The five behaviors that drive so much pain and suffering

Five modifiable behaviors—diet, physical inactivity, smoking, excessive alcohol consumption, and poor medication adherence—are responsible for much of the illness, suffering, and early death related to chronic disease.


In 2007, only 24% of adults reported eating 5 or more servings of fruits and vegetables per day. The average American consumes about 1 gallon of soda per week and 29 lbs of french fries per year.



Roughly 50% of American adults do not get the recommended amount of regular physical activity and 26% are essentially completely inactive. Inactivity drives the risk of developing high blood pressure, cardiovascular disease, type 2 diabetes, certain types of cancer, and osteoporosis.


More than 43 million American adults (approximately 1 in 5) smoke. Lung cancer is the leading cause of cancer death, and cigarette smoking causes almost all cases. Compared to nonsmokers, men who smoke are about 23 times more likely to develop lung cancer and women who smoke are about 13 times more likely. Smoking causes about 90% of lung cancer deaths in men and almost 80% in women. Smoking also causes cancer of the voicebox (larynx), mouth and throat, esophagus, bladder, kidney, pancreas, cervix, and stomach, and causes acute myeloid leukemia.




Binge drinking, the most dangerous pattern of drinking (defined as consuming more than 4 drinks on an occasion for women or 5 drinks for men) is reported by 17% of U.S. adults, averaging 8 drinks per binge. Excessive alcohol consumption contributes to over 54 different diseases and injuries, including cancer of the mouth, throat, esophagus, liver, colon, and breast, liver diseases, and other cardiovascular, neurological, psychiatric, and gastrointestinal health problems.



Overall, about 75% of adults do not follow physician's orders when it comes to taking medicines -- including not filling the prescription, taking less than the recommended dose, or stopping the medicine without the doctor's knowledge. In the United States, nonadherence to medications causes 125,000 deaths annually and accounts for 10% to 25% of hospital and nursing home admissions. Medication nonadherence results in an economic burden of $100 billion to $300 billion per year.


Chronic Disease by the Numbers

Chronic disease is quite serious. The following statistics come from the US Department of Health and Human Services and the Centers for Disease Control and Prevention.

  • 45% of US adults have 1 or more chronic condition.
  • 25% have 2 or more chronic conditions, which drives 66% of healthcare spending.
  • 75% of adults over age 65 have 2 or more chronic conditions.
  • 7 out of 10 deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50% of all deaths each year.
  • In 2005, 133 million Americans – almost 1 out of every 2 adults – had at least one chronic illness.
  • Obesity has become a major health concern. 1 in every 3 adults is obese and almost 1 in 5 youth between the ages of 6 and 19 is obese (BMI ≥ 95th percentile of the CDC growth chart).
  • About one-fourth of people with chronic conditions have one or more daily activity limitations.
  • Arthritis is the most common cause of disability, with nearly 19 million Americans reporting activity limitations.
  • Diabetes continues to be the leading cause of kidney failure, nontraumatic lower-extremity amputations, and blindness among adults, aged 20-74.


How Patient Engagement Can Help

In a series of posts, we explore how patient engagement -- specifically mHealth -- can help chronic disease patients develop healthy behaviors and take control of their health:


Kidney Disease

Heart Failure


Heart Disease


Further reading:

Mobile Health ROI Part 1: Readmissions

Mobile Health ROI Part 2: HCAHPS & Value-Based Purchasing

Mobile Health ROI Part 3: Patient Loyalty

Mobile Health and Medicine Reconciliation

Mobile Health and the Closing Window for Patient Engagement