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February 5, 1997

The High Cost of Lost Opportunities for Prevention

Author Affiliations

University of Maryland School of Medicine Baltimore

JAMA. 1997;277(5):375-376. doi:10.1001/jama.1997.03540290027022

To the Editor.  —The article by Dr Hoffman and colleagues1 details the enormous cost our nation pays for chronic health conditions. It would be easy to bemoan the huge burden of these conditions in terms of higher taxes and health insurance costs, but there is a far larger tragedy that the authors failed to mention: a large proportion of the morbidity, mortality, and costs from chronic conditions is preventable.The major risk factors that cause most chronic diseases have been identified. For example, heart disease is largely attributable to unhealthy diet, elevated blood cholesterol, elevated blood pressure, smoking, and physical inactivity.2 Cancer is caused largely by unhealthy diet and smoking.3 Stroke is caused largely by elevated blood pressure.4 Modifiable risk factors have been delineated for most of the other leading chronic conditions, and research also has identified effective techniques for controlling these risk factors and preventing