1. CHRONIC DISEASE RISK FACTORS

2. Risk Factors  What are the risk factors for chronic disease?  #1??  #2??  Others….

3. Tobacco

4.  Between 1964 and 2014:  Over 20 million Americans died because of smoking 2.5 million nonsmokers More than 100,000 babies  Smoking is still the leading cause of preventable disease and death in the U.S. “The Health Consequences of Smoking: 50 Years of Progress”

5. An evolving process…  “If excessive smoking actually plays a role in the production of lung cancer, it seems to be a minor one.” The National Cancer Institute, 1954  “Tobacco use imposes enormous public health and financial costs on this nation – costs that are completely avoidable.” Kathleen Sebelius, Secretary of Health & Human Services, 2010

6. Mortality Source: www.cancercontrol.cancer.gov

8. Smoking and chronic disease  Responsible for more than heart and lung disease:  13 different types of cancer  Smoking and reproduction  Diabetes, eye disease, immune system

9. FDA & Tobacco Regulation  Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and Adolescents  Restricts sale, distribution, and promotion of tobacco products to make them less accessible to youth.  Law went into effect June 22, 2010 (FDA, 2010)  http://www.fda.gov/TobaccoProducts/Labeling/Cig aretteProductWarningLabels/ucm2024177.htm http://www.fda.gov/TobaccoProducts/Labeling/Cig aretteProductWarningLabels/ucm2024177.htm

10. Graphic labels coming soon. (Fda.gov, 2011)

11. (FDA.gov, 2011)

12.  Thoughts?  Warnings were to appear Sept. 2012 but…. (FDA.gov, 2011)

13. Obesity

14. Obesity rank by country NationMaster.com, 2012

15. Contributing Factors  Portion Sizes  Physical Inactivity  Genetics  Media  Technology

16. (Brownell, 2006)

17. Contributing Factor: Inactivity  What is the recommended amount of daily activity?  Schools and PE  Sedentary Workplaces  Communities  “We have engineered activity out of our lives” (TWON, 2012)

18. Contributing Factor: Advertising  “Toxic advertising”  Health claims on food  TV time has increased

19. Obesity & Stigma  A lot of bias exists when it comes to those who are overweight or obese.  Health care workers  Employment opportunities  Media  Children

20. Alcohol

21. Alcohol and Chronic Disease  3 rd leading lifestyle-related cause of death  How does alcohol contribute to chronic disease?  Short-term health effects  Long-term health effects

22. Other risk factors?

23. SLEEP! Lack of sleep is associated with: Diabetes, cardiovascular disease, obesity, depression and cancer. (CDC, 2009)

24. Prevention  Prevent, prevent, prevent  But how????  Individual education / motivation  Government policy  Built environments

25. Just getting people more active…  “Better to be fat and fit, than skinny and un-fit.” (Dr. Robert Sallis, 2014, pg 10)  Exercise and…  Dementia  Depression  Autoimmune Disorders such as Fibromyalgia  Helping patients  “No amount of exercise is insignificant.” (Dr. Robert Sallis, 2014, pg 26)