Identifying the Problem

The leading causes of death are usually listed as heart attack, stroke, cancer, etc. However, the leading "actual" causes of death in the United States are risk factors that can be modified.

According to an article in the March 10, 2004 edition of the Journal of the American Medical Association, smoking is still the leading actual cause of death, killing 435,000 Americans in 2000, up from 400,000 in 1990. However, poor diet and physical inactivity are a close second.  Predicted to replace smoking as the leading actual cause of death in the near future, these two chronic disease risk factors accounted for 400,000 deaths in 2000, up from 300,000 in 1990.

Being overweight or obese can greatly increase the chances of contracting heart disease, stroke, many types of cancer, diabetes, gall bladder disorders and many other ailments.

The reasons why chronic diseases and obesity flourish in the U.S. are many:

• Lack of time in a fast-paced society coupled with growing numbers of fast-food outlets and restaurants, making it convenient to eat out.
• Restaurants and fast-food outlets serving extremely large portions of food with these foods being high in fat, saturated fat, trans fat, cholesterol, calories and sodium while relatively low in fiber and nutrients necessary for health.
• Vending machines, snack bars and cafeterias with few, if any, healthy choices.
• Increased inactivity due to modern labor-saving devices, computers, video/DVD games, security concerns, lack of sidewalks, walking trails and bike paths.
• Using tobacco for smoking, chewing, dipping, etc.

There has been little progress during the past decade in reducing deaths attributable to the risk factors of poor nutrition, physical inactivity, obesity and tobacco use.  We have always told people "they need to eat better and exercise." This admonition has met with little success. People must live healthier lifestyles, but they need help. Communities, schools, worksites, medical centers and government need to work together to establish environments and create policies that eliminate the barriers to, and increase the opportunities for, people to live healthy.

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