Recommendation 17

The committee recommends that the secretary of HHS establish and support a standing national work group to oversee and coordinate multidimensional chronic diseases surveillance activity, including obtaining patient-level data on health-related quality of life and functional status from electronic medical records and data on the implementation and dissemination of effective chronic disease interventions at the health care system and the community levels, including longitudinal health outcomes.


The burden of chronic disease in America today is indeed vast and continues to grow. The sheer magnitude of this burden for society; the striking inequalities in living well among minorities, the elderly, and the disadvantaged; and the simple fact that numerous chronic illnesses are leading causes of death and disability are all emblematic of the considerable limitations of existing policies, programs, and systems of care and support for people living with chronic illness today.

Government public health agencies have the ability to take action to help people live better with chronic illness. They have the expertise to assess a public health problem, develop an appropriate program or policy, and ensure that programs and policies are effectively delivered and implemented. The committee thinks that its recommendations are rooted in a population-based approach, underscore the importance of public health action in the management and control of chronic disease, and offer strategies to support public health efforts.

As the nation strives to consider and implement new strategies for understanding and addressing the burden of chronic illness, it is imperative that those strategies give ample consideration to all chronic illnesses and all dimensions of suffering. Indeed, all chronic illnesses have the potential to reduce population health not only by causing premature death but also by limiting people’s capacity to live well during all the years of their lives. For society, living well is impacted both by the numbers of persons living with chronic illnesses and by the effects of those illnesses on the quality of life of patients, their peers, and their caregivers. In this context, the overall burden of chronic illness could be drastically reduced through coordinated efforts toward both primary prevention and other interventions and policies designed to improve health for persons already living with chronic illness.

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