title: And Why So Great a "No?": The Donor and Academic Communities' Failure to Confront Global Chronic Disease.
abstract: Chronic diseases are the dominant issues for global public health in terms of mortality, morbidity, and cost, and they have been identified as such for >40 years. Despite their predominance, however, these diseases-cardiovascular disease (CVD), diabetes, cancer, pulmonary disease, mental health, and dementia-attract little attention in the public health curriculum and even less from the funding community. We explore the rationales that have perpetuated this inability or unwillingness to match need with effort. We examine 3 concepts that impede changing this relationship: 1) the traditional contextual view of public health that emerged, to be sure with great success, in the post-World War II era; 2) the failure of public health to transition to economic development as the goal of health assistance; and 3) the unwillingness of public health to confront social, political, and economic policies as the foci of upstream drivers of the public's health. We conclude with a discussion of the need for public health to expand its horizon and tear down the walls of the silos that inhibit the emergence of relevant global public health.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Institute of Human Health, College of Physicians and Surgeons, Columbia University, New York, NY, USA. Electronic address: hmg1@columbia.edu.
authors.forename: Henry
authors.initials: H
authors.lastname: Greenberg
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Menzies Centre for Health Policy and Charles Perkins Centre, School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Leeder
authors.affiliation: Changing our World, Inc., New York, NY, USA.
authors.forename: Susan U
authors.initials: SU
authors.lastname: Raymond
mesh_terms: D002908:Chronic Disease / Q000453:epidemiology*; D014943:Global Health; D006305:Health Status Indicators; D006801:Humans; D009017:Morbidity / Q000639:trends; D011634:Public Health / Q000592:standards*; D064890:Social Determinants of Health / Q000592:standards*