It is easy to point to persisting, increasing, debilitating health problems such as depression, family violence, suicide, obesity, diabetes, disability from degenerative diseases, dementias, cancer and an increasing incidence of ill-defined illnesses. Aging citizens are vulnerable to a variety of debilitating if not tragic illnesses. Five of the ten leading causes of death in the USA are clearly related to wrong food choices. Diseases of nutritional deficiencies have declined and have been replaced by diseases of dietary excesses and imbalances-problems that now rank among the leading causes of illness and death, touch the lives of most Americans, and generate substantial health care costs. We have abandoned the idea of neatly packaged diseases.
Health problems tend to cluster in groups and evolve over time.
Many factors contribute to the final end-stage disease, listed as diagnoses in medical records. Non-specific illnesses may be misunderstood by physicians who have been taught to make diagnoses of specific disorders. Often patients with mild symptoms are progressing toward a major illness, but they may suffer in an ill-defined state for months or years. As illnesses progress, more specific features tend to emerge-dysfunction and tissue changes become more obvious, and medical diagnoses become more useful. A heart attack or stroke, both calamitous events with obvious features, fit the medical model well and tend to be diagnosed reliably and treated in a standard fashion.