The overall goal of this report is to highlight the toll of all chronic illnesses on living well from a population health perspective; to discuss the deficits in chronic disease control; and to make recommendations to improve public health efforts to help individuals live better with chronic illness. However, there are many domains of chronic disease management from a public health perspective for which there is simply not enough research or program evaluations to draw definitive conclusions or make concrete recommendations. The committee examined and addressed several important dimensions of the difficulty of controlling chronic disease and makes recommendations on how to proceed. However, much more remains to be done. The committee provided seventeen recommendations without priority order or measured ranking, as all of them are believed to be equally important strategies and steps to undergird public health action to help individuals living with chronic illnesses.
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. It is difficult, however, for state and local public health agencies to plan, develop, implement, evaluate, or sustain programs, policies, and strategies to manage and control chronic diseases when they are structurally deficient and lack the capacity at the system level to effectively take action. The availability of sufficient resources to fortify the operational infrastructure of government public health agencies is not abundant. Given the serious state of the U.S. economy, infrastructure difficulties, and the need to maximize the impact of public health efforts related to living well with chronic illness, the committee’s recommendations are intended to respond to the statement of task, optimize efforts to better understand the burden and needs of people living with chronic illness, promote the creation and implementation of public health policies an emerging legislation, improve the dissemination of effective community-based interventions, improve preventive clinical guidelines for people with chronic illness, and promote the testing of an aligned health system to help people live well with chronic illness. We think that this report and the recommendations are rooted in a population-based approach and underscore the special attention needed and the importance of public health action and leadership in the management and control of chronic disease in support of living well.