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Sick SocietiesResponding to the global challenge of chronic disease$
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David Stuckler and Karen Siegel

Print publication date: 2011

Print ISBN-13: 9780199574407

Published to Oxford Scholarship Online: January 2012

DOI: 10.1093/acprof:oso/9780199574407.001.0001

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Comprehensive strategies to reduce the burden of chronic diseases

Comprehensive strategies to reduce the burden of chronic diseases

What are the best ways to reduce the burden of chronic disease?

(p.87) Chapter 4 Comprehensive strategies to reduce the burden of chronic diseases
Sick Societies

David Stuckler

Karen Siegel

Kathleen O’Connor Duffany

Sandeep Kishore

Denise Stevens

Sanjay Basu

Oxford University Press

This chapter is organized into two parts. Part I shows how healthcare systems — set up in a period when infectious diseases were dominant — have locked in a focus on treating acute-care episodes. It further demonstrates how global health has come to focus a narrow set of low-cost, magic-bullet solutions, based on historical successes in eradicating smallpox. It argues that these healthcare systems and this smallpox paradigm are inappropriate for caring for people who have chronic, long-term illnesses, and reveals an alternative model of ‘liberatory medicine’ based on chronic care models that could improve patients' outcomes at lower cost. Part II reveals that public health initiatives have been skewed towards medical interventions rather than preventative approaches. This has manifested itself in major gaps in the research base for understanding how chronic diseases can be prevented at low cost. Nevertheless, it is argued that, despite gaps in the evidence base, there are a clear set of proven strategies to reduce the suffering and occurrence of chronic diseases in an entire population.

Keywords:   healthcare systems, infectious disease, disease management, liberatory medicine, patient outcome, medical practice, smallpox paradigm, public health

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