You might know someone with a long-term medical problem like heart disease or diabetes. You may even have a long-term medical problem yourself. Lots of Americans do. In fact, rates of chronic illness in the U.S. and the world are on the rise.¹

Sixty percent of Americans have one long-term health problem, and 40% have at least two.²

The three most common conditions? Heart disease, diabetes and chronic lung disease. What can lead to these health problems? High blood sugar and alcohol and drug use. Rates have been rising over the past decade: Long-term health problems cause more than 26 million deaths a year worldwide.³

Now for some good news. In many cases, these diseases can be preventable, says Tara Ostrom, MD. She’s an internal medicine physician at Optum in Phoenix. That means there are steps you can take so that you don’t get them in the first place.

“People don’t always understand that their health is an investment,” says Dr. Ostrom. “They plan for their financial future. But they don’t realize that it’s the same with physical and mental health. If they don’t invest in them, they won’t be able to do all the things they want to do when they’re 65 or older.”

Here’s a look at three issues that are fueling the jump in chronic illnesses. Your goal: Try to improve one (or all) in your own day-to-day. You’ll set yourself up for a longer, healthier life.

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The connection between habits and health

Your everyday habits have a big influence on your overall health. These four factors play the biggest role:

• Smoking. The toxins in cigarettes can damage every part of your body. In fact, regular tobacco use (a pack per day) can take more than six years off a 30-year-old man’s life expectancy.⁴
   
• Eating poorly. Not getting enough healthy foods makes it harder to fight illness. And getting too much of the unhealthy ones can increase your risk. For instance, 86% of Americans eat too many salty foods. This raises the chance of having high blood pressure.⁵
   
• Drinking too much alcohol. More than 50,000 people die each year from liver disease caused by alcohol abuse.⁶
   
• Lack of physical activity. Simply sitting too much can shorten your life by 2.4 years.⁷ And you’re more likely to die from heart disease, diabetes, Alzheimer’s or kidney disease.⁸ 

COVID made being inactive worse. The pandemic became an excuse to be more sedentary, says Dr. Ostrom. “Even now, people order everything online and use the drive-through. They don’t walk around shops in person,” she says.

All this sitting, plus time spent on smartphones, tablets and computers, has had another effect. “I see a lot more chronic back and neck pain in my practice,” says Dr. Ostrom. This kind of pain can cause you to be less active.

Are these big challenges? Yes. But you don’t have to overhaul your whole life to start improving your health. Small changes can make a big difference. Choose one area to focus on at a time.

Here are some tips to get you started:

Eat to beat disease. Make sure that at least half of each meal includes fruits and vegetables, says Dr. Ostrom. Cool health fact: Research shows that doing something as simple as eating enough fruits and veggies can raise your life expectancy by almost 1½ years.⁴ Over the course of a week, eat a rainbow of colors such as leafy greens, tomatoes, blueberries, yellow peppers and oranges. Need some inspiration? Check out our list of 10 disease-fighting foods.

Get moving. It’s also important to move more and sit less throughout the day. Any activity that gets your heart pumping counts as exercise. Some ideas:

• Do some yard work.
• Take the stairs instead of the elevator.
• Meet a friend for a power walk.
• Go for a bike ride with your kids.

We’ve got more ways to get motivated to move. 

Cut back on alcohol. Binge drinking rose during the pandemic.⁸ If you’re worried about your alcohol consumption but are struggling to cut back, reach out to your doctor. They can support you and offer help. You can also call the Substance Abuse and Mental Health Services Administration, or SAMHSA, at 800-662-4357. It’s answered 24/7.

If you smoke, quit. There are several ways to kick cigarettes for good. There are over-the-counter gums or patches you can try. Your doctor can also prescribe medications to help you quit. Consider joining a local support group. Or call a free counseling hotline such as 800-QUIT-NOW (800-784-8669).

How social factors influence your health

Some factors that affect your health may be harder to change. They include:

• Your income
• Your level of education
• How easy it is for you to get health care
• Where you live
• Your social support

“If you don’t have a car or you can’t afford gas, it’s difficult to get in-person care,” says Dr. Ostrom. Maybe you live alone and don’t have someone to check on you or take you to the doctor. If money is tight, you might worry about food costs or rent.

While you might not be able to change where you live or go back to school, there are some steps you can take to get the care you need.

For starters, turn to technology. Virtual visits let you see a doctor through your phone, laptop or tablet. “Many people who don’t have transportation to get to doctor visits do have smartphones or computers,” says Dr. Ostrom. “And we can do appointments virtually.” That’s convenient for everyone.

And research shows that telehealth is as good, if not better, than in-person care. It works especially well for things like home monitoring and counseling for with long-term health problems.⁹ 

And about that social network: If you don’t have a supportive group of friends or family, build one. You don’t need 20 friends. You just need a few people you can meet for dinner, plan fun activities with and call when you need to talk. It’s important to be proactive. Meeting new people won’t happen on its own. So join a community group or volunteer in your town. Get in touch with an old friend you haven’t seen in a while.

How the cost of care impacts your health

About half of American adults say they can’t afford health care. And about 40% have delayed or gone without medical care in the last year because of cost.¹⁰

Even if you have health insurance through work, it can be expensive. A recent survey found that 80% of doctors believe people refuse or delay care due to cost.¹¹

It’s can also be hard to afford prescription medications that can help you manage your disease.

These costs can add up. Take diabetes, for example. A person with diabetes can spend about four times as much on medicines as someone without it. And one poll found that almost 25% of people who take prescription drugs have trouble paying for them.¹⁰

What’s more, about 23% of adults report cutting back on their medicine because of the cost. As a result, their chronic health problem got worse.¹⁰

One big driver of health care costs is what’s known as low-value care. These are medical services that do little for patients, says Dr. Ostrom. One example is an MRI of the spine for lower back pain.¹²

There are some steps you can take to manage costs. Here are a few to try:

Talk to your doctor about pricey medications. Is cost making it hard to afford your medication? Ask your doctors if there are other, less expensive, options for your prescription. “You shouldn’t have to decide between food and medications,” Dr. Ostrom says. “Sometimes specialists prescribe unaffordable drugs when a less expensive one may work just as well.”

Ask if you need that test. It’s always helpful to ask a doctor if you really need a certain test. You can also ask if there are other things you can do to help your symptoms. Maybe you don’t really need expensive care or testing. For instance, one study found that physical therapy for ongoing back pain is often overlooked. (Physical therapy uses exercise to care for pain and weakness.) Instead, many doctors overuse less proven, more expensive care. Examples include opioids, spinal injections and surgery.¹³

Shop around for insurance. If you’re on a plan that feels too costly to use — or if you don’t have insurance at all — you have options. You can sign up for a plan using the Affordable Care Act (ACA) exchanges. When you choose an ACA-compliant plan, you may qualify for financial help. And all ACA plans must cover preventive health services for free.

That makes it easier to stay on top of your health. And you’re more likely to find potential problems earlier when they’re easier to care for. You can also consider Medicare. This is the federal health insurance program for those 65 or older. Medicare also covers many preventive services at no cost to you. (Learn more about your choices for health insurance.)

Take advantage of medical expense accounts. Look into health savings accounts (HSAs) and health care flexible spending accounts (FSAs). They let you set aside money tax-free to help pay for qualified medical costs. You can use the funds to pay for deductibles, medications, doctor visits and more. Learn how HSAs/FSAs work.

Staying healthy doesn’t always come easy. But there are lots of ways that you can reduce your risk of long-term health problems down the road. “I tell my patients, ‘Exercise for 20 minutes a day. And at meals, fill half your plate with fruits and vegetables. Do this, and you’ll see enormous paybacks in your health,’” says Dr. Ostrom. And that’s a healthy future we can all get behind.