HPJA special edition introductory comments

Chronic diseases (including cardiovascular diseases, cancers, chronic respiratory diseases, musculoskeletal conditions and diabetes mellitus) and their biomedical risk factors (such as obesity, hypertension and hyperlipidaemia) are a serious and urgent global population health problem.1 In Australia, chronic diseases are responsible for eight out of every 10 premature deaths,2 over 11 million of the population have at least one chronic disease and chronic diseases account for 80% of years lost due to ill health, disability or early death.3 The financial burden of chronic diseases on the Australian community is considerable and growing. Based on 2008/2009 data, the Australian Institute of Health and Welfare (AIHW) estimates that 36% of all health spending-about $27 billion a year3-is spent on treating chronic diseases, with this amount dwarfed when accounting for the costs of lost productivity and caring for people with disability.3 Chronic diseases also come at a considerable personal cost to individuals and their families, and adversely affect how millions of Australians live their lives every day.3 Promisingly, it is widely acknowledged that much of the burden of chronic disease is preventable. The AIHW estimates that at least 31% of the burden of disease could be prevented by reducing exposure to modifiable risk factors such as tobacco use, harmful alcohol use, high body mass, physical inactivity and high blood pressure.4 Yet, despite recognition of the urgent need to control chronic diseases5 and growing evidence on both the effectiveness and cost-effectiveness of prevention,6 and the significant successes in some countries in the prevention of cardiovascular disease, no country, including Australia, has successfully reversed or even contained the rising overall burden of chronic disease.