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Diseases of comfort: primary cause of death in the 22nd century
  1. Bernard C K Choi1,
  2. David J Hunter2,
  3. Walter Tsou3,
  4. Peter Sainsbury4
  1. 1Public Health Agency of Canada (PHAC); Department of Public Health Sciences, University of Toronto; Department of Epidemiology and Community Medicine, University of Ottawa, Canada
  2. 2UK Public Health Association (UKPHA); School for Health, Wolfson Research Institute, University of Durham, Durham, UK
  3. 3American Public Health Association (APHA); Tsou Consulting, Philadelphia, Pennsylvania, USA
  4. 4Public Health Association of Australia (PHAA); Division of Population Health, Sydney South West Area Health Service—Eastern zone; School of Public Health, University of Sydney, Camperdown, NSW, Australia
  1. Correspondence to:
 Dr B Choi
 Centre for Chronic Disease Prevention and Control (CCDPC), Public Health Agency of Canada (PHAC), Government of Canada, AL no 6701A, 120 Colonnade Road, Ottawa, Ontario K1A 1B4, Canada;


Context: The world has started to feel the impact of a global chronic disease epidemic, which is putting pressure on our health care systems. If uncurbed, a new generation of “diseases of comfort” (such as those chronic diseases caused by obesity and physical inactivity) will become a major public health problem in this and the next century.

Objective: To describe the concept, causes, and prevention and control strategies of diseases of comfort.

Methods: Brokered by a senior research scientist specialised in knowledge translation, a chair, a president, and a past president of national public health associations contributed their views on the subject.

Results: Diseases of comfort have emerged as a price of living in a modern society. It is inevitable that these diseases will become more common and more disabling if human “progress” and civilisation continue toward better (more comfortable) living, without necessarily considering their effects on health. Modern technology must be combined with education, legislation, intersectoral action, and community involvement to create built and social environments that encourage, and make easy, walking, physical activity, and nutritious food choices, to reduce the health damaging effects of modern society for all citizens and not only the few.

Conclusions: Public health needs to be more passionate about the health issues caused by human progress and adopt a health promotion stance, challenging the assumptions behind the notion of social “progress” that is giving rise to the burden of chronic disease and developing the skills to create more health promoting societies in which individual health thrives.

  • public health
  • chronic diseases
  • epidemic
  • obesity
  • physical inactivity

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Supplementary materials

  • In our March 2006 issue, Oscar H. Franco and colleagues discussed the concept of a fixed-dose combination pill, which was referred to as a polypill, a theoretical combination of six pharmacological compounds for the treatment of cardiovascular disease proposed by N.J. Wald and M.R. Law in their article "A strategy to reduce cardiovascular disease by more than 80%" (BMJ 2003;326:1419). We would like to make it clear that Franco et al's article was a discussion on the theoretical concept of a fixed-does combination pill as proposed in Wald and Law's article and did not intend in any way to refer to the POLYPILL, a term which is currently the subject of trade mark applications by Professor Wald in the USA and Canada. The Editors wish to apologise to Professor Wald for any ambiguity that may have occurred in the wording of this article.


  • Funding: none.

  • Conflicts of interest: none declared.

  • Views expressed are those of the authors and cannot be attributed to any agencies, associations, universities, or organisations.

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