Patient behavior: an extensive review

The most frequent causes of death in the United States and globally are chronic diseases, including heart disease, cancer, lung diseases, and diabetes. Behavioral factors, particularly tobacco use, diet and activity patterns, alcohol consumption, sexual behavior, and avoidable injuries are among the most prominent contributors to mortality. Projections of the global burden of disease for the next two decades include increases in noncommunicable diseases, high rates of tobacco-related deaths, and a dramatic rise in deaths from HIV/AIDS. Worldwide, the major causes of death by 2030 are expected to be HIV/AIDS, depressive disorders, and heart disease. At the same time, in many parts of the world, infectious diseases continue to pose grim threats, especially for the very young, the old, and those with compromised immune systems. Malaria, diarrheal diseases, and other infectious diseases, in addition to AIDS, are major health threats to the poorest people around the world. And, like chronic diseases, their trajectory may be influenced by the application of effective health behavior interventions. Substantial suffering, premature mortality, and medical costs can be avoided by positive changes in behavior at multiple levels. Most recently, there has been a renewed focus on public health infrastructure to plan for emergencies, including both human-made and natural disasters. During the past twenty years, there has been a dramatic increase in public, private, and professional interest in preventing disability and death through changes in lifestyle and participation in screening programs. Much of this interest in disease prevention and early detection has been stimulated by the epidemiological transition from infectious to chronic diseases as leading causes of death, the aging of the population, rapidly escalating health care costs, and data linking individual behaviors to increased risk of morbidity and mortality.