Sick individuals, sick populations: The societal determinants of chronic diseases

This chapter examines why chronic diseases have risen so markedly over the past several decades. It begins by assessing the contribution of individual risk factors to the disease burden. It then evaluates the social and environmental context of these risks using a theoretical framework that spans individual and population levels. It provides a series of case studies to illustrate the importance of major societal changes to population risks of chronic diseases, including political choices in Eastern Europe's transition from communism, the sudden wealth of the Western Pacific islands, and the periods ofprolonged economic hardship experienced in Finland, Japan's 'double-dip' recession, and Cuba's 'Special Period'. The chapter concludes by revisiting the leading population theories of health, health transition, risk factors, and population ageing, in the context of the societal determinants of health.