Chronic diseases are a major menace to the goal of living healthier, longer, and more vital lives. In the 20th century a sustained, and comprehensive scientific effort by public health officials, physicians, researchers, and legislators, was made to reduce the threat of infectious diseases. Chronic afflictions subsequently became the dominant health burden. All of us are vulnerable to various dysfunctions-cardiovascular disease, cancer, chronic obstructive pulmonary disease (COPD), diabetes and cirrhosis- that decrease the vitality of life and longevity, accelerate aging, and increase pain and misery. Sixty percent of Americans are afflicted by at least one of them. This rises to 78% when cohorts reach 55, and as high as 85% after 65. These illnesses cost more than three trillion dollars annually and constitute 6 of the 10 leading causes of US deaths from disease. Numerous factors complicate our understanding of, and efforts to reduce, these dysfunctions: lifestyle and personal habits, involuntary and environmental toxic exposures, and inferior social circumstances and institutions-poor and marginal neighborhoods, limited and inadequate healthcare, poorly protected and dangerous workplaces. To fully understand these maladies Carl F. Cranor casts a wide interdisciplinary net, drawing from the research of physicians, epidemiologists, sociologists and philosophers to identify their nature, development, extent, and causal contributions- ultimately recommending a division of responsibilities between individual and broader socially responsible efforts to justly support vital lives. Individuals can influence chronic afflictions, but these actions alone are insufficient. Cranor argues that, while individuals can influence chronic afflictions, they must be comprehensively and responsibly supported by improved social conditions, healthcare and health-protection institutions, all of which require enhanced social responsibility by public officials and legislators.
