2011-11-18 / Top Stories

DOH: Chronic Diseases Reduce Quality Of Life

The Health Department recently re-leased a new study that, using an analysis looking at disability-adjusted life years, reveals the extent to which chronic diseases contribute to a reduction in quality of life as well as premature death. Unlike traditional health studies which measure solely the risk of premature death, this analysis more broadly translates the effect of illness by quantifying the impact that chronic illness has on quality of life (including the loss of ability to work or function independently at home) into a measurement of “healthy years of life lost” for an individual. Taking into account years lived with illness as well as years of life lost due to untimely death, the study shows that heart disease and major depression impose the largest health burden on New Yorkers.

“These data show that many New Yorkers are living with chronic, disabling conditions, which highlights the importance of prevention, early detection and treatment for these ill-nesses,” said New York City Health Commissioner Dr. Thomas Farley. “For example, depression is treatable, but because it is often not diagnosed, it goes untreated.”

Disability-adjusted life years were first used by the World Health Organization to measure the relative burden of disease associated with specific diseases and injuries. This approach provides a means for establishing research and treatment priorities based on the total burden of disease, rather than causes of death alone. These results are important for helping the city direct its efforts to-ward those health problems that cause the greatest loss of years of healthy life.

Ischemic heart disease, an illness where hardening of arteries restricts blood flow to the heart, is the top cause of disability-adjusted life years for New Yorkers, and the number one cause of years lost to premature death. Many heart disease deaths could be prevented also by quitting smoking, getting regular exercise, eating a well-balanced diet, and maintaining a healthy weight. Major depression ranks second in the health burden it places on New Yorkers, because of its profound negative effect on people’s lives. Alcohol and drug dependence, osteoarthritis and asthma are also associated with a significant burden of disease on New Yorkers since these illnesses can cause many years of disability. Some of these conditions can also lead to premature death.

Adults who suffer from major depression often experience psychological, behavioral, and physical symptoms. Major depression is characterized as depressed mood or loss of interest or pleasure in various aspects of life. Other symptoms include feelings of anxiety, hopelessness, worthlessness and changes in appetite and sleep. These symptoms can affect people’s work and social lives. Those suffering from major depression may be more likely to engage in poor health behaviors such as lack of physical activity and substance use, which can put them at increased risk for physical illness and contribute to significant disability. Adults suffering from major depression have an increased risk of dying of heart disease compared to those without major depression. Adults with heart disease are also at higher risk of experiencing major depression than the general population.

Alcohol use was the fourth leading cause of disability-adjusted life years, after HIV, and amounted to twice as many healthy years of life lost in men compared with women. Excessive drinking contributes significantly to chronic diseases, such as liver disease and cancer, and to injuries from mo-tor-vehicle accidents and violence, many of which lead to many years of healthy life lost because they occur in relatively young people. Excessive alcohol use can contribute to loss of productivity and other negative social consequences.

“The burden of disease from excessive drinking and alcoholism is often underestimated,” said Farley. “These data reinforce that alcohol causes great suffering, in addition to its effects on premature death, and emphasize the need for improved public awareness and strengthened policies to reduce excessive drinking.”

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