There is clear evidence that the costs of chronic conditions are enormous, as are the potential savings from preventing them, even if there may not always be agreement on the exact amounts of these costs and savings. Since a large part of the root cause of chronic conditions involves attitudes and behavioral choices, the prospect of reducing their prevalence appears daunting and promising at the same time. Attitudes and behaviors may be resistant to change, even when the desire to change is there. Moreover, people often encounter significant barriers in their social and physical environments. On the other hand, the actions that would eliminate much of the morbidity and mortality in our country are clear, and to a large extent these are practicable measures that the average person can take. By changing the way they live, Americans could change their personal health status and the health landscape of the Nation dramatically. Americans could save themselves, their employers, and the Nation substantial amounts of money if they took certain measures that are well-understood and relatively modest in scope. Even though some efforts over the last several decades to educate individuals about ways to improve their health and prevent disease have had limited influence on large proportions of our population, others have been very successful. Public and private policies need to focus on sustained efforts to encourage positive behaviors, building on proven, successful models. Key to these efforts is the recognition that the worksite is a place that can be conducive to good health.
The stakes are so great that the challenge must be met. It is ironic that in this day of high-tech, complex, and costly medical procedures and treatments, simple, inexpensive, easily-understood actions, such as increasing physical activity, controlling weight, and quitting smoking, could have such a huge impact on the quality of life and the cost of health care. While there always will be legitimate debate over the costs and benefits of particular health promotion and disease prevention endeavors, the Nation simply cannot afford not to step up efforts to reverse the growing prevalence of chronic disorders. Resources and energy need to be marshaled in all sectors and at all levels of society-federal, state, tribal, and local governments, foundations, associations, health care providers and insurers, businesses, communities, schools, families, and individuals-to control and prevent the chronic conditions that threaten the Nation's physical and financial well-being.