The Epidemiology of Medical Diseases and Associated Behavioral Risk Factors

  • Sarah Lindeman
  • Jon Nolan
  • Alexandros MaragakisEmail author


Drastic improvements in public health paired with advancements in medicine have lowered infant mortality and significantly boosted the average life span (Centers for Disease Control and Prevention (CDC), 2003). As a result, many of the challenges healthcare professionals face have shifted from the treatment of acute illnesses to a focus on the management and prevention of chronic disease (CDC, 2003, 2013). This is partially due to the fact that outbreaks of deadly communicable diseases have been greatly reduced, such as tuberculosis, small pox, and measles. Simultaneously, increased rates of noncommunicable, chronic conditions, as a result of longer life spans and problematic lifestyles, have led to new areas of foci for healthcare professionals.


Epidemiology Chronic disease Behavioral health Health risk factors Behavioral risk factors 


  1. Alzheimer Society Canada. (2015). Treatment options. Retrieved from
  2. Alzheimer’s Association. (2014). 2014 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 10(2), e47–e92 Retrieved from CrossRefGoogle Scholar
  3. Alzheimer’s Foundation of America. (2016). About dementia. Retrieved from
  4. American Diabetes Association. (2004). Diagnosis and classification of diabetes mellitus. Diabetes Care, 27, S5–S10.CrossRefGoogle Scholar
  5. American Diabetes Association. (2013a). Statistics about diabetes. Retrieved from
  6. American Diabetes Association. (2013b). Managing stress and diabetes. Retrieved from
  7. American Heart Association. (2015a). Direct and indirect costs of cardiovascular disease (CVD) and stroke (in billions of dollars), United States, 2011. Retrieved from
  8. American Heart Association. (2015b). What are heart disease and stroke? Retrieved from
  9. American Lung Association. (2013). Trends in COPD (chronic bronchitis and emphysema): Morbidity and mortality. Retrieved from
  10. American Speech-Language-Hearing Association. (2016). Dementia. Retrieved from
  11. Anderson, L., Oldridge, N., Thompson, D. R., Zwisler, A., Rees, K., Martin, N., & Taylor, R. S. (2016). Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis. Journal of the American College of Cardiology, 67(1), 1–12. CrossRefPubMedGoogle Scholar
  12. Azar, K. J., Chung, S., Wang, E. J., Zhao, B., Linde, R. B., Lederer, J., & Palaniappan, L. P. (2015). Impact of education on weight in newly diagnosed Type 2 diabetes: Every little bit helps. PLoS One, 10(6), e0129348. CrossRefPubMedPubMedCentralGoogle Scholar
  13. Barbero, U., D’Ascenzo, F., Nijhoff, F., Moretti, C., Biondi-Zoccai, G., Mennuni, M., … Gaita, F. (2016). Assessing risk in patients with stable coronary disease: When should we intensify care and follow-up? Results from a meta-analysis of observational studies of the COURAGE and FAME era. Scientifica, 2016, 1–10. CrossRefGoogle Scholar
  14. Bartlett, Y. K., Sheeran, P., & Hawley, M. S. (2014). Effective behaviour change techniques in smoking cessation interventions for people with chronic obstructive pulmonary disease: A meta-analysis. British Journal of Health Psychology, 19(1), 181–203. CrossRefPubMedGoogle Scholar
  15. Bellisari, A. (2008). Evolutionary origins of obesity. Obesity Reviews, 9(2), 165–180. CrossRefPubMedGoogle Scholar
  16. Cardoso, D., Moraes, G., Rosa, G., & Bello Moreira, A. S. (2015). Effectiveness of nutritional treatment assessed by the quality of the diet in patients with chronic coronary artery disease. Nutricion Hospitalaria, 32(3), 1344–1352. CrossRefPubMedGoogle Scholar
  17. Carlson, S. A., Fulton, J. E., Pratt, M., Yang, Z., & Adams, K. E. (2015). Inadequate physical activity and healthcare expenditures in the Unites States. Progress in Cardiovascular Diseases, 57, 315–323. CrossRefGoogle Scholar
  18. Centers for Disease Control and Prevention. (2003). Public health and aging: Trends in aging—United States and worldwide. Morbidity and Mortality Weekly Report, 52(06), 101–106 Retrieved from Google Scholar
  19. Centers for Disease Control and Prevention. (2012a). Summary health statistics for U.S. adults: National health interview survey, 2010. Vital and Health Statistics, 10(252), 1–207. Retrieved from Google Scholar
  20. Centers for Disease Control and Prevention. (2012b). Defining adult overweight and obesity. Retrieved from
  21. Centers for Disease Control and Prevention. (2013). The state of aging and health in America. Atlanta, GA: United States Department of Health and Human Services Retrieved from Google Scholar
  22. Centers for Disease Control and Prevention. (2015a). Annual number (in thousands) of new cases of diagnosed diabetes among adults aged 18-79 years, United States, 1980–2014. Retrieved from
  23. Centers for Disease Control and Prevention. (2015b). Obesity facts. Retrieved from
  24. Centers for Disease Control and Prevention. (2015c). Obesity prevalence maps. Retrieved from
  25. Centers for Disease Control and Prevention. (2015d). Prevalence of overweight, obesity and extreme obesity among adults: United States, trends 1960–62 through 2005–2006. Retrieved from
  26. Centers for Disease Control and Prevention. (2015e). Strategies to prevent obesity. Retrieved from
  27. Centers for Disease Control and Prevention. (2016a). Chronic disease prevention and health promotion. Retrieved from
  28. Centers for Disease Control and Prevention. (2016b). Smoking and tobacco use. Retrieved from
  29. Centers for Disease Control and Prevention. (2016c). The surprising truth about prediabetes. Retrieved from
  30. Centers for Medicare and Medicaid Services. (2015). National health expenditure fact sheet. Retrieved from
  31. Chapman, D. P., Williams, S. M., Strine, T. W., Anda, R. F., & Moore, M. J. (2006). Dementia and its implications for public health. Preventing Chronic Disease, 3(2), A34 Retrieved from PubMedPubMedCentralGoogle Scholar
  32. Chen, G., Zhou, M., Chen, L., Meng, Z., Xiong, X., Liu, H., … Zhang, J. (2016). Cigarette smoke disturbs the survival of CD8+ Tc/Tregs partially through muscarinic receptors-dependent mechanisms in chronic obstructive pulmonary disease. PLoS One, 11(1), 1–11. CrossRefGoogle Scholar
  33. Chen, H., Huang, M., Yeh, Y., Huang, W., & Chen, C. (2015). Effectiveness of coping strategies intervention on caregiver burden among caregivers of elderly patients with dementia. Psychogeriatrics: The Official Journal of the Japanese Psychogeriatric Society, 15(1), 20–25. CrossRefGoogle Scholar
  34. Chrysohoou, C., Panagiotakos, D. B., Aggelopoulos, P., Kastorini, C. M., Kehagia, I., Pitsavos, C., & Stefanadis, C. (2010). The Mediterranean diet contributes to the preservation of left ventricular systolic function and to the long-term favorable prognosis of patients who have had an acute coronary event. American Journal of Clinical Nutrition, 92(1), 47–54. CrossRefPubMedGoogle Scholar
  35. COPD Foundation. (2016). What is COPD? Retrieved from
  36. Dehghan, M., & Merchant, A. T. (2008). Is bioelectrical impedance accurate for use in large epidemiological studies? Nutrition Journal, 7, 26. CrossRefPubMedPubMedCentralGoogle Scholar
  37. Duckworth, M. P., Iezzi, T., & Sewell, M. T. (2010). Assessing and managing chronic pain in the primary care setting. In L. C. James & W. T. O’Donahue (Eds.), The primary care toolkit: Practical resources for the integrated behavioral care provider (pp. 121–130). New York: Springer.Google Scholar
  38. Dugan, A. (2013, November 21). Americans say cost is top health problem. Gallup. Retrieved from
  39. Emery, C. F., Shermer, R. L., Hauck, E. R., Hsiao, E. T., & MacIntyre, N. R. (2003). Cognitive and psychological outcomes of exercise in a 1-year follow-up study of patients with chronic obstructive pulmonary disease. Health Psychology, 22(6), 598–604. CrossRefPubMedGoogle Scholar
  40. Gaskin, D. J., & Richard, P. (2012). The economic costs of pain in the United States. The Journal of Pain, 13(8), 715–724.CrossRefGoogle Scholar
  41. Gatchel, R. J., McGeary, D. D., McGeary, C. A., & Lippe, B. (2014). Interdisciplinary chronic pain management: Past, present, and future. American Psychologist, 69(2), 119–130. CrossRefGoogle Scholar
  42. Goodwin, L., Ostuzzi, G., Khan, N., Hotopf, M. H., & Moss-Morris, R. (2016). Can we identify the active ingredients of behaviour change interventions for coronary heart disease patients? A systematic review and meta-analysis. PLoS One, 11(4), 1–23. CrossRefGoogle Scholar
  43. Harle, C. A., Bauer, S. E., Hoang, H. Q., Cook, R. L., Hurley, R. W., & Fillingim, R. B. (2015). Decision support for chronic pain care: How do primary care physicians decide when to prescribe opioids? A qualitative study. BMC Family Practice, 16(1), 48–55. CrossRefPubMedPubMedCentralGoogle Scholar
  44. Harvard School of Public Health. (2016). From calipers to CAT scans, ten ways to tell whether a body is fat or lean. Retrieved from
  45. Hill, K., Gardiner, P. A., Cavalheri, V., Jenkins, S. C., & Healy, G. N. (2015). Physical activity and sedentary behaviour: Applying lessons to chronic obstructive pulmonary disease. Internal Medicine Journal, 45(5), 474–482. CrossRefPubMedGoogle Scholar
  46. International Association for the Study of Pain. (2014). IASP taxonomy. Retrieved from
  47. Johannes, C. B., Le, T. K., Zhou, X., Johnston, J. A., & Dworkin, R. H. (2010). The prevalence of chronic pain in United States adults: Results of an Internet-based survey. The Journal of Pain, 11(11), 1230–1239.CrossRefGoogle Scholar
  48. Kawi, J. (2014). Influence of self-management and self-management support on chronic low back pain patients in primary care. Journal of the American Association of Nurse Practitioners, 26(12), 664–673. CrossRefPubMedGoogle Scholar
  49. Khan, S. B., Hafizullah, M., Gul, A. M., Rehman, H. U., Ali, J., Qureshi, M. S., … Abbas Shah, S. F. (2012). Frequency of coronary heart disease risk factors among nurses. Journal of Postgraduate Medical Institute, 26(4), 377–385.Google Scholar
  50. Koolhaas, C. M., Dhana, K., Golubic, R., Schoufour, J. D., Hofman, A., van Rooij, F. A., & Franco, O. H. (2016). Physical activity types and coronary heart disease risk in middle-aged and elderly persons. American Journal of Epidemiology, 183(8), 729–738. CrossRefPubMedGoogle Scholar
  51. Lavin, D. (2010). Smoking. In L. C. James & W. T. O’Donahue (Eds.), The primary care toolkit: Practical resources for the integrated behavioral care provider (pp. 277–289). New York: Springer.Google Scholar
  52. Laz, T. H., Rahman, M., Pohlmeier, A. M., & Berenson, A. B. (2015). Level of nutrition knowledge and its association with weight loss behaviors among low-income reproductive-age women. Journal of Community Health, 40(3), 542–548. CrossRefPubMedPubMedCentralGoogle Scholar
  53. Lewy Body Dementia Association. (2016). Cost of dementia tops $157 billion annually in the United States. Retrieved from
  54. Malmivaara, A., Hakkinen, U., Aro, T., Heinrichs, M. L., Koskenniemi, L., Kuosma, E., … Vaaranen, V. (1995). The treatment of acute low back pain--bed rest, exercises, or ordinary activity. New England Journal of Medicine, 332(6), 351–355 Retrieved from\n CrossRefGoogle Scholar
  55. Mannino, D. M., Buist, A. S., Petty, T. L., Enright, P. L., & Redd, S. C. (2003). Lung function and mortality in the United States: Data from the first National Health and Nutrition Examination Survey follow up study. Thorax, 58(5), 388–393.CrossRefGoogle Scholar
  56. Mayo Clinic. (2015). Counting calories: Get back to weight loss basics. Retrieved from
  57. Mayo Foundation for Medical Education and Research. (2014). Emphysema. Retrieved from
  58. McKinney, M. (2015). Building better supports for dementia. Modern Healthcare, 45(39), 32.PubMedGoogle Scholar
  59. MedicineNet. (2013). Bronchitis. Retrieved from
  60. Moitra, E., Sperry, J. A., Mongold, D., Kyle, B. N., & Selby, J. (2011). A group medical visit program for primary care patients with chronic pain. Professional Psychology: Research & Practice, 42(2), 153–159. CrossRefGoogle Scholar
  61. Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., … American Heart Association Statistics Committee and Stroke Statistics Subcommittee. (2015). Heart disease and stroke statistics-2015 update: A report from the American Heart Association. Circulation, 131(24), 535–535.Google Scholar
  62. National Health Service. (2014a). Type 2 diabetes: Symptoms. Retrieved from
  63. National Health Service. (2014b). Type 2 diabetes: Causes. Retrieved from
  64. National Health Service. (2014c). Type 2 diabetes: Complications. Retrieved from
  65. National Heart, Lung, and Blood Institute. (2012). What are the health risks of overweight and obesity? Retrieved from
  66. National Heart, Lung, and Blood Institute. (2013a). What is COPD.? Retrieved from
  67. National Heart, Lung, and Blood Institute. (2013b). How COPD is diagnosed. Retrieved from
  68. National Heart, Lung, and Blood Institute. (2015a). What is atherosclerosis? Retrieved from
  69. National Heart, Lung, and Blood Institute. (2015b). What is coronary heart disease? Retrieved from
  70. National Heart, Lung, and Blood Institue. (2018). Bronchitis. Retrieved from
  71. National Institute of Diabetes and Digestive and Kidney Diseases. (2014). Causes of diabetes. Retrieved from
  72. National Institute of Health. (2011). Chronic pain: Symptoms, diagnosis, and treatment. Retrieved from
  73. National Institute of Health. (2013). Pain Management. Retrieved from
  74. National Institute of Health. (2016). Pain in America. Retrieved from
  75. National Institute of Mental Health. (n.d.). Fact sheet on stress. Retrieved from
  76. National Institute of Nursing Research. (2015). Palliative care. Retrieved from
  77. National Institute on Aging. (2013). Risk factors for dementia. Retrieved from
  78. National Institute on Aging. (2016). National study reports decreased dementia prevalence. Retrieved from
  79. O’Brien, G., & Davies, M. (2007). Nutrition knowledge and body mass index. Health Education Research, 22(4), 571–575.CrossRefGoogle Scholar
  80. Peppin, J. F., Cheatle, M. D., Kirsh, K. L., & McCarberg, B. H. (2015). The complexity model: A novel approach to improve chronic pain care. Pain Medicine, 16(4), 653–666. CrossRefPubMedGoogle Scholar
  81. Respiratory Health Association. (2016). Understanding COPD: Comorbidities. Retrieved from
  82. Schmid, S. M., Hallschmid, M., Jauch-Chara, K., Born, J., & Schultes, B. (2008). A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men. Journal of Sleep Research, 17(3), 331–334. CrossRefPubMedGoogle Scholar
  83. Schobitz, R. P., Bauer, L. L., & Schobitz, E. P. (2010). Behavioral health consultation for coronary heart disease. In L. C. James & W. T. O’Donahue (Eds.), The primary care toolkit: Practical resources for the integrated behavioral care provider (pp. 121–130). New York: Springer.Google Scholar
  84. Srivastava, G., Tripathi, R. K., Tiwari, S. C., Singh, B., & Tripathi, S. M. (2016). Caregiver burden and quality of life of key caregivers of patients with dementia. Indian Journal of Psychological Medicine, 38(2), 133–136. CrossRefPubMedPubMedCentralGoogle Scholar
  85. Tashkin, D. P., & Murray, R. P. (2009). Smoking cessation in chronic obstructive pulmonary disease. Respiratory Medicine, 103(7), 963–974.CrossRefGoogle Scholar
  86. Truthmann, J., Busch, M. A., Scheidt-Nave, C., Mensink, G. M., Gößwald, A., Endres, M., & Neuhauser, H. (2015). Modifiable cardiovascular risk factors in adults aged 40-79 years in Germany with and without prior coronary heart disease or stroke. BMC Public Health, 15(1), 1–7. CrossRefGoogle Scholar
  87. Waddell, G., Feder, G., & Lewis, M. (1997). Systematic reviews of bed rest and advice to stay active for acute low back pain. British Journal of General Practice, 47, 647–652.PubMedGoogle Scholar
  88. Walters, J. E., Cameron-Tucker, H., Courtney-Pratt, H., Nelson, M., Robinson, A., Scott, J., … Wood-Baker, R. (2012). Supporting health behaviour change in chronic obstructive pulmonary disease with telephone health-mentoring: Insights from a qualitative study. BMC Family Practice, 13(1), 55–61. CrossRefPubMedPubMedCentralGoogle Scholar
  89. Widmer, J. R., & Lerman, A. (2014). Endothelial dysfunction and cardiovascular disease. Global Cardiology Science & Practice, 2014(3), 1–33. CrossRefGoogle Scholar
  90. World Health Organization. (2006). Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. Retrieved from
  91. World Health Organization. (2014). Top 10 causes of death. Retrieved from
  92. World Health Organization. (2016). Integrated chronic disease prevention and control. Retrieved from
  93. Yan-Fang, W., Xiao-Li, M., Chen, Y., Ling, F., Jing, Y., & Jun, Z. (2015). Impact of daily lifestyle on coronary heart disease. Experimental and Therapeutic Medicine, 10(3), 1115–1120. CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sarah Lindeman
    • 1
  • Jon Nolan
    • 1
  • Alexandros Maragakis
    • 2
    Email author
  1. 1.Department of Psychology and CounselingUniversity of Central ArkansasConwayUSA
  2. 2.Department of PsychologyEastern Michigan UniversityYpsilantiUSA

Personalised recommendations