Abstract
Chronic disease is a significant burden in the United States. Currently, more than 60% of Americans live with at least one chronic disease and, collectively they account for approximately 70% of all deaths and 86% of total health care costs. The prevalence of most chronic conditions is projected to continue increasing, and as a result, much work is being done by way of mitigation and prevention. Key to this work is the identification of the root causes of chronic disease. A burgeoning specialty field in lifestyle medicine has developed to address the root causes of chronic disease via participation in self-care activities. The purpose of this manuscript is to critique the current philosophies and practices that address the root causes and to propose an alternate viewpoint. Central to the argument is a misalignment that exists between of the factors that determine health and current biomedical practices. Social and economic factors have the greatest influence, but are currently addressed only minimally. Additionally, research has demonstrated that chronic stress is a plausible explanation for chronic disease. Exploring the root causes of chronic stress may lead to greater clarity of the root causes of chronic disease. Theories that exist within the social science literature provide explanations for the rise in chronic stress as it manifests from the modern way of living of most Americans. The Chronicity of Modernity theory is used to argue that connections exist between modern lifeways and chronic stress that lead to chronic disease. Power and agency are central to the argument as each are largely controlled at the institutional level rather than the personal or community levels. As such, the root causes of chronic disease are not being addressed within lifestyle medicine practices. Including a broader perspective of health professionals within lifestyle medicine, such as medical anthropologists, is a possible new direction for this field. This new direction can more holistically develop a philosophy and strategy that more effectively addresses the mitigation of chronic diseases at the root cause.