In a recent Roanoke City and Alleghany Health Districts (RCAHD) newsletter survey about non-COVID health issues, readers ranked “chronic disease” the third highest concern, after mental health and substance abuse. Chronic diseases are health conditions that are persistent or long-lasting in their duration and generally slow in their progression.

Chronic diseases are extremely common, making them a leading public health concern. Across the country, six out of every 10 American adults have a chronic disease, and four in 10 have two or more.

The main types of chronic disease are:

• cardiovascular diseases (such as heart attacks and stroke)
• cancers
• respiratory diseases (such as chronic obstructed pulmonary disease and asthma)
• kidney disease
• diabetes
• dementia, including Alzheimer’s disease

Unfortunately, residents of our RCAHD communities experience higher rates of hospitalizations for asthma, diabetes, high blood pressure, and stroke (according to 2020 Virginia hospital admissions data) compared to the rest of the Commonwealth of Virginia. Similarly, our local rates of deaths due to cancer are also higher than in Virginia as a whole (we’ll discuss cancer in a future column).

Chronic diseases can limit a person’s ability to perform daily activities, cause a loss of independence, and result in the need for in-home caregivers or institutional care. Although there are things outside our control that can affect our health, there are many steps we can take to improve our overall health.

Some of the top actions a person can take to decrease the risk of chronic disease and help manage chronic diseases if we have them are to:

• Visit your doctor and dentist regularly for preventive services. Have conversations with your provider about managing your blood pressure, cholesterol, and blood sugar (glucose).
• If you smoke, stop smoking to lower the risk of serious health problems, such as heart disease, lung disease, cancer, and diabetes, even if you have been a longtime smoker. Call 1-800-QUIT- NOW for free support for yourself or a loved one.
• Eat a healthy diet with lots of fruits and vegetables, and exercise regularly.
• Get enough sleep- good sleep habits can protect you against many chronic health conditions.

While people have a responsibility to take care of themselves through choices with diet and exercise, the opportunity for good health starts long before illness sets in. While medical care is important, it is not enough to make people healthy. For example:

• Access to affordable, quality childcare can assist one or both parents to find stable employment which can in turn result in improved opportunities for families to purchase more nutritious food and better-quality housing.
• Nutrition programs that provide home-delivered meals can enable residents ages 60 and older to age in place, remaining healthy and independent in their own homes.

Additional research is needed to help us better understand which community improvements can have the best impact, but we know health begins with healthy communities. The investments that individuals can make for their own health together with bigger picture strategies that promote improvements in places where health starts will have the biggest impact on whether people stay well in the first place.