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29 - Evolutionary Medicine and the Causes of Chronic Disease

Published online by Cambridge University Press:  05 August 2012

By
Paul W. Ewald
Edited by
Michael P. Muehlenbein
Michael P. Muehlenbein
Affiliation:
Indiana University, Bloomington
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Summary

The current integration of evolution with medicine is artificially narrow because it reflects the biases of medicine as a whole and the specializations of particular investigators. If evolutionary principles are to offer a fundamental framework for understanding medical issues they should help identify these biases and the areas over which integration needs to be broadened. The chapter discusses this problem as it relates to evolutionary interpretations of chronic diseases. It also illustrates how an evolutionary perspective can provide a broader framework for resolving the causes and control of chronic diseases, focusing on the greatest killers in prosperous societies – atherosclerosis and cancer.

OVERVIEW OF CHRONIC DISEASES

Chronic diseases account for about 70% of the mortality in the United States and other wealthy countries. Most of this disease-induced mortality is attributable to heart attacks, strokes, and cancer. In spite of this importance, the causes of chronic diseases remain largely unresolved. This situation represents a major short-coming of modern medicine because understanding the causes of disease enables prevention, and prevention is the most effective way of eliminating the damage inflicted by disease. We can therefore expect that a better understanding of the causes of chronic diseases will yield some of the most valuable contributions that any discipline can make to improvements in health.

Chronic diseases can be defined broadly as diseases that persist within individuals for a long time. The US National Center for Health Statistics considers “long” to mean persistence for at least three months.

Type
Chapter
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Human Evolutionary Biology , pp. 502 - 517
Publisher: Cambridge University Press
Print publication year: 2010

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