronic Disease Is Biggest Scourge In American Health. Abbott, Brianna.  Wall Street Journal, Eastern edition; New York, N.Y.. 16 May 2025: A3.